Online Survey for the Assessment of Generic Health Literacy among Adolescents in Germany (GeKoJu): Study Protocol

Exploring barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public hospitals; Northeast, Ethiopia, 2023: application of socio-ecological model

BACKGROUND

Health literacy is the important for the prevention of non-communicable disease to make informed health decisions, and practice healthy and protective behaviours. Therefore, application of socioecological model to this study aimed to identify multilevel factors on health literacy among patients and develop scientific health communication interventional strategies to improve health literacy on non-communicable disease prevention and care.

OBJECTIVE

To explore barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public Hospitals, Northeast Ethiopia, 2023.

METHOD

In this study phenomenological study design was conducted from February 5 to 30/2023.We have used purposive sampling technique to select study participants from chronic follow up clinics. Data were collected using in-depth interview and focused group discussion in which audio was recorded, transcribed verbatim and translated to English. Thematic analysis was performed with atlas ti. 7 software.

RESULT

In this study four main themes with seven subthemes were developed. The main themes were factors at the organizational, community, interpersonal, and intra-personal factors. The poor knowledge, lack of enough money for transportation and medication at the hospital were identified as barrier to get early diagnosis and treatment. Some participants explored that they have no any support from family or others. The cultural norms like weeding and funeral ceremonies enforce patients to consume prohibited substances like alcohol and salty foods.

CONCLUSION

In this study different barriers of health literacy were explored. Lack of knowledge, economic problems, lack of social support, poor communication with health care providers, cultural influences, lack of regular health education, lack of access to health care services and poor infrastructure were main barriers of health literacy in patients with NCD. Therefore, we recommended all concerned bodies to work on social and behavioral change communication intervention focusing on awareness creation, supply of drugs and create supportive environment to get accessible and affordable health care service to decrease the impact of non-communicable disease at personal, community and national level.

Adolescents' understanding of the Nepalese version of HLS-CHILD-Q15: qualitative pre-testing in ninth-graders

INTRODUCTION

Research on health literacy is still at an early stage, lacking a dedicated measurement instrument for assessing children's and adolescents' health literacy. Such tools are necessary to generate the evidence required for informed intervention development. This study translated the validated German HLS-Child-Q15 into the Nepalese context, creating the HLS-Child-Q22-NEP.

METHODS

The research team initially created the HLS-Child-Q22-NEP using an additional item pool. We conducted thirteen one-on-one cognitive interviews with adolescent students from community schools in three districts of Nepal during the pre-test. We employed verbal probing techniques and deductively analysed the interviews based on Tourneau's model, uncovering four main themes: (1) comprehension (with the two sub-categories: a) item comprehension and b) word comprehension); (2) retrieval; (3) judgement; and (4) response.

RESULTS

Overall, participants responded positively to the HLS-Child-Q22-NEP. However, this study revealed comprehension challenges such as unfamiliarity, misunderstandings, and translation issues. Additionally, the study identified retrieval challenges and poor judgement, indicating limitations in the assessment. Participants experienced varying levels of difficulty with some items, emphasising the need for revised instructions. Subsequent revisions, guided by pretest insights, led to the development of the HLS-Child-Q24-NEP.

CONCLUSION

The development of the HLS-Child-Q22-NEP is a significant step in addressing Nepali adolescents' lack of health literacy measurement. Despite its generally positive reception, this study encountered challenges in comprehending the scale, prompting enhancements, and developing the HLS-Child-Q24-NEP. Further research, both qualitative and quantitative, is necessary to evaluate the validity and reliability of the modified items.

Assessing the Readability of Online Patient Education Resources Related to Gynecomastia

BACKGROUND

The Internet has a plethora of online patient education resources for many symptoms and diseases. National medical governing bodies recommend that patient education materials are written at or below the eighth-grade level, and the literature suggests that health literacy has been linked to increased adherence to treatment regimens and improved outcomes. The primary aim of the study is to assess the readability of online patient materials relating to gynecomastia and ascertain the availability of patient materials in non-English languages.

METHODS

The readability of patient education materials relating to gynecomastia for academic-based websites and nonacademic websites was assessed using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). The prevalence of non-English patient education materials was assessed for both academic-based and nonacademic websites.

RESULTS

Fifty-eight documents were collected across academic websites. Overall median values were 10.7 for the FKGL, 47.0 for the FRE, and 11.4 for the SMOG. For the 10 nonacademic institutions, the overall median values were 10.6 for the FKGL, 45.2 for the FRE, and 10.8 for the SMOG. No appreciable differences were observed for readability when stratified by region or source. The prevalence of non-English patient materials was 19.1% across institutions. None of the noninstitutional materials had information in non-English languages.

CONCLUSIONS

The readability of patient education materials related to gynecomastia is at higher levels than recommended by national organizations. There are limited non-English patient education materials. Future efforts should focus on improving the readability and accessibility of patient materials.

Health literacy, health perception and related factors among different ethnic groups: a cross-sectional study in southeastern Turkey

BACKGROUND

Low levels of health literacy are associated with increased hospitalization rates, problems regarding the proper intake of medications, poor general health and increased mortality rates. It is a well-known fact that health literacy differs among ethnic groups and ethnic minorities, in particular, are known to have a low level of health literacy. The present study aimed to reveal the levels of health literacy among different ethnic groups and the affecting factors as well as the relationship between health literacy and health perceptions.

