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Junge T, Pihl GT, Bak CK, Skou ST. Co-designing municipal multimorbidity rehabilitation leveraging health literacy and social networks: Protocol for the CURIA study. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2024; 14:26335565241258353. [PMID: 38779357 PMCID: PMC11110505 DOI: 10.1177/26335565241258353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
Background Managing multimorbidity poses significant challenges for individuals, their families, and society due to issues with health information comprehension, communication with healthcare providers, and navigating the healthcare system. These challenges emphasise the critical need to prioritize individual and organisational health literacy. Multimorbidity is associated with a lack of social support for health; however, social networks and community dynamics can enhance health literacy. The "Co-designing municipal rehabilitation" (CURIA) project targets enhancing individual and organisational health literacy, and social networks for individuals with multimorbidity, with the overall aim of addressing health inequity through a collaborative local co-design process involving stakeholders. Methods The CURIA study employs a mixed-method approach that initially explores the health literacy experiences of individuals with multimorbidity participating in rehabilitation programs in selected Danish municipalities and the practices of professionals overseeing these programs. The subsequent co-design process will comprise individuals with multimorbidity, their relatives, municipalities, general practitioners, civil society, and knowledge institutions working together. This iterative and collaborative process involves tailoring and aligning health literacy needs with responsiveness within the context of local healthcare systems and developing supportive social networks. Discussion Given the increasing burden of multimorbidity, there is an urgent need to develop evidence-based practice for multimorbidity rehabilitation practices, developed in collaboration with municipalities and civil society. Emphasising self-care support for individuals, managing complex rehabilitation needs, and involving individuals in intervention prioritisation and customisation are crucial aspects addressed by CURIA to enhance health literacy and align municipal rehabilitation with identified needs.
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Affiliation(s)
- Tina Junge
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Gitte Thybo Pihl
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Carsten Kronborg Bak
- Department of Social Work, University College of Southern Denmark, Esbjerg, Denmark
| | - Søren Thorgaard Skou
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
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Klinger J, Berens EM, Schaeffer D. Health literacy and the role of social support in different age groups: results of a German cross-sectional survey. BMC Public Health 2023; 23:2259. [PMID: 37974154 PMCID: PMC10652531 DOI: 10.1186/s12889-023-17145-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Scholars demand more focus on context-related factors of health literacy as the management of health information is seen as a social practice. One prominent factor is social support that is expected to be particularly relevant for persons vulnerable for low health literacy. It was shown that health literacy can differ across the life span and especially older people have been demonstrated to be vulnerable for low health literacy. Therefore, health literacy and the relation of social support on health literacy in different age groups should be investigated. METHODS In a German nationwide survey 2,151 adults were interviewed face-to-face. General comprehensive health literacy was measured with the HLS19-Q47 which differentiates single steps of health information management - access, understand, appraise, and apply. Social support was measured with the Oslo 3 Social Support Scale. Bivariate and multivariate analyses were performed for all respondents and for five age groups. RESULTS Health literacy is relatively low in all age groups but particularly low among old-old people (76 + years). Also, the youngest adults (18-29 years) have slightly lower health literacy than middle-aged adults. On average, health literacy is higher among people with higher social support but this association varies between age groups. It tends to be quite strong among younger adults (18-45 years) and young-old persons (65-75 years) but is weak among older middle-aged (46-64 years) and old-old persons. The association also differs between steps of information management. It is stronger for accessing and applying information but there are differences in age groups as well. CONCLUSIONS Social support is a relevant aspect to improve individuals' health literacy and therefore should be addressed in interventions. However, it is necessary to differentiate between age groups. While both young adults and particularly old-old persons are challenged by health information management, young adults can strongly profit from social support whereas it can barely compensate the low health literacy of old-old persons. In addition, different challenges in information management steps in different age groups need to be considered when designing health literacy interventions. Thus, target group specific services and programs are needed.
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Affiliation(s)
- Julia Klinger
- Institute of Sociology and Social Psychology, University of Cologne, 50931, Cologne, Germany
| | - Eva-Maria Berens
- Ethics Committee, Bielefeld University, 33501, Bielefeld, Germany
| | - Doris Schaeffer
- School of Public Health, Bielefeld University, 33501, Bielefeld, Germany.
