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Joshi H, Kalauni BR, Bhusal K, Bhandari R, Subedi A, Bhandari B. Health literacy among patients with non-communicable diseases at a tertiary level hospital in Nepal- A cross sectional study. PLoS One 2024; 19:e0304816. [PMID: 38829843 PMCID: PMC11146733 DOI: 10.1371/journal.pone.0304816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024] Open
Abstract
Health literacy (HL) is crucial in achieving the Sustainable Development Goal of reducing one-third of premature mortality by 2030 from Non-Communicable Diseases (NCDs) and improving Universal Health Coverage. Low health literacy is linked to poor health outcomes, and evidence shows that levels of limited HL are high, even among highly educated individuals. This study aims to assess HL levels and related factors among patients with NCDs at Tribhuvan University Teaching Hospital (TUTH) in Nepal. A cross-sectional survey was conducted at TUTH among 303 patients with NCDs with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease, Diabetes Mellitus, Hypertension, Epilepsy, Asthma and Cancer who came for follow-up from December 2022 to February 2023. Data was collected via face-to-face interviews by the trained enumerators using a structured Health Literacy Questionnaire (HLQ) containing 44 items (divided into nine domains). Multivariate logistic regression analysis was performed using SPSS version 26, with statistical significance at 0.05, to determine the associated factors of HL. The mean ±SD age of the respondents was 47.4±16.18 years. More than half of the respondents were female (56.1%). The patients had higher HL in all HL domains except 'Navigating the healthcare system'. Educational status was significantly associated with six out of nine HL domains. Co-morbidity, attendance at health-related seminars, regular physical activity, and social connectedness were associated with at least one of the domains of HL. This study identified the important factors of HL, such as socio-demographic and medical factors among patients with NCDs. This highlights the need for a comprehensive approach to address identified gaps in HL, considering its multifaceted and composite nature and promoting interventions to improve HL in high-risk populations.
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Affiliation(s)
- Hari Joshi
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bhoj Raj Kalauni
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Kiran Bhusal
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Rabindra Bhandari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Aastha Subedi
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Buna Bhandari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States of America
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Bindhu S, Nattam A, Xu C, Vithala T, Grant T, Dariotis JK, Liu H, Wu DTY. Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review. Online J Public Health Inform 2024; 16:e50898. [PMID: 38506914 PMCID: PMC10993137 DOI: 10.2196/50898] [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: 07/17/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Health literacy (HL) is the ability to make informed decisions using health information. As health data and information availability increase due to online clinic notes and patient portals, it is important to understand how HL relates to social determinants of health (SDoH) and the place of informatics in mitigating disparities. OBJECTIVE This systematic literature review aims to examine the role of HL in interactions with SDoH and to identify feasible HL-based interventions that address low patient understanding of health information to improve clinic note-sharing efficacy. METHODS The review examined 2 databases, Scopus and PubMed, for English-language articles relating to HL and SDoH. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine the roles of HL and interventions. RESULTS The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, the role of HL, and interventions. Most articles (n=23) noted that HL was a result of SDoH, but other articles noted that it could also be a mediator for SdoH (n=6) or a modifiable SdoH (n=14) itself. CONCLUSIONS The multivariable nature of HL indicates that it could form the basis for many interventions to combat low patient understandability, including 4 interventions using informatics-based solutions. HL is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving HL or addressing poor HL in patients can help increase comprehension of health information, including the information contained in clinic notes shared with patients.
