1
|
Terzi H, Akca A, Ayaz-Alkaya S. Adaptation of the health literacy survey 19-Europe-Q12 into Turkish culture: A psychometric study. J Eval Clin Pract 2024; 30:1782-1790. [PMID: 39373230 DOI: 10.1111/jep.14161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/24/2024] [Accepted: 09/18/2024] [Indexed: 10/08/2024]
Abstract
RATIONALE Misinformation can lead to adverse outcomes on the health beliefs and behaviors of individuals. Therefore, health literacy skills are needed as a central competency to recognize the trustfulness of health-related knowledge in any resources. To ensure this, a time-efficient, skill-oriented psychometric tools are needed to measure the comprehensive general health literacy level of communities. AIMS AND OBJECTIVES This research was conducted to evaluate the psychometric properties of the 12-item Health Literacy Survey-Europe (HLS19-Q12) regarding Turkish culture. METHOD A methodological design was adopted. The population consisted of adult individuals registered to two family health centers in Ankara. The sample was determined based on 5-10 times the number of scale items rule (ntotal = 192). A questionnaire and Health Literacy Survey-Europe-Q12 were used to collect data. Language, content and construct validities and internal consistency reliability tests were performed through IBM-SPSS 25.0 and AMOS 24.0 programs. The content validity was determined via the Davis technique. The construct validity was examined by exploratory (EFA) (n1 = 120) and confirmatory factor analysis (CFA) (n2 = 72). Internal consistency was evaluated using Cronbach's alpha coefficient. Time invariance was evaluated by test-retest method (nretest = 32) 4 weeks later. RESULTS The mean age was 30.17 ± 10.37 (min. 18-max. 61). The Kaiser-Meyer Olkin test result was 0.898, and the Bartlett's Test of Sphericity result was 604.889 (p < 0.001). The model-fit indices showed good fit. The difference between the first and the second measurements was statistically insignificant (t = -1.659, p = 0.107). The Cronbach's alpha was 0.88. CONCLUSIONS The HLS19-Q12-TR was a valid and reliable measurement tool in determining the health literacy level of the Turkish adult population. As one of the social determinants of health, easy measurement and generating a general health literacy map of the population is considered a necessity.
Collapse
Affiliation(s)
- Handan Terzi
- Ankara Medipol University Faculty of Health Sciences, Ankara, Turkey
| | - Ayşegül Akca
- Ankara Yıldırım Beyazıt University Faculty of Health Sciences, Ankara, Turkey
| | | |
Collapse
|
2
|
Peng RX, Shen F. Why fall for misinformation? Role of information processing strategies, health consciousness, and overconfidence in health literacy. J Health Psychol 2024:13591053241273647. [PMID: 39175178 DOI: 10.1177/13591053241273647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Health misinformation, defined as false or misleading claims lacking scientific evidence, poses a significant threat to public health. This paper investigates factors associated with the failure to discern misinformation, including health consciousness, information processing strategies, and inaccurate self-assessments of health literacy. Through an online experiment involving 707 English-speaking U.S. participants (mean age = 43 years, 56.2% female), we found that misinformation beliefs about nutrition, vaccination, vaping, and cancer were significantly correlated, implying susceptibility across health topics. Greater susceptibility was associated with higher health consciousness, lower objective health literacy, more elaboration, and more selective scanning. Results provided evidence for the Dunning-Kruger effect and metacognitive monitoring errors, whereby confident individuals were unaware of inadequate health literacy and showed poor misinformation identification. Findings suggest that promoting both health literacy education and cognitive reflection skills among the general adult population could empower them to more critically evaluate online health information.
Collapse
|
3
|
Wieczorek M, Meier C, Kliegel M, Maurer J. Relationship Between Health Literacy and Unhealthy Lifestyle Behaviours in Older Adults Living in Switzerland: Does Social Connectedness Matter? Int J Public Health 2023; 68:1606210. [PMID: 37876738 PMCID: PMC10590881 DOI: 10.3389/ijph.2023.1606210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
Objectives: To investigate the association between health literacy (HL) and unhealthy lifestyle behaviours and to explore the moderating role of social connectedness in this relationship in older adults in Switzerland. Methods: We used data from 1,455 respondents to Wave 8 of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Associations between the number of unhealthy lifestyle behaviours (smoking, risky alcohol consumption, suboptimal daily consumption of fruits/vegetables, lack of vigorous physical activity) and HL were examined using multivariable Poisson regression models, which allowed for interactions between HL and social connectedness to test the moderation hypothesis. Results: Respondents with inadequate HL were significantly more likely to have a higher number of unhealthy lifestyle behaviours than respondents with sufficient HL. We found a stronger positive association between inadequate HL and the number of unhealthy lifestyle behaviours among socially isolated individuals. Conclusion: Greater social connectedness seems to buffer the negative impact of inadequate HL on unhealthy lifestyle behaviours in older adults, highlighting the importance of good HL for healthy lifestyles, especially in individuals with low social reserve.