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Luo Y, Zhao H, Chen H, Xiao M. Association between cultural capital and health literacy during the COVID-19 pandemic among community residents in China: the mediating effect of social capital. Front Public Health 2023; 11:1199941. [PMID: 38026294 PMCID: PMC10647931 DOI: 10.3389/fpubh.2023.1199941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Health literacy is crucial for managing pandemics such as COVID-19 and maintaining the health of the population; our goal was to investigate the impact of cultural capital on health literacy during the COVID-19 pandemic among community residents and to further examine the mediating role of social capital in the relationship between cultural capital and health literacy. Methods A cross-sectional study was conducted among 1,600 community residents selected in Chongqing, China using a stratified random sampling method. Data were gathered through a questionnaire survey, including sociodemographic characteristics, cultural capital, social capital, and health literacy. Chi-square analysis, one-way ANOVA, t-test, and hierarchical linear regression were used to analyze the level of health literacy among community residents and the related elements; the structural equation model (SEM) was used to explore the influential mechanisms of health literacy and explore whether social capital acted as a mediator in the relationship between cultural capital and health literacy. Results Cultural capital, community participation, community trust, reciprocity, and cognitive social capital had a significant positive effect on health literacy. In addition, the results of SEM indicated that cultural capital not only directly influences health literacy (β = 0.383, 95% CI = 0.265-0.648), but also indirectly influences health literacy through three types of social capital (β = 0.175, 95% CI = 0.117-0.465; β = 0.191, 95% CI = 0.111-0.406; β = 0.028, 95% CI = 0.031-0.174); its mediating effect accounting for 50.7% of the overall effect. Conclusions Our results highlight the empirical link between cultural capital and health literacy, and suggest that social capital mediates this connection. These findings suggest that governments and communities should focus on the construction of community cultural capital and provide residents with better social capital to improve their health literacy to prepare for future pandemics.
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Affiliation(s)
| | | | | | - Mimi Xiao
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
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4
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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.
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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
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Upreti R, Saiki K, Abrams MA, Jones A, Melendez K, Chevrolet J, Pennington H, Leadingham A, Martin D, Sentell T. Building Community Health Literacy to Achieve Health Equity: Insights from Ethiopian Tewahedo Social Services Community Leader in a County-Level Health Literacy Initiative. Health Equity 2023; 7:592-597. [PMID: 37731788 PMCID: PMC10507930 DOI: 10.1089/heq.2023.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 09/22/2023] Open
Abstract
This perspectives article shares insights from a county-level project in Franklin County, Ohio, to build collective organizational health literacy (HL) capacity across new sustainable networks to advance community-level HL. We provide an overview of the initiative followed by specific insights from a cultural liaison, the article's first author, who works in a community-based organization. He shares his collectivist perspective in building HL capacity at the grassroots level toward community-level goals. A shift in focus from individual responsibility to collective impact represents an important mindset change for attaining HL and builds on community strengths and values toward health equity.