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Affiliation(s)
- Shwetha Bindhu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Anunita Nattam
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Catherine Xu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Tripura Vithala
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Tiffany Grant
- University of Cincinnati Libraries Research and Data Services, University of Cincinnati, Cincinnati, OH, United States
| | - Jacinda K Dariotis
- Department of Human Development and Family Studies, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
- The Family Resiliency Center, College of Agricultural, Consumer and Environmental Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Biomedical and Translational Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Hexuan Liu
- School of Criminal Justice, University of Cincinnati, Cincinnati, OH, United States
| | - Danny T Y Wu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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Suzuki T, Mizuno A, Yasui H, Noma S, Ohmori T, Rewley J, Kawai F, Nakayama T, Kondo N, Tsukada YT. Scoping Review of Screening and Assessment Tools for Social Determinants of Health in the Field of Cardiovascular Disease. Circ J 2024; 88:390-407. [PMID: 38072415 DOI: 10.1253/circj.cj-23-0443] [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] [Indexed: 02/23/2024]
Abstract
BACKGROUND Despite the importance of implementing the concept of social determinants of health (SDOH) in the clinical practice of cardiovascular disease (CVD), the tools available to assess SDOH have not been systematically investigated. We conducted a scoping review for tools to assess SDOH and comprehensively evaluated how these tools could be applied in the field of CVD. METHODS AND RESULTS We conducted a systematic literature search of PubMed and Embase databases on July 25, 2023. Studies that evaluated an SDOH screening tool with CVD as an outcome or those that explicitly sampled or included participants based on their having CVD were eligible for inclusion. In addition, studies had to have focused on at least one SDOH domain defined by Healthy People 2030. After screening 1984 articles, 58 articles that evaluated 41 distinct screening tools were selected. Of the 58 articles, 39 (67.2%) targeted populations with CVD, whereas 16 (27.6%) evaluated CVD outcome in non-CVD populations. Three (5.2%) compared SDOH differences between CVD and non-CVD populations. Of 41 screening tools, 24 evaluated multiple SDOH domains and 17 evaluated only 1 domain. CONCLUSIONS Our review revealed recent interest in SDOH in the field of CVD, with many useful screening tools that can evaluate SDOH. Future studies are needed to clarify the importance of the intervention in SDOH regarding CVD.
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Affiliation(s)
- Takahiro Suzuki
- Department of Cardiovascular Medicine, St. Luke's International Hospital
| | - Atsushi Mizuno
- Department of Cardiovascular Medicine, St. Luke's International Hospital
- Leonard Davis Institute for Health Economics, University of Pennsylvania
| | - Haruyo Yasui
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Satsuki Noma
- Department of Cardiovascular Medicine, Nippon Medical School
| | | | - Jeffrey Rewley
- Leonard Davis Institute for Health Economics, University of Pennsylvania
- The MITRE Corporation
| | - Fujimi Kawai
- Department of Academic Resources, St. Luke's International University
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University
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Portela-Pino I, Hernaiz-Sanchez A, Lomba-Portela L. Evaluation of health literacy and its predictive formative factors among Spanish military personnel. MILITARY PSYCHOLOGY 2023:1-8. [PMID: 37921646 DOI: 10.1080/08995605.2023.2274755] [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: 03/09/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
Health literacy (HL) is an aspect that has been widely studied. However, in the military population there are hardly any studies on the influence of educational variables. Knowing the level of health literacy of military professionals is important as it has an impact on adequate health decision making, avoids the abuse of health services and makes it possible to ask for help when needed, especially in aspects related to mental health. The aim of this study was to measure the level of literacy, as well as its association with other training variables in a sample of military personnel. The study was carried out in 695 military personnel of the Spanish Army. A cross-sectional observational design was used, using a survey with the HLS-EU-Q47 scale. Among the results, it stands out that the level of health literacy of the military is high compared to the rest of the population. The results showed that the level of HL does not seem to be influenced by the level of languages, nor by the degree they hold, nor by experiences abroad. On the other hand, it was observed that the performance of professional internships and work in multidisciplinary teams, extracurricular training, does influence the level of HL, especially in the dimension related to health promotion. This fact seems to mean that the military have learned during these experiences to keep abreast of health-related issues, to understand, to value and to form a considered opinion on health-related information.
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Affiliation(s)
- Iago Portela-Pino
- Department of Health Sciences, Faculty of Health Sciences, Isabel I University, Burgos, Spain
| | | | - Lucía Lomba-Portela
- Department of Didactics, School Organisation and Research, University of Vigo, Vigo, Spain
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da Costa AC, da Conceição AP, Butcher HK, Butcher RDCGES. Factors that influence health literacy in patients with coronary artery disease. Rev Lat Am Enfermagem 2023; 31:e3878. [PMID: 36995856 PMCID: PMC10077861 DOI: 10.1590/1518-8345.6211.3878] [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: 05/02/2022] [Accepted: 11/06/2022] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. METHODS a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. RESULTS age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. CONCLUSION this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.