Collapse
Affiliation(s)
- Maud Wieczorek
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| | - Clément Meier
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
- Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Matthias Kliegel
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Jürgen Maurer
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
4
|
Rodkjaer LØ, Storgaard M, Sørensen NT, Schougaard LMV. Levels of health literacy among people living with HIV in outpatient care: a cross-sectional study from Denmark. AIDS Res Ther 2023; 20:59. [PMID: 37633910 PMCID: PMC10463697 DOI: 10.1186/s12981-023-00562-8] [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: 09/03/2022] [Accepted: 08/20/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Low health literacy (HL) among people living with HIV (PLWHIV) encounter more disease related complications, more difficulty understanding health-related information and low adherence. Considering that, the HL levels among PLWHIV needs to be further investigated. The objective of this study was to investigate the levels of HL and patient involvement among PLWHIV in an outpatient clinic in Denmark. A second objective was to examine differences in HL levels across socio-demographic characteristics. METHODS In 2019, a population of 682 PLWHIV from a Danish outpatient hospital clinic were enrolled in cross-sectional study. Patients who had a digital postbox received an electronic questionnaire including following domains; health literacy, patient involvement, and socio-demographic status. Health literacy was measured using the Health Literacy Questionnaire (HLQ) through scores on three subscales: social support for health (HLQ4), engaging with healthcare providers (HLQ6), and understanding health information (HLQ9). An unpaired t-test was used to investigate mean differences in the HLQ scores across socio-demographic variables. RESULTS A total of 338 (55%) patients responded to the questionnaire. The included participants demonstrated high levels of HLQ4 (mean = 4.2) and HLQ6 (mean = 4.2), but lower for HLQ9 (mean = 2.9). In total 70-80% reported being involved in decisions about their health. We found a positive association between high level of HL (HLQ9) and living with a partner and higher levels of HL (HLQ4, HLQ6, and HLQ9) and employment. CONCLUSION PLWHIV in a Danish out-patient care population were found to have high levels of HL despite differences in demographic characteristics. Further research is needed to examine the levels of HL among non-responders to develop HL approaches and strategies to meet the needs of individuals with different HL skills.
Collapse
Affiliation(s)
- Lotte Ørneborg Rodkjaer
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
- Research Centre for Patient Involvement, Central Denmark Region, Aarhus University, Aarhus, Denmark.
| | - Merete Storgaard
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | - Liv Marit Valen Schougaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Central Denmark Region, Aarhus University, Aarhus, Denmark
- Center for Patient-reported Outcomes, AmbuFlex, Gødstrup Hospital, Herning, Denmark
| |
Collapse
|
5
|
Friedrich J, Münch AK, Thiel A, Voelter-Mahlknecht S, Sudeck G. Occupational Health Literacy Scale (OHLS): development and validation of a domain-specific measuring instrument. Health Promot Int 2023; 38:7026245. [PMID: 36738454 DOI: 10.1093/heapro/daac182] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Occupational health literacy (OHL) is a domain-specific approach that can empower people to make health-appropriate decisions in the work environment. OHL comprises the knowledge, skills and willingness of people to access and process health-related information and to apply it in work situations. The aim of this study was to evolve a conceptual model and validate a scale for OHL, that can be used in many sectors in the Western industrial countries, which does not yet exist. After piloting, item selection and alteration were carried out in a pretest with n = 163 working adults in diverse small- and medium-sized enterprises in Germany. The resulting OHL items were validated in a main survey with n = 828 participants working in small- and medium-sized enterprises and among them 47.5% people with migration background. The final 12-item questionnaire had good structural characteristics and is reliable and valid for measuring OHL. Using exploratory structural equation modeling, good fit indices (root mean square error of approximation = 0.063, comparative fit index = 0.940) confirmed a two-factor structure: (i) knowledge and skill-based processing of health information (internal consistency α = 0.88) and (ii) willingness and responsibility for occupational health (α = 0.74). The OHL scale fills the gap regarding domain-specific OHL questionnaires for working adults in diverse sectors in Western industrial countries. The Occupational Health Literacy Scale can be used to identify the needs of employees and companies and then to adapt and evaluate health promotion measures. Further research could include validation and use in other countries and large companies.
Collapse
Affiliation(s)
- Julian Friedrich
- Eberhard Karls Universität Tübingen, Institute of Sports Science, Wilhelmstraße 124, 72074 Tübingen, Germany
| | - Anne-Kristin Münch
- Medical University of Tübingen, Institute for Clinical Epidemiology and Applied Biostatistics, Silcherstraße 5, 72076 Tübingen, Germany
| | - Ansgar Thiel
- Eberhard Karls Universität Tübingen, Institute of Sports Science, Wilhelmstraße 124, 72074 Tübingen, Germany
| | - Susanne Voelter-Mahlknecht
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität, Berlin and Humboldt-Universität zu Berlin, Institute of Occupational Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Gorden Sudeck
- Eberhard Karls Universität Tübingen, Institute of Sports Science, Wilhelmstraße 124, 72074 Tübingen, Germany
| |
Collapse
|
6
|
Sawyers L, Anderson C, Aslani P, Duncan G, Janjua SS, Toh LS. Community health literacy outcome measurement practices: A scoping review of recent interventions. Health Sci Rep 2022; 5:e810. [PMID: 36101717 PMCID: PMC9455946 DOI: 10.1002/hsr2.810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Evidence suggests that, while a preference for functional Health Literacy (HL) outcome measurement exists, researchers are converging towards more all-encompassing instruments. While this claim is present in the HL field, minimal research has comprehensively explored the state of community HL measurement practices at the direct and proxy level. The almost exclusive focus on direct, as opposed to proxy, community HL measurement indicates a review of progress is needed. Objective To identify HL outcome measurement practices for community HL interventions at the direct and proxy level of measurement. Search Strategy Medline, PsycINFO, Web of Science, ERIC, Embase, Scopus, CINAHL, ProQuest Dissertations and Theses, Google Scholar and targeted websites were searched. Inclusion Criteria Studies were sampled from the general population, included HL as an outcome of interest, involved an intervention aiming to improve HL, were English-text publications and were published ≥2010. Data Extraction and Synthesis Study author(s) and publication years, sample characteristics, intervention profiles and direct and proxy instrument and outcome measurement information were extracted. Full-text review retrieved 25 eligible studies. Main Results In total, 21 unique direct and 38 unique proxy instruments were extracted. The majority of interventions assessed functional compared to communicative, critical, and other HL domains, with objective instruments more frequently used than subjective or combined objective-subjective types, though more unique subjective HL instruments were extracted overall. The Test of Functional HL in Adults was the most popular instrument, and perceived health, knowledge, behaviors and health intentions were the most frequent proxy outcome measures, with only the Healthy Lifestyle Behavior Scale-II and Patient Activation Measure used across multiple interventions. Discussion and Conclusions Direct HL outcome practices endured a unidimensional profile, despite previous suggestions of a convergence towards holistic instruments. This review provides the first overview of proxy HL measurement across community HL interventions, identifying substantial variation in proxy outcome practices. Patient or Public Contribution A University-based senior librarian contributed to the development of the search strategy, and reviewed iterations of the strategy until refinement was complete. No further public or patient contribution was made given the review-based nature of the research.