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Affiliation(s)
- Ram Upreti
- Ethiopian Tewahedo Social Services, Columbus, Ohio, USA
| | - Kara Saiki
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, Hawaii, USA
| | - Mary Ann Abrams
- Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | | | | | | | | | | | - Denise Martin
- Ethiopian Tewahedo Social Services, Columbus, Ohio, USA
| | - Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, Hawaii, USA
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Uemura K, Tsukasa K, Watanabe A, Okamoto H, Yamada M. Association between community-level health literacy and frailty in community-dwelling older adults. Aging Clin Exp Res 2023; 35:1253-1261. [PMID: 37087703 DOI: 10.1007/s40520-023-02405-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/31/2023] [Indexed: 04/24/2023]
Abstract
AIMS We aimed to investigate whether high community-level health literacy, beyond individual-level health literacy, is associated with a low prevalence of frailty among community-dwelling older adults. METHODS A large cross-sectional questionnaire survey was conducted among citizens in Maizuru City, Kyoto, Japan, aged 65 years or older who were not certified as "support" or "care" level according to Japan's public long-term care insurance system, who could perform basic activities of daily living, and who did not have dementia or Parkinson's disease. Frailty status was assessed using the Kihon Checklist, with a score ≥ 8 indicating frailty. Health literacy was assessed using the Communicative and Critical Health Literacy Scale. The mean health literacy score of 20 school districts was used as the community-level health literacy index. We investigated demographic data and other potential confounding factors, including education, living arrangement, body mass index, comorbidity, smoking status, depressive symptoms, social networks, and community-level covariates. RESULTS The primary analysis included 6230 individuals (mean age = 74.3 years [SD = 6.1]). In each school district, the prevalence of frailty was 21.2-34.2% (mean: 26.2%), and community-level health literacy index was 3.1-3.5 (mean: 3.4). Multilevel logistic regression model including school district as random effect showed that the community-level health literacy was significantly associated with frailty (odds ratio [95% confidence interval] = 0.28 [0.08 to 0.96]) after adjusting for the covariates. CONCLUSIONS Not only high individual-level health literacy but also high community-level health literacy is associated with a low prevalence of frailty in community-dwelling older adults.
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Affiliation(s)
- Kazuki Uemura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-City, Osaka, 583-8555, Japan.
| | - Kamitani Tsukasa
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Atsuya Watanabe
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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Agner J, Meyer M, Kaukau TM, Liu M, Nakamura L, Botero A, Sentell T. Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai'i. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:837. [PMID: 36613158 PMCID: PMC9820034 DOI: 10.3390/ijerph20010837] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Health literacy is the ability to obtain and utilize health information to make health-related decisions and to navigate health systems. Although health literacy has traditionally been understood as an individual-level construct, current research is revealing the impact that social networks can have on health literacy. To date, no studies have examined associations between health literacy and social networks among people with serious mental illness (PWSMI), who are at high risk of physical illness and premature mortality. To begin to fill this gap, this study explores associations between health literacy, relationships with health discussion partners, and self-reported health outcomes in a racially diverse sample of Clubhouse members in Hawai'i. Clubhouses are community mental health centers that promote recovery from mental illness through destigmatization, meaningful activity, and strong social relationships. Health literacy was assessed using two single-item screeners (SILS). In a sample of 163 members, 56.2% reported adequate ability to understand health-related instructions or pamphlets, and 43.3% reported adequate confidence filling out medical forms independently. This is consistent with other health literacy studies with PWSMI in the United States, and indicates lower health literacy within this group than is reported in national averages. Multivariate logistic regression revealed a larger Clubhouse staff social network and completing high school were significantly associated with requiring less help to read materials. Higher age, male gender, and being Native Hawaiian and/or Pacific Islander were associated with less confidence filling out medical forms, while higher self-efficacy was associated with higher confidence filling out medical forms. This study provides preliminary evidence that relationships fostered within Clubhouses are associated with health literacy among PWSMI, and highlights the need for more research to examine how social networks and health literacy interventions can be leveraged in community mental health settings to improve health outcomes within this vulnerable population.
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Affiliation(s)
- Joy Agner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA
| | - Monet Meyer
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | | | - Maileen Liu
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Lisa Nakamura
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Adriana Botero
- Hawai‘i School of Professional Psychology, Chaminade University of Honolulu, Honolulu, HI 96816, USA
| | - Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
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Achstetter K, Köppen J, Haltaufderheide M, Hengel P, Blümel M, Busse R. Health Literacy of People with Substitutive Private Health Insurance in Germany and Their Assessment of the Health System Performance According to Health Literacy Levels: Results from a Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16711. [PMID: 36554592 PMCID: PMC9778886 DOI: 10.3390/ijerph192416711] [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: 10/31/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Health literacy (HL) is a competence to find, understand, appraise, and apply health information and is necessary to maneuver the health system successfully. People with low HL are, e.g., under the risk of poor quality and safety of care. Previous research has shown that low HL is more prevalent among, e.g., people with lower social status, lower educational level, and among the elderly. In Germany, people with substitutive private health insurance (PHI) account for 11% of the population and tend to have a higher level of education and social status, but in-detail assessments of their HL are missing so far. Therefore, this study aimed to investigate the HL of PHI insureds in Germany, and to analyze their assessment of the health system according to their HL level. In 2018, 20,000 PHI insureds were invited to participate in a survey, which contained the HLS-EU-Q16, and items covering patient characteristics and the World Health Organization health systems framework goals (e.g., access, quality, safety, responsiveness). Low HL was found for 46.2% of respondents and was more prevalent, e.g., among men and insureds with a low subjective social status. The health system performance was perceived poorer by respondents with low HL. Future initiatives to strengthen health systems should focus on promoting HL.