METHODS

This cross-sectional study was carried out with different ethnic groups (Kurdish, Arab, Turkish and Assyrian origin), between 18 and 65 years old in the province of Mardin in Turkey. The study was conducted with a total of 600 people. The European Health Literacy Scale-Turkish Adaptation (EHLS-TR) and Health Perception Scale (HPS) were used for measurement. Descriptive analysis, Mann Whitney U Test, Kruskal Wallis Test and Spearman correlation were used in the data analysis.

RESULTS

It was found that 80.7% of the participants had relatively low levels of health literacy. The lowest levels of health literacy were among those of Kurdish origin. There were correlations between sufficient levels of health literacy and several factors including being of Assyrian origin, being 50-65 years old, living in a nuclear family, being a secondary school graduate, having a high financial status, being retired, evaluating one's own health status as good, obtaining health information from healthcare professionals, preferring to visit a state hospital to seek medical assistance first, smoking and drinking alcohol. A positive correlation was also identified between the levels of health literacy and health perception.

CONCLUSIONS

It is essential to develop programs to increase health literacy for the public and, in particular, for the ethnic groups that are disadvantaged in many aspects in the context of health literacy.

[Evidence-based primary prevention and health promotion: methods and procedures in 5 research consortia]

Von 2014 bis 2022 erforschen die 5 deutschen Forschungsverbünde AEQUIPA, CAPITAL4HEALTH, HLCA, PartKommPlus und SMARTACT Themen der Primärprävention und Gesundheitsförderung mit dem Ziel, die Evidenzgrundlagen in diesen Bereichen weiterzuentwickeln. In diesem Beitrag wird die Arbeit der 5 Forschungsverbünde für Primärprävention und Gesundheitsförderung unter dem Aspekt der Evidenzbasierung aus der internen Perspektive vorgestellt, analysiert und diskutiert. Als orientierender Rahmen dient ein Modell der evidenzbasierten Public Health.

Die 5 Forschungsverbünde nutzen für die Evidenzgenerierung vielfältige Zugangswege bzgl. der Beteiligung nichtakademischer, zivilgesellschaftlicher Akteur*innen und Nutzer*innen. Es finden sich vielfältige Studiendesigns, die von randomisiert kontrollierten Studien und systematischen Reviews zu diversen qualitativen Designs reichen. Die Nutzung von Modellen und Theorien unterstützt die Evidenzbasierung. Über die Evidenzentwicklung hinaus legen alle Verbünde einen Schwerpunkt auf die zumindest exemplarische Implementierung des neuen Wissens.

Durch die Methodenvielfalt kann eine breit gefächerte Evidenzbasierung unter Berücksichtigung verbundspezifischer Aspekte realisiert werden. Grenzen für eine weitere systematische Stärkung der Evidenzbasierung liegen in strukturellen Rahmenbedingungen. Insbesondere die Einbindung von nichtakademischen, zivilgesellschaftlichen Akteur*innen und Nutzer*innen für die Arbeit mit schwer erreichbaren Zielgruppen kann oft nicht ausfinanziert bzw. zeitlich berücksichtigt werden. Die COVID-19-Pandemie verdeutlicht die Wichtigkeit eines flexiblen Methodenspektrums, in dem ein sinnvolles Zusammenspiel von digitalen und analogen Methoden anzustreben ist.

Subjective Generic Health Literacy and Its Associated Factors among Adolescents: Results of a Population-Based Online Survey in Germany

Profound data on adolescent health literacy are needed as a requirement for the development of health literacy promoting interventions. This paper aims to study the level of generic health literacy among adolescents and to explore associations between health literacy and socio-demographic (age, sex, family affluence, migration background), social (social support by family and friends) and personal (self-efficacy) factors. We conducted a representative cross-sectional online survey. Four health literacy dimensions were captured among 14-17 years old adolescents living in Germany (n = 1235) with the "Measurement of Health Literacy Among Adolescents-Questionnaire" (MOHLAA-Q). Descriptive, bivariate and multiple logistic regression analyses were used to analyse the data (n = 1202). We found poor health literacy levels-to varying degrees-in all examined health literacy dimensions: dealing with health-related information (8.41% with many difficulties), health-related communication skills (28.13% with low skills), attitudes toward one's own health and health information (8.81% with passive attitudes) and health-related knowledge (22.73% with low levels). We identified significant associations between poor health literacy levels and all factors studied except for age. Our results indicate a need for the implementation of evidence-based health literacy-related promoting interventions, preferentially in education and training institutions.

Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19

As we write our editorial for a health literacy special issue in the midst of the international COVID-19 crisis, we take this opportunity to highlight the importance of individual, community, and population health literacy. We are not only in a "pandemic" but also an "infodemic". Health literacy is more important than ever in the face of these global health threats, which have impacted outcomes across the levels of the socio-ecological model (SEM), including individual health behaviors, family relationships, organizational behavior, state policy-making, national mortality statistics, and the international economy in the span of weeks. Our special issue sought to pull together interdisciplinary threads guided by two principles. The first was defining health literacy as essential skills and situational resources needed for people to find, understand, evaluate, communicate, and use information and services in a variety of forms across various settings throughout their life course to promote health and wellbeing. The second was the idea that enhancing health literacy in populations and systems is critical to achieving health equity. In this time of public health need across traditional borders, the inter-sectoral and international perspectives of special issue articles are more urgent than ever. A greater understanding, appreciation, and application of health literacy can support policy action on multiple levels to address major public health challenges. Health literacy should be built deliberately as a population-level resource and community asset. We have summarized the set of articles in this special issue across the levels of the SEM, hoping their thoughtful considerations and interesting findings will help to support global health and wellness and inspire future research, policy, and practice in this global public health emergency and beyond.