Collapse
Affiliation(s)
- Luke Sawyers
- Division of Pharmacy Practice and Policy, School of PharmacyUniversity of NottinghamNottinghamUK
| | - Claire Anderson
- Division of Pharmacy Practice and Policy, School of PharmacyUniversity of NottinghamNottinghamUK
| | - Parisa Aslani
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of SydneySydneyAustralia
| | - Gregory Duncan
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia
| | - Sobia S. Janjua
- Division of Pharmacy Practice and Policy, School of PharmacyUniversity of NottinghamNottinghamUK
| | - Li Shean Toh
- Division of Pharmacy Practice and Policy, School of PharmacyUniversity of NottinghamNottinghamUK
| |
Collapse
|
7
|
Levic M, Bogavac-Stanojevic N, Krajnovic D. Cross-Cultural Adaptation and Validation of the Functional, Communicative and Critical Health Literacy Instrument (FCCHL-SR) for Diabetic Patients in Serbia. Healthcare (Basel) 2022; 10:healthcare10091667. [PMID: 36141279 PMCID: PMC9498457 DOI: 10.3390/healthcare10091667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/20/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Thoroughly validated instruments can provide a more accurate and reliable picture of how the instrument works and of the level of health literacy in people with type 2 diabetes mellitus (T2DM). The present work aimed at cross-cultural adaptation and validation of the Functional, Communicative and Critical Health Literacy Instrument (FCCHL) in patients with T2DM in Serbia. After translation and back-translation, views from an expert group, one cognitive interview study (n = 10) and one survey study (n = 130) were conducted among samples of diabetic patients. Item analysis, internal consistency, content validity, confirmatory factor analysis (CFA) and reliability testing were performed. When all 14 items were analyzed, loading factors were above 0.55, but without adequate model fit. After removing two items with the lowest loadings FHL1 and IHL2 the fit indexes indicated a reasonable normed χ2 (SB scaled χ2/df = 1.90). CFI was 0.916 with SRMR = 0.0676 and RMSEA = 0.0831. To determine internal consistency, Cronbach’s alpha coefficient was 0.796 for the whole FCCHL-SR12. With only minor modifications compared to the English version, the 12-item FCCHL instrument is valid and reliable and can be used to measure health literacy among Serbian diabetic patients. However, future research on a larger population in Serbia is necessary for measuring the levels of HL and their relationship with other determinants in this country.
Collapse
Affiliation(s)
- Marija Levic
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade 11221, Serbia
| | - Natasa Bogavac-Stanojevic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade 11221, Serbia
| | - Dusanka Krajnovic
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade 11221, Serbia
- Correspondence:
| |
Collapse
|
8
|
Feinberg I, Tighe EL, Ogrodnick MM. Strengthening the Case for Universal Health Literacy: The Dispersion of Health Literacy Experiences Across a Southern U.S. State. Health Lit Res Pract 2022; 6:e182-e190. [PMID: 35858187 PMCID: PMC9272571 DOI: 10.3928/24748307-20220620-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: How individuals perceive their health literacy may differ based on demographic and individual characteristics. Objective: The purpose of this study was to understand the dispersion of health literacy across demographics in the state of Georgia in 2021 and to determine which factors influence health literacy. Methods: Study participants were age 18 years and older and completed an on-line Health Literacy Questionnaire (N = 520). The participant pool was stratified to mirror state-wide demographics of geography and race. Results were further collapsed into composite scales reflecting basic, communicative, and critical health literacy. Descriptive statistics, bivariate Pearson's correlations, and multiple regression analyses were used. A two-step cluster analysis was performed with the nine health literacy scales. Key Results: Rural county and no health insurance were negatively related to all three composite scales (rs = .093-.254, ps < .05). Demographic predictors accounted for 6.7% of the variance in basic (F[6, 439] = 5.287, p < .001), 10% in communicative (F[6, 438] = 8.154, p < .001), and 6% for critical (F[6, 439] = 4.675, p < .0010. In all scales, health insurance status was the strongest primary unique predictor (βs = .236, .295, .181, ps <.05, respectively). In a two-step cluster analysis only health insurance status differentiated the health literacy level clusters (X2(3) = 9.43, 34.51, ps = 024, <.001 respectively). Conclusion: Lacking health insurance is the most consistent and largest contributor to low health literacy across the state of Georgia; population demographics are not. Health literacy policies and practices should be developed for universal application and not focus on specific populations. [HLRP: Health Literacy Research and Practice. 2022;6(3):e182–e190.] Plain Language Summary: In this study, demographics that are usually associated with low health literacy like age, sex, race, educational attainment, and type of county (rural or urban) were not associated with; the only significant factor was lack of health insurance. This relationship strengthens the case for universal health literacy precautions that go beyond population demographics.