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Affiliation(s)
- Katharina Achstetter
- Department of Health Care Management and Berlin Centre for Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany
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9
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Vetter NS, Ilskens K, Seidl N, Latteck ÄD, Bruland D. Health Literacy of People with Intellectual Disabilities: How Meaningful Is the Social Context for a Target Group-Oriented Model of Health Literacy? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316052. [PMID: 36498123 PMCID: PMC9741347 DOI: 10.3390/ijerph192316052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 06/01/2023]
Abstract
Health literacy is primarily understood as an individual construct. People with intellectual disabilities still seem to be a "hidden" population in health literacy research. A target-orientated health literacy approach for this population is needed for developing precise and effective interventions that consider social context dimensions. Therefore, the following research question was answered: Which dimensions influence the health literacy of people with intellectual disabilities? A secondary data analysis containing 38 guided interviews with people with mild to moderate intellectual disabilities was conducted. The analysis followed the content analysis by Schreier (2012). Six main dimensions were inductively outlined, which are "interpersonal relationship", "organizations and communities", "healthcare system", "education", "digital interaction spaces", "politics", and "cultural contexts". All these dimensions influence people with intellectual disabilities on an individual level regarding their level of health literacy. The importance of these single dimensions becomes clear, although for now, the link between all these dimensions is not yet considered. In future research, the focus should be on how to develop interventions considering social context dimensions. Furthermore, analyzing the connection between those dimensions seems promising.
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Li C, Liu M, Zhou J, Zhang M, Liu H, Wu Y, Li H, Leeson GW, Deng T. Do Health Information Sources Influence Health Literacy among Older Adults: A Cross-Sectional Study in the Urban Areas of Western China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13106. [PMID: 36293683 PMCID: PMC9602478 DOI: 10.3390/ijerph192013106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/25/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Previous studies have found that the dissemination pattern and delivery mechanism of information can provide crucial resources and empowerment for individuals to the promotion of health literacy. The present study investigates how health information sources are associated with health literacy among older adults in west China, and tries to explain the mechanisms underlying the link between health information sources and health literacy in the Chinese context. METHODS The cross-sectional study employed a representative sample of 812 urban citizens aged 60 and older in 2017 in Western China. RESULTS We found that health information sources including healthcare practitioners (B = 4.577, p < 0.001), neighbors (B = 2.545, p < 0.05), newspapers (B = 4.280, p < 0.001), and television (B = 4.638, p < 0.001) were positively associated with health literacy. Additionally, age (B = -1.781, p < 0.001) was negatively associated with health literacy, and the socio-economic status factors including minority (B = -10.005, p < 0.001), financial strain status of perceived very difficult (B = -10.537, p < 0.001), primary school (B = 11.461, p < 0.001), junior high school (B = 18.016, p < 0.001), polytechnic school or senior high school (B = 21.905, p < 0.001), college and above (B = 23.433, p < 0.001) were significantly linked to health literacy, and suffering from chronic diseases (B = 3.430, p < 0.01) was also positively related to health literacy. CONCLUSIONS Health information sources including healthcare practitioners, neighbors, newspapers, and television have a strong influence on health literacy, which implies that the four main types of sources are the important patterns of health information dissemination in the reinforcement of health literacy. In addition, the present findings also indicate age, minority and disease differences in health literacy and confirm the influence of enabling factors including educational attainment and financial strain on health literacy. Based on these findings and their implications, specific evidence is presented for the reinforcement of health literacy in interpersonal and mass communication, and in the educational and financial settings in the Chinese context. The present results also suggest that the age-specific, minority-specific and disease-specific measures should be taken to promote health literacy among older adults.