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Affiliation(s)
- Ana Caroline da Costa
- Faculdade Wenceslau Braz, Departamento de Enfermagem, Itajubá, MG, Brasil
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
| | - Ana Paula da Conceição
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Instituto Dante Pazzanese de Cardiologia, Departamento de Enfermagem, São Paulo, SP, Brasil
| | - Howard Karl Butcher
- Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, Florida, Estados Unidos da América
| | - Rita de Cassia Gengo e Silva Butcher
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, Florida, Estados Unidos da América
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Gheiasi SF, Cheraghi MA, Dastjerdi M, Navid H, Khoshavi M, Peyrovi H, Khachian A, Seylani K, Esmaeili M, Navab E. Experiences of Facilitators and Inhibitors to Treatment Adherence in Patients with Heart Failure. Clin Nurs Res 2023; 32:648-659. [PMID: 36788432 DOI: 10.1177/10547738221147402] [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: 02/16/2023]
Abstract
Treatment adherence is a fundamental aspect of heart failure (HF) management. This study aimed to explore the experiences of facilitators and inhibitors of treatment adherence in patients with HF. This descriptive qualitative study was conducted from May 2020 to June 2021. Participants including people with HF, their family caregivers and physicians, and nurses were selected purposefully, with the aim of obtaining sufficient information power. Semi-structured interviews were used to collect data. Data were analyzed using thematic analysis. Two main themes "the driving forces behind treatment adherence" and "the deterrent forces behind treatment adherence" emerged from the analysis. The first theme contained the following subthemes: "supportive family," "positive personality characteristics," and "having health literacy." The second theme consisted of "negligence," "psychological problems," "cultural, social, and economic problems," "physical limitations," and "lack of self-care management knowledge." Nurses can consider facilitators and inhibitors of treatment adherence in designing educational and care programs for patients with HF.
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7
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García-García D, Pérez-Rivas FJ. Health Literacy and Its Sociodemographic Predictors: A Cross-Sectional Study of a Population in Madrid (Spain). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11815. [PMID: 36142082 PMCID: PMC9517037 DOI: 10.3390/ijerph191811815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Health literacy enhances a population's self-care capacity and helps to reduce health inequalities. This work examines the health literacy of a population attending primary care services and explores its relationship with sociodemographic factors. METHODS This cross-sectional study, conducted at a healthcare center in the Madrid region (Spain), involved adult patients requiring primary care nursing services. One hundred and sixty-six participants were recruited via systematic random sampling. Health literacy was measured using the Health Literacy Questionnaire (HLQ). RESULTS The studied population showed higher health literacy scores for literacy dimensions 1 (feeling understood and supported by healthcare providers) and 4 (social support for health); the lowest scores were recorded for dimensions 5 (appraisal of health information) and 8 (ability to find good health information). People with a better perceived health status showed a higher level of health literacy. People over 65 years of age, those with an incomplete secondary education, and those who were unemployed returned lower scores for several literacy dimensions. CONCLUSIONS The results contribute to our understanding of the factors that influence health literacy. Identifying the areas in which patients show the poorest health literacy may help us comprehend their needs and better support them.