Collapse
Affiliation(s)
- Iris Feinberg
- Address correspondence to Iris Feinberg, PhD, Adult Literacy Research Center, Department of Learning Sciences, College of Education and Human Development, Georgia State University, P.O. Box 3978, Atlanta, GA 30302;
| | | | | |
Collapse
|
9
|
Stock S, Isselhard A, Jünger S, Peters S, Schneider G, Haarig F, Halbach S, Okan O, Fischer F, Bollweg TM, Bauer U, Schaeffer D, Vogt D, Berens EM, Ernstmann N, Bitzer EM. [DNVF Memorandum Health Literacy (Part 2) - Operationalisation and Measuring of Health Literacy from a Health Services Research Perspective]. DAS GESUNDHEITSWESEN 2022; 84:e26-e41. [PMID: 35472769 PMCID: PMC9050455 DOI: 10.1055/a-1807-0853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Das vorliegende „DNVF Memorandum Gesundheitskompetenz (Teil 2) –
Operationalisierung und Messung von Gesundheitskompetenz aus Sicht der
Versorgungsforschung“ des Deutschen Netzwerks Versorgungsforschung e.V.
(DNVF) stellt die Fortführung des Memorandums „DNVF Memorandum
Gesundheitskompetenz (Teil 1) – Hintergrund, Gegenstand und
Fragestellungen in der Versorgungsforschung“ dar. Neben den allgemeinen
Anforderungen an die Messung der Gesundheitskompetenz, beschäftigt sich
dieses Memorandum auch mit den speziellen Anforderungen, wie die Abgrenzung zu
verwandten Konstrukten, den Unterschieden zwischen performanzbasierten und
Selbsteinschätzungsverfahren, den Unterschieden zwischen generischen und
spezifischen Instrumenten, dem Einsatz von Screeninginstrumenten sowie der
Messung der Gesundheitskompetenz bei speziellen Personengruppen. Weiterhin
werden Besonderheiten bei der Messung der digitalen Gesundheitskompetenz,
Potenziale qualitativer und partizipativer Forschungszugänge sowie
forschungsethische Gesichtspunkte bei der Messung der Gesundheitskompetenz
erarbeitet. Ein besonderer Wert wird auf den Praxisbezug gelegt, der am Ende der
jeweiligen Abschnitte mit einem Fazit für die Versorgungsforschung
aufgegriffen wird. Abschließend wird einen Blick auf Herausforderungen
und Forschungsdesiderate im Zusammenhang mit der Messung von
Gesundheitskompetenz im Rahmen der Versorgungsforschung geworfen.
Collapse
Affiliation(s)
- Stephanie Stock
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln, Cologne, Germany
| | - Anna Isselhard
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln, Cologne, Germany
| | - Saskia Jünger
- Department of Community Health, Hochschule für Gesundheit, Bochum, Germany
| | - Stefan Peters
- Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Hürth Efferen, Germany
| | - Gundolf Schneider
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Standort Berlin, Berlin, Germany
| | - Frederik Haarig
- Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Carl Gustav Carus der Technischen Universität Dresden, Dresden, Germany
| | - Sarah Halbach
- Bundeszentrale für gesundheitliche Aufklärung (BzgA), Köln, Germany.,Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Universitätsklinikum Bonn, Bonn
| | - Orkan Okan
- Fakutät für Sport- und Gesundheitswissenschaften, Technische Universität München, München, Germany
| | - Florian Fischer
- Institut für Gerontologische Versorgungs- und Pflegeforschung, Hochschule Ravensburg-Weingarten, Weingarten, Germany
| | - Torsten Michael Bollweg
- Fakultät für Erziehungswissenschaft, AG 2 Sozialisation, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung (IZGK), Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Bielefeld, Germany
| | - Ullrich Bauer
- Fakultät für Erziehungswissenschaft, AG 2 Sozialisation, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung (IZGK), Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Bielefeld, Germany
| | - Doris Schaeffer
- Interdisziplinäres Zentrum für Gesundheitskompetenzforschung, Universität Bielefeld, Bielefeld, Germany
| | - Dominique Vogt
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Eva-Maria Berens
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Nicole Ernstmann
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Universitätsklinikum Bonn, Bonn
| | - Eva Maria Bitzer
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Germany
| |
Collapse
|
10
|
Kuo SF, Yeh YC, Chang CC, Lin YF, Wang SY. Psychometrics and measurement invariance: Health Literacy Scale for Vietnamese and Indonesian married immigrants. J Adv Nurs 2022; 78:1836-1847. [PMID: 35384029 DOI: 10.1111/jan.15241] [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: 09/22/2021] [Revised: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine the psychometrics and measurement invariance of the Short-Form Health Literacy 12-item questionnaire (HL-SF12) among Vietnamese and Indonesian married immigrants. DESIGN A cross-sectional survey design. METHODS In total, 1171 Vietnamese and Indonesian married immigrants were enrolled between September 2019 and December 2019. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to verify the structural validity of the suggested factor structure. The multiple-group CFA (MGCFA) used a series of hierarchical nested-in models as a measurement invariance test which confirmed the adequacy of the model fit at each stage. RESULTS/FINDINGS The Kaiser-Meyer-Olkin coefficient was 0.898, and the Bartlett test of sphericity was statistically significant (χ2 [66] = 1965.97, p < 0.01). According to a scree plot and Kaiser's criterion for eigenvalues of >1, the EFA explained 61.6% of the total variance and confirmed three theoretically supported factors of health care, disease prevention and health promotion. The 12 items showed factor loadings of >0.4 and four items were in each subscale. The CFA showed adequate structural validity, including a relative chi-squared/degrees of freedom (X2 /df) of 2.01, a comparative fit index (CFI) of 0.98 and a root mean square error of approximation (RMSEA) of 0.04 (95% confidence interval [0.03, 0.05]) in married immigrants. For the measurement invariance, a change in the goodness-of-fit measures did not exceed 0.02 for the RMSEA or 0.01 for the CFI. The results indicated Cronbach's α values of 0.87 for the HL-SF12 scale in Vietnamese and Indonesian combined samples (n = 1171). A t-test showed that the HL-SF12 and its three subscales were unable to significantly differentiate between Vietnamese and Indonesian groups (all p > 0.05). CONCLUSIONS The HL-SF12 scale showed acceptable theoretically supported structural validity, equivalent measurement invariance and reliable internal consistency among Vietnamese and Indonesian married immigrants. Measurements of immigrants' HL using the HL-SF12 could be integrated into future immigrant health policies. IMPACT As the first study of the measurement invariance of the HL-SF12 instrument among immigrants. Related factors of immigrants' HL can be further explored to increase immigrants' health and empowerment.