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Affiliation(s)
- Chengbo Li
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
| | - Mengyao Liu
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
| | - Jin Zhou
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
| | - Mei Zhang
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
| | - Huanchang Liu
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
| | - Yuting Wu
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
| | - Hui Li
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
| | - George W. Leeson
- Oxford Institute of Population Ageing, University of Oxford, Oxford OX2 6PR, UK
| | - Tingting Deng
- School of Journalism and Communication, Chongqing University, Chongqing 400044, China
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Berens EM, Klinger J, Carol S, Schaeffer D. Differences in health literacy domains among migrants and their descendants in Germany. Front Public Health 2022; 10:988782. [PMID: 36211672 PMCID: PMC9541527 DOI: 10.3389/fpubh.2022.988782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/25/2022] [Indexed: 01/26/2023] Open
Abstract
Background Health literacy (HL) is considered to be an important precondition for health. HL research often identifies migrants as vulnerable for low HL. However, in-depth data on HL among migrants especially in its domains of health care, disease prevention and health promotion and its determinants are still scarce. Objective The aim of this study was therefore to analyse the current status of HL among migrants and their descendants from Turkey and from the former Soviet Union (FSU) in Germany and factors associated with it. This has not been studied using large-scale data and bilingual interviews. We differentiate between dimensions of HL, namely the domains of health care, disease prevention and health promotion which goes beyond many previous studies. In addition, we explore new mechanisms by testing the explanatory power of self-efficacy and interethnic contacts for migrants' HL. Methods The study includes 825 first- and second-generation adult migrants from two of the largest immigration groups in Germany, from Turkey and FSU, who were interviewed face-to-face in German, Turkish or Russian in late summer 2020. HL was measured using the HLS19-Q47 instrument. Age, gender, educational level, social status and financial deprivation, chronic illness, health-related literacy skills, self-efficacy, interethnic contacts, migration generation, duration of stay and region of origin were considered as possible determinants. Ordinary least square regressions were estimated. Results The average general HL score was 65.5. HL in health promotion and disease prevention was lower than in health care. Low financial deprivation, health-related literacy skills, and self-efficacy were positively correlated with each HL domain. Educational level, social status, age, gender, duration of stay and interethnic contacts were positively correlated with HL in some domains. Region of origin was only correlated with the domain of disease prevention until interethnic contact was accounted for. Conclusion Our study contributes to the existing knowledge by analyzing different domains of HL and testing its correlations with self-efficacy and interethnic contact among migrants. We reveal that migrants cannot generally be considered as vulnerable for low HL, as oftentimes outlined. There is a need for interventions e.g. to enhance the understanding of health information among subgroups with lower HL.
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Affiliation(s)
- Eva-Maria Berens
- Interdisc. Cen. for Health Literacy Research, Bielefeld University, Bielefeld, Germany
| | - Julia Klinger
- Interdisc. Cen. for Health Literacy Research, Bielefeld University, Bielefeld, Germany
- Institute for Sociology and Social Psychology, University of Cologne, Köln, Germany
| | - Sarah Carol
- School of Sociology, University College Dublin, Dublin, Ireland
| | - Doris Schaeffer
- Interdisc. Cen. for Health Literacy Research, Bielefeld University, Bielefeld, Germany
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Jenkins CL, Sykes S, Wills J. Public Libraries as Supportive Environments for Children's Development of Critical Health Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11896. [PMID: 36231198 PMCID: PMC9564910 DOI: 10.3390/ijerph191911896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/11/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Critical health literacy enables individuals to use cognitive and social resources for informed action on the wider determinants of health. Promoting critical health literacy early in the life-course may contribute to improved health outcomes in the long term, but children's opportunities to develop critical health literacy are limited and tend to be school-based. This study applies a settings-based approach to analyse the potential of public libraries in England to be supportive environments for children's development of critical health literacy. The study adopted institutional ethnography as a framework to explore the public library as an everyday setting for children. A children's advisory group informed the study design. Thirteen children and 19 public library staff and community stakeholders were interviewed. The study results indicated that the public library was not seen by children, staff, or community stakeholders as a setting for health. Its policies and structure purport to develop health literacy, but the political nature of critical health literacy was seen as outside its remit. A supersetting approach in which children's everyday settings work together is proposed and a conceptual model of the public library role is presented.