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Affiliation(s)
| | - Francisco Javier Pérez-Rivas
- Grupo de Investigación UCM “Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario”, Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud—RICAPPS—(RICORS), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain
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Gaalema DE, Savage PD, O'Neill S, Bolívar HA, Denkmann D, Priest JS, Khadanga S, Ades PA. The Association of Patient Educational Attainment With Cardiac Rehabilitation Adherence and Health Outcomes. J Cardiopulm Rehabil Prev 2022; 42:227-234. [PMID: 34840247 PMCID: PMC9127001 DOI: 10.1097/hcr.0000000000000646] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Participating in cardiac rehabilitation (CR) after a cardiac event provides many clinical benefits. Patients of lower socioeconomic status (SES) are less likely to attend CR. It is unclear whether they attain similar clinical benefits as patients with higher SES. This study examines how educational attainment (one measure of SES) predicts both adherence to and improvements during CR. METHODS This was a prospective observational study of 1407 patients enrolled between January 2016 and December 2019 in a CR program located in Burlington, VT. Years of education, smoking status (self-reported and objectively measured), depression symptom level (Patient Health Questionnaire), self-reported physical function (Medical Outcomes Survey), level of fitness (peak metabolic equivalent, peak oxygen uptake, and handgrip strength), and body composition (body mass index and waist circumference) were obtained at entry to, and for a subset (n = 917), at exit from CR. Associations of educational attainment with baseline characteristics were examined using Kruskal-Wallis or Pearson's χ 2 tests as appropriate. Associations of educational attainment with improvements during CR were examined using analysis of covariance or logistic regression as appropriate. RESULTS Educational attainment was significantly associated with most patient characteristics examined at intake and was a significant predictor of the number of CR sessions completed. Lower educational attainment was associated with less improvement in cardiorespiratory fitness, even when controlling for other variables. CONCLUSIONS Patients with lower SES attend fewer sessions of CR than their higher SES counterparts and may not attain the same level of benefit from attending. Programs need to increase attendance within this population and consider program modifications that further support behavioral changes during CR.
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Affiliation(s)
- Diann E Gaalema
- Larner College of Medicine at the University of Vermont, Burlington (Drs Gaalema, O'Neill, and Bolívar and Ms Denkmann); Department of Medicine, Division of Cardiology, University of Vermont Medical Center, Burlington (Mr Savage and Drs Khadanga and Ades); and Department of Biostatistics, University of Vermont, Burlington (Dr Priest)
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Valero-Chillerón MJ, Mena-Tudela D, Cervera-Gasch Á, González-Chordá VM, Soriano-Vidal FJ, Quesada JA, Castro-Sánchez E, Vila-Candel R. Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095411. [PMID: 35564807 PMCID: PMC9104596 DOI: 10.3390/ijerph19095411] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 01/27/2023]
Abstract
Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24−48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of “literacy in breastfeeding”, in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.
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Affiliation(s)
- María Jesús Valero-Chillerón
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
- Correspondence:
| | - Águeda Cervera-Gasch
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Víctor Manuel González-Chordá
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Department of Nursing, University of Alicante, 03080 Alicante, Spain
- Department of Obstetrics and Gynaecology, Hospital Luis Alcanyis, 46819 Xàtiva, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain;
| | - Enrique Castro-Sánchez
- Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance at Imperial College London, London W12 0NN, UK;
- College of Nursing, Midwifery and Healthcare, University of West London, Brentford TW8 9GA, UK
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Valencia, Spain
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Dev R, Raparelli V, Pilote L, Azizi Z, Kublickiene K, Kautzky-Willer A, Herrero MT, Norris CM. Cardiovascular health through a sex and gender lens in six South Asian countries: Findings from the WHO STEPS surveillance. J Glob Health 2022; 12:04020. [PMID: 35265330 PMCID: PMC8876159 DOI: 10.7189/jogh.12.04020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Sex and gender-based differences in cardiovascular health (CVH) has been explored in the context of high-income countries. However, these relationships have not been examined in low- and middle-income countries. The main aim of this study was to examine how sex and gender-related factors are associated with cardiovascular risk factors of people in South Asian countries. Methods We conducted a retrospective analysis of the World Health Organization’s “STEPwise approach to surveillance of risk factors for non-communicable disease” or “STEPS” from six South Asian countries, surveys conducted between 2014-2019. The main outcomes were CVH as measured by a composite measure of STEPS-HEART health index (smoking, physical activity, fruit and vegetable consumption, overweight/obesity, diabetes and hypertension), values ranging from 0 (worst) to 6 (best or ideal) and self-reported occurrence of cardiovascular disease (ie, heart attack and stroke). Multivariate linear and logistic regression models were performed. Multiple imputation with chained equations was performed. Results The final analytic sample consisted of 33 106 participants (57.5% females). The mean STEPS-HEART index score in the South Asian population was 3.43 [SD: 0.92]. Female sex (β: 0.05, 95% confidence interval (CI) = 0.01-0.08, P < 0.05) was significantly associated with better CVH compared to males. Being married (βmale = -0.30, 95% CI = -0.37, -0.23 vs βfemale = -0.23, 95% CI = -0.29, -0.17; P < 0.001) and having a household size ≥5 (βmale = -0.15, 95% CI = -0.24, -0.06 vs βfemale = -0.11, 95% CI = -0.16, -0.04; P < 0.01) were associated with poorer CVH, more so in males. Being married was also associated with high risk of CVD (ORmale = 2.54, 95% CI = 1.68-3.86, P < 0.001 vs ORfemale = 1.19, 95% CI = 0.84-1.68, P = 0.31), significant in males. Conclusions Among the South Asian population, being female may be advantageous in having an ideal CVH. However, gender-related factors such as marital status and large household size were associated with poorer CVH and greater risk of CVD, regardless of sex.