Collapse
Affiliation(s)
- Shu-Fen Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Chen Yeh
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, and Dean of College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
| | - Yu-Fang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yi Wang
- Loretto Heights School of Nursing, Rueckert-Hartman College for Health Professions, Regis University, Denver, Colorado, USA
| |
Collapse
|
11
|
Svendsen IW, Damgaard MB, Bak CK, Bøggild H, Torp-Pedersen C, Svendsen MT, Berg-Beckhoff G. Employment Status and Health Literacy in Denmark: A Population-Based Study. Int J Public Health 2021; 66:598083. [PMID: 34744563 PMCID: PMC8565272 DOI: 10.3389/ijph.2021.598083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Examining whether specific population groups who are not working and those who have an employment have the same health literacy level. Methods: Data were retrieved from a nationally representative cross-sectional study of the Danish population conducted with the health literacy questionnaire (HLS-EU-Q16) in 2016 and 2017. Socio-demographic characteristics were drawn from national registers. Odds ratio for the association between employment status and health literacy was estimated from logistic regression models, adjusted for socio-demographic characteristics. Probability weights were used to adjust for differences in responses. Results: Logistic regression analyses showed that receiving unemployment benefits, social assistance, employment and support allowance, retirement pension and sickness benefit were significantly associated with having inadequate health literacy compared to being employed in any industry. The highest odds ratio for inadequate health literacy was present for receiving unemployment benefit OR = 1.78 (95% CI: 1.23-2.56). Conclusion: Population groups not working and receiving economic public support have higher odds of inadequate health literacy competencies compared to those active in the labor force, considering age and socioeconomic factors. The result contributes to understanding health disparities in connection to occupational situation.
Collapse
Affiliation(s)
- Ida W Svendsen
- CIMT - Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.,Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Maria B Damgaard
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Carsten K Bak
- Department of Research and Development, University College South, Esbjerg, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Christian Torp-Pedersen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Majbritt T Svendsen
- Department of Cardiology, Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
| | - Gabriele Berg-Beckhoff
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.,Hospital South West Jutland, Esbjerg, Denmark
| |
Collapse
|
12
|
Levic M, Bogavac-Stanojevic N, Krajnovic D. The Instruments Used to Assess Health Literacy and Pharmacotherapy Literacy of Diabetes Mellitus Type 2 Patients: A Scoping Review. Front Public Health 2021; 9:747807. [PMID: 34646807 PMCID: PMC8502961 DOI: 10.3389/fpubh.2021.747807] [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: 07/26/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with chronic diseases, like diabetes need to continuously perform tasks associated with self-management especially with medications they use. It is shown that the patients with diabetes with limited HL and PTHL cannot read medication labels correctly, may misuse their medications, spend much more on therapy and generally have difficulties in understanding printed care instructions and perceiving health advice and warnings. There has been an increasing demand for valid and reliable instruments for HL and PTHL assessment in this population. This review aims to search and critically discuss instruments used to assess HL and PTHL in people with type 2 diabetes and propose their use in different settings. Methods: Authors conducted a comprehensive, electronic search of original studies using a structured approach of the Scopus and PubMed databases, during November and the first 2 weeks of December 2020 to find relevant papers. The review was conducted in accordance with the Cochrane guidelines and the reporting was based on the PRISMA-ScR. The comparison of instruments was made by utilizing a comparison model related to their structure, measurement scope, range, psychometric properties, validation, strengths, and limitations. Results: The final number of included studies was 24, extracting the following identified instruments: Korean Functional Test HL, NVS, FCCHL, HLS-EU-47, TOFLHA, S-TOFHLA, REALM-R, 3-brief SQ, REALM, HLQ and DNT-15. In all, FCCHL and 3-brief SQ are shown with the broadest measurement scopes. They are quick, easy, and inexpensive for administration. FCCHL can be considered the most useful and comprehensive instrument to screen for inadequate HL. The limitation is that the English version is not validated. Three-brief SQ has many advantages in comparison to other instruments, including that it is less likely to cause anxiety and shame. These instruments can be considered the best for measuring functional HL in patients with diabetes mellitus type 2 and other chronic diseases. PTHL instruments (REALM and DNT-15) did not find the best application in this population. Conclusions: The future research should be directed in validation of the FCCHL in English and establishing of the structural validity of this questionnaire. Developing a specific PTHL questionnaire for this population will be of great help in management of their disease.
Collapse
Affiliation(s)
- Marija Levic
- Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | | | | |
Collapse
|
13
|
Neter E, Brainin E, Baron-Epel O. Group differences in health literacy are ameliorated in ehealth literacy. Health Psychol Behav Med 2021; 9:480-497. [PMID: 34104571 PMCID: PMC8158255 DOI: 10.1080/21642850.2021.1926256] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Heath literacy and eHealth literacy are skills that enable individuals to seek, understand and use information in ways which promote and maintain health. The present study examined group differences (ethnicity, immigration) in both literacies and whether there exists an association between the literacies and potential outcomes/gains in health behaviors, health care utilization, perceived health and perceived outcomes of Internet search. METHODS Participants included 819 Israeli men and women who responded to a nationally representative random-digital-dial (RDD) telephone survey. Respondents were veteran Jews, immigrants from the Former Soviet Union, and Palestinian Citizens of Israel. RESULTS Significant differences between the groups were found in health literacy, especially in higher ordered skills, so that the immigrant group was the lowest, after accounting for demographic variables. No significant group differences were found in eHealth literacy. Health literacy was found to be significantly associated with healthcare utilization, perceived health and perceived outcomes of Internet search while eHealth literacy was associated with perceived health and perceived outcomes of Internet search. No interaction was found between group and literacies in the prediction of the outcomes. CONCLUSIONS Immigration hampers health literacy but differences are ameliorated in eHealth literacy. Finding on association between literacies and outcomes replicated previous ones and the absence of moderation by group attests to the robustness of the models on health literacies.