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Hoseini AS, Dehdari T, Solhi M, Janani L, Rahideh ST. Development of an Instrument to Measure Dietary Supplement Health Literacy. Health Lit Res Pract 2022; 6:e159-e166. [PMID: 35680121 PMCID: PMC9179037 DOI: 10.3928/24748307-20220523-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Health literacy is one of the important social determinants of health. Objective: The aim of this study was to develop an instrument to measure Dietary Supplement Health Literacy (DSHL) of Iranian women. Methods: In this psychometrics study, an initial nine-factor instrument was developed. Face validity and content validity of the instrument were evaluated. The factor structure of the instrument was explored by the Exploratory Factor Analysis (EFA) among 400 women taking Dietary supplement. Confirmatory Factor Analysis (CFA) was done to determine the underlying factor structure of the instrument in this population. The internal and external reliability of the instrument was evaluated. Key Results: According to expert panel opinions, 16 items were deleted. The results of the EFA showed that the Kaiser-Meyer-Olkin and Bartlett's test of sphericity were significant. EFA showed that 30 items could be grouped into nine factors that accounted for 60.84% of the variance. Since two items in the ability to actively engage with health care providers factor were loaded in factor 1, this factor was labeled Engaging in receiving informational supports from health care providers. In addition, one item of the dimension was loaded in factor 3. Given that the one item of factor 5 and 1 item of factor 6 were loaded in a new factor 9, this factor was labeled Applying information to decision-making. The CFA indicated that the nine-factor structure of the DSHL instrument had a poor fit. To modify indices, factor 9 with 2 items and 1 item of factor 6 were deleted. The Cronbach's alpha and intraclass correlation coefficient of the instrument were acceptable. Finally, a 27-item instrument with 8 dimensions was confirmed. Conclusions: The results of the study showed that the instrument developed was a valid tool for identifying the DSHL of Iranian women. [HLRP: Health Literacy Research and Practice. 2022;6(2):e159–e166.] Plain Language Summary: This study sought to develop and validate a multidimensional instrument to measure the health literacy of Iranian women about dietary supplements that was performed from July 2019 to May 2020 in Iran. Findings showed that the 30-item instrument developed in this study is a valid instrument to be used for identifying the health literacy of Iranian women about dietary supplements.
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Affiliation(s)
| | - Tahereh Dehdari
- Address correspondence to Tahereh Dehdari, PhD, Health Promotion Research Center, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran;
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Poureslami I, FitzGerald JM, Tregobov N, Goldstein RS, Lougheed MD, Gupta S. Health literacy in asthma and chronic obstructive pulmonary disease (COPD) care: a narrative review and future directions. Respir Res 2022; 23:361. [PMID: 36529734 PMCID: PMC9760543 DOI: 10.1186/s12931-022-02290-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Respiratory self-care places considerable demands on patients with chronic airways disease (AD), as they must obtain, understand and apply information required to follow their complex treatment plans. If clinical and lifestyle information overwhelms patients' HL capacities, it reduces their ability to self-manage. This review outlines important societal, individual, and healthcare system factors that influence disease management and outcomes among patients with asthma and chronic obstructive pulmonary disease (COPD)-the two most common ADs. For this review, we undertook a comprehensive literature search, conducted reference list searches from prior HL-related publications, and added insights from international researchers and scientists with an interest in HL. We identified methodological limitations in currently available HL measurement tools in respiratory care. We also summarized the issues contributing to low HL and system-level cultural incompetency that continue to be under-recognized in AD management and contribute to suboptimal patient outcomes. Given that impaired HL is not commonly recognized as an important factor in AD care, we propose a three-level patient-centered model (strategies) designed to integrate HL considerations, with the goal of enabling health systems to enhance service delivery to meet the needs of all AD patients.