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Affiliation(s)
- Rubee Dev
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Valeria Raparelli
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Louise Pilote
- Research Institute of McGill University Health Centre, Division of Clinical Epidemiology McGill University, Montreal, Quebec, Canada
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Karolina Kublickiene
- Department of Clinical Science, Intervention & Technology (CLINTEC), Section for Renal Medicine, Karolinska Institute and Karolinska University hospital, Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, and Gender Institute, Iapura, Gars am Kamp, Austria
| | - Maria Trinidad Herrero
- Clinical & Experimental Neuroscience (NiCE-IMIB-IUIE), School of Medicine. University of Murcia, Murcia, Spain
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Tenani CF, Silva MF, Lino CM, de Sousa MDLR, Batista MJ. The role of health literacy as a factor associated with tooth loss. Rev Saude Publica 2021; 55:116. [PMID: 34932703 PMCID: PMC8664067 DOI: 10.11606/s1518-8787.2021055003506] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The objective was to analyze the role of health literacy (HL) as a factor associated with tooth loss among users of the Brazilian Health System with chronic non-communicable diseases. METHODS The cross-sectional analytical study was conducted with adult and elderly users chosen at ten Family Health Clinics in a draw in the town of Piracicaba, São Paulo State, Brazil. A questionnaire was applied with sociodemographic data (sex, age, skin color and education), behavioral data (brushing and flossing), determinants in health (type of dental health services and how often) and clinical data (pain). Mouth conditions were collected by intraoral examination of visible dental biofilm and community Pediodontal Index. The systemic clinical conditions (blood glucose, glycated hemoglobin and blood pressure) were extracted from the medical records. The explanatory variable was HL (low, medium and high), measured with the Health Literacy Scale (HLS-14). RESULTS The outcome was tooth loss measured by the index of decayed, missing and filled teeth. Logistic regression was performed using a conceptual model for HL (p < 0.05). For the 238 subjects, the mean age was 62.7 years (± 10.55). Tooth loss was associated with HL in regression models adjusted by type of dental service, dental frequency, and dental floss. In the final model, the factors associated with tooth loss are older age (OR = 1,12; 95%CI: 1,07-1,17), a lower education (OR = 3,43; 95%CI: 1,17-10,10), irregular use of dental floss (OR = 4,58; 95%CI: 1.75 in-7,31), irregular use of dental services (n = 2,60; 95% 1,32-5,12), periodontal pocket (> 4 mm) (n = 0,31; 95%CI: 0,01-0,08), having visible dental biofilm (OR = 7,23; 95%CI: 3,19-16,41) and a higher level of blood sugar (glucose) (n = 1,98; 95%CI: 1.00-3,92). CONCLUSIONS tooth loss was associated with HL when adjusted by health behaviors; when sociodemographic variables and clinical conditions were included, it was less significant. In the final model, behaviors, determinants in health and clinical conditions were risk indicators of tooth loss, showing the multifactorial nature of this phenomenon.