Collapse
Affiliation(s)
- Efrat Neter
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Esther Brainin
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Orna Baron-Epel
- Faculty of Social Welfare and Health, School of Public Health, University of Haifa, Haifa, Israel
| |
Collapse
|
14
|
Pisl V, Volavka J, Chvojkova E, Cechova K, Kavalirova G, Vevera J. Dissociation, Cognitive Reflection and Health Literacy Have a Modest Effect on Belief in Conspiracy Theories about COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5065. [PMID: 34065023 PMCID: PMC8151867 DOI: 10.3390/ijerph18105065] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 12/31/2022]
Abstract
Understanding the predictors of belief in COVID-related conspiracy theories and willingness to get vaccinated against COVID-19 may aid the resolution of current and future pandemics. We investigate how psychological and cognitive characteristics influence general conspiracy mentality and COVID-related conspiracy theories. A cross-sectional study was conducted based on data from an online survey of a sample of Czech university students (n = 866) collected in January 2021, using multivariate linear regression and mediation analysis. Sixteen percent of respondents believed that COVID-19 is a hoax, and 17% believed that COVID-19 was intentionally created by humans. Seven percent of the variance of the hoax theory and 10% of the variance of the creation theory was explained by (in descending order of relevance) low cognitive reflection, low digital health literacy, high experience with dissociation and, to some extent, high bullshit receptivity. Belief in COVID-related conspiracy theories depended less on psychological and cognitive variables compared to conspiracy mentality (16% of the variance explained). The effect of digital health literacy on belief in COVID-related theories was moderated by cognitive reflection. Belief in conspiracy theories related to COVID-19 was influenced by experience with dissociation, cognitive reflection, digital health literacy and bullshit receptivity.
Collapse
Affiliation(s)
- Vojtech Pisl
- Department of Psychiatry, Faculty of Medicine and University Hospital in Pilsen, Charles University, 30100 Pilsen, Czech Republic; (V.P.); (J.V.)
| | - Jan Volavka
- Department of Psychiatry, Faculty of Medicine and University Hospital in Pilsen, Charles University, 30100 Pilsen, Czech Republic; (V.P.); (J.V.)
- Department of Psychiatry, School of Medicine, New York University, New York, NY 10016, USA
| | - Edita Chvojkova
- Department of Psychological Methods, University of Amsterdam, 1012 Amsterdam, The Netherlands;
| | - Katerina Cechova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, 15006 Prague, Czech Republic;
- International Clinical Research Center, St. Anne’s University Hospital Brno, 65691 Brno, Czech Republic
| | - Gabriela Kavalirova
- Center of Physical Education and Sport, Faculty of Education, University of West Bohemia, 30100 Pilsen, Czech Republic;
| | - Jan Vevera
- Department of Psychiatry, Faculty of Medicine and University Hospital in Pilsen, Charles University, 30100 Pilsen, Czech Republic; (V.P.); (J.V.)
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, 12808 Prague, Czech Republic
- Institute for Postgraduate Medical Education, 10005 Prague, Czech Republic
| |
Collapse
|
15
|
Health Literacy in Pregnant Women: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073847. [PMID: 33917631 PMCID: PMC8038834 DOI: 10.3390/ijerph18073847] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
Health literacy plays a crucial role during pregnancy, as the mother’s health behavior influences both her own health and that of her child. To the authors’ best knowledge, no comprehensive overview on evidence of the health literacy of pregnant women and its impact on health outcomes during pregnancy exists. Therefore, this review aims to assess health literacy levels in pregnant women, whether health literacy is associated with outcomes during pregnancy and whether effective interventions exist to improve the health literacy of pregnant women. A systematic literature search was conducted in PubMed and EBSCO, resulting in 14 studies. The results show mixed levels of health literacy in pregnant women. Limited health literacy is associated with unhealthy behaviors during pregnancy. Mixed health literacy levels can be attributed to the recruitment site, the number of participants and the measurement tool used. Quality assessment reveals that the quality of the included studies is moderate to good. The review revealed that randomized controlled trials and interventions to improve health literacy in pregnant women are rare or do not exist. This is crucial in the light of the mixed health literacy levels found among pregnant women. Healthcare providers play a key role in this context, as pregnant women with limited health literacy rely on them as sources of health information.
Collapse
|
16
|
Glinert LH. Communicative and Discursive Perspectives on the Medication Experience. PHARMACY 2021; 9:pharmacy9010042. [PMID: 33671135 PMCID: PMC8006053 DOI: 10.3390/pharmacy9010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/01/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022] Open
Abstract
Taking the ‘medication experience’ in the broad sense of what individuals hear and say about their medication, as well as how they experience it, this paper explores diverse research on medication information available to patients and their modes and capacities for interaction, including personal circles, doctors and pharmacists, labeling and promotion, websites, and the patient’s own inner conversations and self-expression. The goal is to illustrate, for nonspecialists in communication, how the actors, messages, mediums, genres, and contextual factors within a standard ethnographic and social semiotic model of discourse and communication are operating, not always effectively or beneficially, to mediate or construct a patient’s medication experience. We also suggest how disparate insights can be integrated through such a model and might generate new research questions.