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Affiliation(s)
- Iraj Poureslami
- grid.417243.70000 0004 0384 4428Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, 716-828 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada ,Canadian Multicultural Health Promotion Society (CMHPS), Vancouver, BC Canada
| | - J. Mark FitzGerald
- grid.417243.70000 0004 0384 4428Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, 716-828 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada
| | - Noah Tregobov
- grid.417243.70000 0004 0384 4428Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, 716-828 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, Vancouver-Fraser Medical Program, University of British Columbia, Vancouver, BC Canada
| | - Roger S. Goldstein
- grid.17063.330000 0001 2157 2938Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada ,Respiratory Medicine, Westpark Healthcare Centre, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - M. Diane Lougheed
- grid.410356.50000 0004 1936 8331Asthma Research Unit, Department of Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston, ON Canada ,grid.418647.80000 0000 8849 1617Institute for Clinical Evaluative Sciences, Toronto, ON Canada
| | - Samir Gupta
- grid.415502.7Unity Health, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON Canada
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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: 11] [Impact Index Per Article: 3.7] [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.
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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
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Bíró É, Vincze F, Mátyás G, Kósa K. Recursive Path Model for Health Literacy: The Effect of Social Support and Geographical Residence. Front Public Health 2021; 9:724995. [PMID: 34650950 PMCID: PMC8506042 DOI: 10.3389/fpubh.2021.724995] [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: 06/14/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The public health relevance of health literacy is highlighted by the fact that its higher levels can improve health outcomes and reduce health inequities. In order to design effective interventions for improving health literacy, the relationship between health literacy and other factors such as sociodemographic variables, subjective health and social support must be understood. Objective: Our aim was to test a socioecological model of the determinants of health literacy with a special focus on the effect of residence. Our study investigated geographical differences regarding the levels of health literacy and its determinants as this was not investigated before in European nationwide surveys. Methods: Data was collected by a polling company in a sample (n = 1,200) of the Hungarian adult population nationally representative by age, gender, and permanent residence in 2019 January. The questionnaire included items on sociodemographic data, subjective well-being, social support, and two health literacy scales. A recursive path model was used to outline the mediating effect of social support between sociodemographic variables and health literacy where both direct and indirect effects of the explanatory variables and multiple relationships among the variables were analyzed simultaneously. Multiple-group analysis was applied to the three pre-set categories of permanent residence (capital city, urban and rural). Results: There was no statistically significant difference by residence regarding levels of health literacy. Social support and educational attainment were the most important determinants of health literacy after adjusting for the effect of other sociodemographic variables. However, the magnitude of effect of social support and educational attainment is different between types of settlements, the strongest being in rural areas. Conclusion: Social support seems to mediate the effect of socioeconomic position on health literacy which could be taken into account when designing interventions to improve health literacy, especially in rural areas. Further studies would be needed especially in rural communities to see whether improvement of social support could be utilized in projects to increase the level of health literacy.
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Affiliation(s)
- Éva Bíró
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gabriella Mátyás
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Karolina Kósa
- Department of Behavioral Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Carl J, Grüne E, Pfeifer K. What About the Environment? How the Physical Activity-Related Health Competence Model Can Benefit From Health Literacy Research. Front Public Health 2021; 9:635443. [PMID: 33937169 PMCID: PMC8086962 DOI: 10.3389/fpubh.2021.635443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/25/2021] [Indexed: 11/22/2022] Open
Abstract
Research cultivates a multitude of frameworks, models, and theories with different determinants internal and/or external to the individual contributing to the understanding and explaining of physical activity levels. The physical activity–related health competence (PAHCO) model can be located at the interface between research of health literacy and physical activity. Because of its primary person orientation, however, the model has not yet undergone discussions on the relevance of the environment. Encouraged by the developments in the area of health literacy, the goal of the present perspective article was to stimulate some initial reflections on potential solutions for the competence–environment relationship within the PAHCO model. We extracted three potential solutions for this issue. Dubbed the solution of integration, we first discussed that the PAHCO model could be placed into overarching, more holistic, and abstract models of health-enhancing physical activity, such as the capability approach or the socioecological model. Applying a solution of elaboration, researchers could second substantiate existing components of the PAHCO model, such as control competence or self-regulation competence, by further explanations. Characterizing the solution of extension, it would third be possible to introduce (a) separate competence component(s) that highlight(s) the manageability of the environment, for instance, by establishing a (socio)ecological competence. The article concludes with a short overview of potential empirical approaches, given their potential to assist researchers in identifying preferences for the theoretical advancement and to put the development on a stronger evidence base.