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Affiliation(s)
- Carla Fabiana Tenani
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaPrograma de Pós-Graduação em OdontologiaPiracicabaSão PauloBrasilUniversidade Estadual de Campinas. Faculdade de Odontologia de Piracicaba. Programa de Pós-Graduação em Odontologia. Piracicaba, São Paulo, Brasil
| | - Manoelito Ferreira Silva
- Universidade Estadual de Ponta GrossaFaculdade de OdontologiaDepartamento de OdontologiaPonta GrossaParanáBrasilUniversidade Estadual de Ponta Grossa. Faculdade de Odontologia. Departamento de Odontologia. Ponta Grossa, Paraná, Brasil
| | - Carolina Matteussi Lino
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaPrograma de Pós-Graduação em OdontologiaPiracicabaSão PauloBrasilUniversidade Estadual de Campinas. Faculdade de Odontologia de Piracicaba. Programa de Pós-Graduação em Odontologia. Piracicaba, São Paulo, Brasil
| | - Maria da Luz Rosário de Sousa
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Ciências da Saúde e Odontologia InfantiliracicabaSão PauloBrasilUniversidade Estadual de Campinas. Faculdade de Odontologia de Piracicaba. Departamento de Ciências da Saúde e Odontologia Infantil. iracicaba, São Paulo, Brasil
| | - Marília Jesus Batista
- Universidade Estadual de CampinasFaculdade de Odontologia de PiracicabaDepartamento de Ciências da Saúde e Odontologia InfantiliracicabaSão PauloBrasilUniversidade Estadual de Campinas. Faculdade de Odontologia de Piracicaba. Departamento de Ciências da Saúde e Odontologia Infantil. iracicaba, São Paulo, Brasil
- Faculdade de Medicina de JundiaíDepartamento de Saúde ColetivaJundiaíSão PauloBrasilFaculdade de Medicina de Jundiaí. Departamento de Saúde Coletiva. Jundiaí, São Paulo, Brasil
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12
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Taye BW, Valery PC, Liddle B, Woodward AJ, Sackey D, Williams S, Chang GKF, Clark PJ. Fitting Health Care to People: Understanding and Adapting to the Epidemiology and Health Literacy of People Affected by Viral Hepatitis from Culturally and Linguistically Diverse Migrant Backgrounds. J Immigr Minor Health 2021; 24:1196-1205. [PMID: 34787805 DOI: 10.1007/s10903-021-01305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
This study explored the epidemiology and health literacy of people affected by viral hepatitis (VH) from migrant culturally and linguistically diverse (CALD) backgrounds attending a community-based general practitioner and specialty hepatology shared-care (HEPREACH) clinic in Brisbane, Australia. Patient-reported data on health literacy and clinical information from adult patients (n = 66) of CALD background recruited from the liver clinic were analyzed. Health literacy was assessed using a 5-question, 12-point scale. Variance weighted multiple linear regression was used to identify factors associated with knowledge about VH. About three-quarters of patients (74.2%) were diagnosed with hepatitis B. The median knowledge score was 7.8 (interquartile range [IQR] 6‒9). One in five patients did not understand the infective nature of VH, 30.3% did not understand mother-to-child transmission risk, and 30-40% of patients thought activities such as kissing, sharing food or mosquito bites could spread VH. Only 6% of patients understood the risk of liver cancer and the need for regular screening. Higher educational level (secondary, β = 4.8, p < 0.0001 or tertiary, β = 8.1, p < 0.0001 vs. primary) was associated with better knowledge, and transition through a refugee camp (vs. not, β = - 1.2, p = 0.028) and country of diagnosis (overseas vs. Australia, β = - 1.9, p = 0.016) were associated with poorer knowledge. Country of origin, refugee status and opportunities for tertiary education impact patients' understanding of VH. Ensuring delivery of culturally appropriate care and education is critical to improve knowledge, reduce misconceptions to improve care and outcomes for VH in CALD migrant communities.