Collapse
Affiliation(s)
- Lewis H Glinert
- Middle Eastern Studies and Linguistics, Dartmouth College, NH 03755, USA
| |
Collapse
|
17
|
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: 1.0] [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.
Collapse
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
| |
Collapse
|
18
|
Health Literacy and Physical Activity: A Systematic Review. J Phys Act Health 2020; 17:1259-1274. [PMID: 33129198 DOI: 10.1123/jpah.2020-0161] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/30/2020] [Accepted: 09/13/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The importance of health literacy (HL) in health promotion is increasingly clear and acknowledged globally, especially when addressing noncommunicable diseases. This paper aimed to collect and summarize all current data from observational studies generating evidence of the association between HL and physical activity (PA) and to analyze intervention studies on the promotion of PA to ascertain whether HL moderates the efficacy of such intervention. METHODS A comprehensive systematic literature search of observational studies investigating the association between HL and PA was performed. Intervention studies on the promotion of PA that also measured the HL levels of participants and its effect on the outcome of the intervention were also identified. RESULTS Of the 22 studies included in this review, 18 found a significant positive association between high HL and high levels of PA. The only intervention study among them indicated that HL was not a significant moderator of the intervention's effectiveness. CONCLUSION HL can enable individuals to make deliberate choices about their PA and thus contribute to preventing many chronic noncommunicable diseases. That said, low levels of HL do not seem to influence the efficacy of health promotion interventions.
Collapse
|
19
|
Horshauge PM, Gabel P, Larsen MB, Kirkegaard P, Edwards A, Andersen B. The association between health literacy and colorectal cancer screening uptake in a publicly funded screening program in Denmark: Cross-sectional study. Prev Med Rep 2020; 19:101132. [PMID: 32551215 PMCID: PMC7287294 DOI: 10.1016/j.pmedr.2020.101132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 05/13/2020] [Accepted: 05/23/2020] [Indexed: 02/07/2023] Open
Abstract
There are multiple reasons for not participating in colorectal cancer screening, but the role of health literacy in screening uptake is not well understood. The aims of this study were to determine the association between health literacy and colorectal cancer screening uptake and to explore whether socioeconomic and -demographic characteristics and worry and attitude variables modify this association. In a cross-sectional study, 10,030 53-74-year-old randomly selected citizens resident in Central Denmark Region received a questionnaire assessing health literacy using the European Health Literacy Survey Short Scale 16-item. Data on colorectal cancer screening uptake were obtained from the Danish Colorectal Cancer Screening database, and socioeconomic and -demographic data were linked from Statistics Denmark. The response rate was 71% (n = 7142). Odds ratio (OR) for uptake was 1.06 (95% confidence interval (CI): 0.96, 1.19) for problematic health literacy and 1.00 (95% CI: 0.87, 1.16) for inadequate health literacy, when using adequate health literacy as the reference value. The association was not modified by socioeconomic or -demographic characteristics, worry or attitude. No association was found between health literacy and colorectal cancer screening uptake. Future research needs to clarify which dimensions of health literacy may predict screening uptake and how it is best measured.
Collapse
Affiliation(s)
- Petricia Marie Horshauge
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.,Department of Clinical Medicine, Aarhus University, Denmark
| | - Pernille Gabel
- Department of Public Health Programmes, Randers Regional Hospital, Denmark
| | - Mette Bach Larsen
- Department of Public Health Programmes, Randers Regional Hospital, Denmark
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, Denmark
| | - Adrian Edwards
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.,Division of Population Medicine, School of Medicine, Cardiff University, UK
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.,Department of Clinical Medicine, Aarhus University, Denmark
| |
Collapse
|
20
|
Mwanri L, Gesesew H, Lee V, Hiruy K, Udah H, Kwedza R, Dune T. Health Literacy Environment of Breast and Cervical Cancer among Black African Women Globally: A Systematic Review Protocol of Mixed Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3158. [PMID: 32369999 PMCID: PMC7246761 DOI: 10.3390/ijerph17093158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/20/2023]
Abstract
Adequate health literacy is a necessity to enable effective decision making to seek, access and utilise appropriate health care service. Evidence exists indicating a low level of general health literacy among Black African women, especially those with a refugee background. Breast and cervical are the most common cancers, with Black African women or women with African ethnicity being disproportionately overrepresented. The level of health literacy specific to breast and cervical cancer among Black African women, especially those with a refugee background, has not been reviewed systematically. The present study describes a protocol for a systematic review of the available evidence on the level of health literacy specific to breast and cervical cancer among Black African women globally. We will perform a systematic review of the available quantitative and qualitative studies. The search will include studies that describe the level of health literacy specific to breast and cervical cancer among Black African women. We will conduct a preliminary search on Google scholar to build the concepts for search terms, and a full search strategy using the identified concepts and keywords across four databases namely PubMed, SCOPUS, CINAHL and Web of Sciences. We will use Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to schematically present the search strategy. We will use the standardized Joanna Briggs Institute quality appraisal and selection tool to recruit studies, and the data extraction tool to synthesise the information extracted from the recruited studies. We will be guided by socioecological theory and Indigenous epistemology to synthesise the non-quantifiable information thematically, and pool the quantitative information using meta-analysis, based on the availability of information.