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Affiliation(s)
- Belaynew W Taye
- Faculty of Medicine, The University of Queensland, Brisbane, Australia. .,Mater Research Institute, Brisbane, Australia. .,QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | | | - Burglind Liddle
- Department of Gastroenterology and Hepatology, Mater Hospitals, Brisbane, Australia
| | - Aidan J Woodward
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Donata Sackey
- Mater Refugee Health and Mater-University of Queensland, Brisbane, Australia
| | | | | | - Paul J Clark
- Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Mater Research Institute, Brisbane, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Gastroenterology and Hepatology, Mater Hospitals, Brisbane, Australia
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13
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Cabellos-García AC, Martínez-Sabater A, Díaz-Herrera MÁ, Gea-Caballero V, Castro-Sánchez E. Health literacy of patients on oral anticoagulation treatment- individual and social determinants and effect on health and treatment outcomes. BMC Public Health 2021; 21:1363. [PMID: 34243749 PMCID: PMC8272331 DOI: 10.1186/s12889-021-11259-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 06/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background Assessment health literacy in people with cardiovascular health problems would facilitate the development of appropriate health strategies for the care and reduction of complications associated with oral anticoagulation therapy. Aim: To evaluate the relationship between health literacy and health and treatment outcomes (concordance with oral anticoagulants, Normalized Ratio control and occurrence of complications) in patients with cardiovascular pathology. Methods Observational, analytic and cross-sectional study carried out on 252 patients with cardiovascular pathology (atrial fibrillation, flutter or valve prosthesis), aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. Variables referring to anticoagulant treatment with vitamin K antagonists (years of treatment, adequate control, polypharmacy and occurrence of complications, among others) and health literacy (Health Literacy Questionnaire) were analysed. Results All dimensions of health literacy were significantly related to the level of education (p < 0.02), social class (p < 0.02), an adequate control of acenocoumarol (p < 0.001), frequentation of health services (p < 0.001), information by patients to health professionals about anticoagulant treatment (p < 0.03), emergency care visits (p < 0.001) and unscheduled hospital admissions (p < 0.001). Conclusion Health literacy has a relevant influence on the adequate self-management of anticoagulation treatment and the frequency of complications. The different dimensions that comprise health literacy play an important role, but the “social health support” dimension seems to be essential for such optimal self-management. Trial registration ACC-ACE-2016-01. Registration date: December 2015.
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Affiliation(s)
- Ana Cristina Cabellos-García
- Hospital Universitario y politécnico La Fe, Valencia, Spain.,Health Research Institut La Fe, Research Group GREIACC, Valencia, Spain
| | - Antonio Martínez-Sabater
- Nursing Department, Universitat de València, Valencia, Spain. .,Facultat d'Infermeria i Podologia. Nursing Care and Education Research Group. (GRIECE). Grupo Investigación en Cuidados (INCLIVA), Hospital Clínico Universitario, Valencia, Spain.
| | - Miguel Ángel Díaz-Herrera
- Direcció d'Atenció Primaria Costa Ponent, Institut Català de la Salut, Avinguda de la Gran via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.,Unitat de Suport a la Recerca Costa de Ponent, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08940, Cornellà de Llobregat, Spain
| | - Vicente Gea-Caballero
- Health Research Institut La Fe, Research Group GREIACC, Valencia, Spain.,Escuela de Enfermería La Fe, centre affiliated to Universitat de Valencia, Valencia, Spain
| | - Enrique Castro-Sánchez
- School of Health Sciences, University of London, London, UK.,National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK
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14
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Gąska I, Sygit K, Cipora E, Sygit M, Pacian A, Surmach M, Kaleta D, Rzeźnicki A. Assessment of the Health Behaviours and Value-Based Health Analysis of People Aged 50+ Who Were Hospitalized Due to Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084221. [PMID: 33923460 PMCID: PMC8074081 DOI: 10.3390/ijerph18084221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022]
Abstract
Introduction: The basic determinant of healthy behaviour—among other human behaviours—is the fact that it consistently affects health. Nowadays, health behaviour studies are considered to be an important method of measuring the health of a population. Objective: To assess the health behaviours and value-based health analysis of people aged 50+ who were hospitalized due to cardiovascular disease, depending on the selected descriptive variables. Materials and methods: The study was conducted between April 2018 and December 2018 among 411 subjects aged 50+ who were hospitalized due to cardiovascular disease at the Independent Public Health Care Unit in Sanok (Podkarpackie voivodship in Poland). The method used in the study was a diagnostic survey. The study used the authors’ survey questionnaire and two standardized tests: Inventory of Health-Related Behaviour (IHB) and List of Health Criteria (LHC). A statistical analysis was carried out in the R program, version 3.5.1. The obtained results were subjected to thorough statistical analysis using the following tests: Student’s t, Mann–Whitney U, ANOVA, Kruskal–Wallis, Fisher’s Least Significant Difference (LSD), Pearson, and Spearman. Results: The strongest correlation between health status and health behaviours (according to the IHB questionnaire) was in the area of ‘health practices’, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. Based on the LHC questionnaire, the most important health criteria according to the subjects were ‘not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. A positive correlation was found in the group of respondents where the ‘preventive health behaviours’ were more intense; herein, the more important criterion for the respondents was ‘eating properly’. Conclusions: Respondents aged 50+ and hospitalized for cardiovascular diseases indicated (based on the IHB questionnaire) that health behaviours in the area of ‘health practices’ had the strongest correlation with their health, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. According to the respondents, the most important criteria determining health (according to the LHC questionnaire) included ’not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. Based on the information collected from the respondents, it was found that the most important criteria determining health depended on selected descriptive variables, such as age, gender, place of residence, education, and marital status.
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Affiliation(s)
- Izabela Gąska
- Medical Institute, Jan Godek State University in Sanok, 38-500 Sanok, Poland; (I.G.); (E.C.)
| | - Katarzyna Sygit
- Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland;
- Correspondence:
| | - Elżbieta Cipora
- Medical Institute, Jan Godek State University in Sanok, 38-500 Sanok, Poland; (I.G.); (E.C.)
| | - Marian Sygit
- Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland;
| | - Anna Pacian
- Department of Public Health, Faculty of Health Sciences, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Maryna Surmach
- Head of the Department of Public Health and Health Services, Grodno State Medical University, 230009 Grodno, Belarus;
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Medical University of Lodz, 90-647 Lodz, Poland;
| | - Adam Rzeźnicki
- Department of Social Medicine, Faculty of Health Sciences, Medical University of Lodz, 90-647 Lodz, Poland;
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Vulnerability of poorly literate adult consumers regarding over-the-counter drugs. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2020. [DOI: 10.1108/ijphm-09-2019-0062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose
This study aims at verifying the impact of literacy on over-the-counter (OTC) drug consumer vulnerability as evaluated by health literacy and label comprehension.
Design/methodology/approach
The item response theory (IRT) was used to estimate the health literacy of two groups and the two-way analysis of variance tests was used to test the hypotheses for the existence of mean differences between the two populations. The convenience sample involved 188 OTC consumers: 94 (50%) poorly literate and 94 (50%) university students/graduates.
Findings
University consumers/graduates have a level of health literacy and label comprehension that is superior to those presented by poor literate consumers. Also, age does not influence the level of health literacy by OTC drug users but has a significant impact on the understanding of OTC drug labels. Finally, the level of schooling and the “age group,” simultaneously, does not impact the understanding of OTC drug labels or health literacy.
Research limitations/implications
This study has added in the field of knowledge by investigating the behavior of poor literate consumers in Brazil, a developing country. The results may be relevant to Marketing professionals, especially those in the pharmaceutical industry, and to police makers, as they help identify the main problems faced by poorly literate consumers.
Practical implications
It is necessary to raise awareness of the dangers of self-medication and wrong use of medications, mainly focused on people with low literacy. As a suggestion, a simple glossary presented along with the label could provide explanations of scientific terms, thus increasing health literacy and reducing the vulnerability of the consumers.
Social implications
This study showed that when using common words such as gastritis to define a health problem, there is a higher degree of correctness. These results suggest the adoption of a more straightforward language and more precise explanations. By doing that, the pharmaceutical industry and policymakers will improve their social impact by increasing consumer power and taking care of the health of the most vulnerable population: the illiterate people.
Originality/value
This study contributes to the international literature, as it enhances and clarifies the knowledge about the customers’ power and vulnerability in developing countries. It fills a gap by evaluating label comprehension and heath literacy at the same time, giving an academic contribution for pharmaceutical consumers’ studies.
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Sentell T, Vamos S, Okan O. Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3010. [PMID: 32357457 PMCID: PMC7246523 DOI: 10.3390/ijerph17093010] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 01/06/2023]
Abstract
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.
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Affiliation(s)
- Tetine Sentell
- Office of Public Health Studies, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA
| | - Sandra Vamos
- School of Interdisciplinary Health Programs, Western Michigan University, Kalamazoo, MI 49008, USA
| | - Orkan Okan
- Interdisciplinary Center for Health Literacy Research, Bielefeld University, 33615 Bielefeld, Germany
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