Collapse
Affiliation(s)
- Lillian Mwanri
- Public Health, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia;
| | - Hailay Gesesew
- Public Health, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia;
- Epidemiology, School of Health Sciences, Mekelle University, Mekelle 231, Ethiopia
| | - Vanessa Lee
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia; (V.L.); (R.K.)
| | - Kiros Hiruy
- Centre for Social Impact Swinburne, Faculty of Business and Law, Swinburne University of Technology, Melbourne 3122, Australia;
| | - Hyacinth Udah
- College of Arts, Society and Education James Cook University, Queensland 4811, Australia;
| | - Ru Kwedza
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore NSW 2480, Australia; (V.L.); (R.K.)
| | - Tinashe Dune
- School of Health Sciences & Translational Health Research Institute, Western Sydney University, Sydney 2751, Australia;
| |
Collapse
|
21
|
Lee EH, Lee YW, Lee KW, Hong S, Kim SH. A New Objective Health Numeracy Test for Patients with Type 2 Diabetes: Development and Evaluation of Psychometric Properties. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:66-72. [DOI: 10.1016/j.anr.2020.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 10/25/2022] Open
|
22
|
The Impact of the Chronic Disease Self-Management Program on Health Literacy: A Pre-Post Study Using a Multi-Dimensional Health Literacy Instrument. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010058. [PMID: 31861752 PMCID: PMC6982295 DOI: 10.3390/ijerph17010058] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 01/20/2023]
Abstract
This study assessed the impact of the Chronic Disease Self-Management Program (CDSMP) on different domains of health literacy using a pre-post study design. Participants aged over 16 years and with one or more self-reported chronic diseases were recruited for the CDSMP in western Sydney (a highly diverse area of New South Wales, Australia) between October 2014 and September 2018. Health literacy was assessed pre- and immediately post-intervention using the Health Literacy Questionnaire (HLQ), with differences in mean scores for each HLQ domain analysed using paired sample t-tests. A total of 486 participants were recruited into the CDSMP. Of those, 316 (65.0%) completed both pre- and post-intervention surveys and were included in the analysis. The median age of the participants was 68 years, the majority were female (62.5%), and most were born in a country other than Australia (80.6%). There were statistically significant (P < 0.001) improvements across all nine domains of the HLQ. This is the first study evaluating the potential impact of the CDSMP on improving different domains of health literacy amongst a diverse sample of participants with chronic diseases using a multi-dimensional instrument. The absence of a control population in this study warrants caution when interpreting the results.
Collapse
|
23
|
Abstract
Despite weak health literacy is considered a concause of vaccine hesitancy, it is rarely taken into account when discussing about this subject. The association between health literacy skills and vaccine acceptance has been shown to be uneven when using general measures, also depending on the population settings and type of vaccine considered. Vaccine literacy has been built on the same idea of health literacy, but very few specific measuring tools have been developed until now. It is desirable that more of these instruments are validated and extensively used with the objective of assessing peoples' vaccine literacy skills and defining interventions aimed at their improvement.
Collapse
|
24
|
Neter E, Brainin E. Association Between Health Literacy, eHealth Literacy, and Health Outcomes Among Patients With Long-Term Conditions. EUROPEAN PSYCHOLOGIST 2019. [DOI: 10.1027/1016-9040/a000350] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Abstract. The objective of this paper is to synthesize and update findings from systematic review on health literacy and health outcomes among patients with long-term conditions, and extend the review to the digital domain. Health outcomes include clinical outcomes, processes of care, and health service use. Data sources are the following: (1) studies which appeared in two previous systematic reviews in 2004 and 2011 whose participants were people with long-term conditions or elderly ( n = 54); (2) articles on health literacy and health outcomes identified in an updated 2011–2016 search ( n = 26); (3) articles on eHealth literacy and its association with health outcomes ( n = 8). Strength of evidence was determined by a qualitative assessment of risk of bias, consistency, and directness. There was a lack of consistent evidence on the relationship between health literacy and clinical outcomes despite the consistent evidence on the association with mortality. There was low to insufficient evidence on the association between health literacy and self-rated health/function and emotional states of anxiety and depression, alongside high evidence on lack of association with quality of life. There was insufficient to low evidence on the association between health literacy and behavioral outcomes (medication adherence, other health behaviors) and finally also low to moderate evidence on the association between health literacy and use of health services such as hospitalization and emergency department. In the eHealth literacy domain, there were few studies reporting association with health behaviors and self-rated health with inconsistent results. In conclusion, it is advocated to examine performed heath literacy and eHealth literacy in large longitudinal studies.
Collapse
Affiliation(s)
- Efrat Neter
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Esther Brainin
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| |
Collapse
|
25
|
Yim CK, Shumate L, Barnett SH, Leitman IM. Health literacy assessment and patient satisfaction in surgical practice. Ann Med Surg (Lond) 2018; 35:25-28. [PMID: 30263114 PMCID: PMC6156741 DOI: 10.1016/j.amsu.2018.08.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 08/17/2018] [Accepted: 08/27/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Limited health literacy has been associated with poorer health outcomes and increased morbidity and mortality. Though caring for surgical patients requires communication about complex topics, there is limited literature on health literacy competency in this population. The objective of this study was to assess health literacy in an adult surgical outpatient clinic population, to explore potential determinants of adequate health literacy, and to assess patient satisfaction with physician-patient communication. MATERIALS AND METHODS A prospective cross-sectional study was performed and anonymous data including health literacy, demographics, and patient satisfaction with provider communication were collected. The study population included adult patients who visited an outpatient surgical practice over a one-month period. Health literacy was assessed using the Newest Vital Sign while the satisfaction questions came from the Outpatient Satisfaction Survey (Press-Ganey Associates, Chicago, IL). RESULTS 148 patients participated in the study. The mean age was 49 years, 41% of those who gender identified were male, and 76% were White/Caucasian. 34 (27%) of those who answered the question had received a four-year undergraduate/university degree. 55 (37%) of the patients were identified as having low health literacy. More years of education was significantly associated with adequate health literacy and those patients who were more educated and had adequate health literacy were more satisfied with provider communication. CONCLUSION Patients on average were highly satisfied with provider communication in this outpatient surgical clinic. Higher education levels were associated with better health literacy and patients with both characteristics were more satisfied with provider communication.
Collapse
Affiliation(s)
- Cindi K. Yim
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lauren Shumate
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott H. Barnett
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - I. Michael Leitman
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|