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Affiliation(s)
- Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Eva Grüne
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Pinheiro P. Conceptualizations of Health Literacy: Past Developments, Current Trends, and Possible Ways Forward Toward Social Practice. Health Lit Res Pract 2021; 5:e91-e95. [PMID: 34213999 PMCID: PMC8082953 DOI: 10.3928/24748307-20210316-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/14/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Paulo Pinheiro
- Address correspondence to Paulo Pinheiro, MD, Bielefeld University, PO Box 10 01 31, 33501 Bielefeld, Germany;
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Knowledge of prescribed drugs among primary care patients: findings from Prover Project. Int J Clin Pharm 2021; 43:1265-1273. [PMID: 33713008 DOI: 10.1007/s11096-021-01246-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Abstract
Background Evidence on patient medication knowledge and associated factors within primary care patients is limited, especially in developing countries. Objective To estimate the prevalence and investigate the role of individual and contextual factors on insufficient medication knowledge among primary care patients. Setting Public community pharmacies in a health pole city (234,937 inhab.) in Minas Gerais State, Brazil. Methods Exit-survey conducted with a representative sample of 1221 patients (≥ 18 years) interviewed after dispensing. Data collected for medicines included its name, therapeutic indication, dosage, time of administration, treatment duration, side effects and warnings. Information were compared to the prescription and official guidelines. Descriptive statistics and logistic regression analysis were applied. Main outcome measure Insufficient patient medication knowledge. Results Prevalence of insufficient medication knowledge was 30.1%. Side effects (96.3%) and warnings (71.1%) had the highest percentage of misses. Musculoskeletal system drugs presented the lowest knowledge score (mean = 5.9; SD = 1.9). Significant determinants of insufficient medication knowledge with respective odds ratio (OR) were: level of education (≤ 3 years, OR 1.50; 95% CI 1.06-2.11 and 4-7 years, OR 1.37; 95% CI 1.02-1.84), number of comorbidities (≤ 2, OR 1.36; 95% CI 1.04-1.77), use of prescription drugs in the last 15 days (no, OR 2.22; 95% CI 1.31-3.76) and number of people able to lend money (no person, OR 1.34; 95% CI 1.04-1.74). Conclusion Counselling and monitoring practices should be tailored to patients with less schooling, that are initiating treatment and with low disease burden. Equally important is the need to implement strategies to increase the patient's level of social capital to improve treatment knowledge.
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"Was Test Designed for Africans?" Health Literacy and African Immigrants. J Racial Ethn Health Disparities 2021; 9:315-324. [PMID: 33428160 DOI: 10.1007/s40615-020-00959-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Immigrants experience barriers to accessing and utilizing health care. Language and cultural differences regarding health and healing impact use of health care. Limited health literacy is associated with decreased preventive health services and is reported among immigrant groups in the USA, but the health literacy of African immigrants is not known. OBJECTIVE Assess health literacy, its association with engagement in primary care and select sociodemographic variables, and the use of two health literacy measures with African immigrants. METHODS We conducted a community-based participatory research cross-sectional survey among African immigrants in Massachusetts. Participants completed the Newest Vital Sign, the Health Literacy Skills Instrument, acceptability questionnaires, and a Health Survey. We observed and recorded comments and questions as participants completed the surveys. KEY RESULTS Out of 75 participants, 60% have limited health literacy. Over 80% are connected to a health care system and comfortable speaking with their doctor/nurse. Education, English proficiency, country of origin, and access to health care are associated with health literacy. Participants found the measures easy to understand but difficult to answer. Observation data revealed unfamiliarity with nutrition labels, cooking measurements, and navigation of internet links, and the need for clarification of select items. CONCLUSIONS Most African immigrants in this study have limited health literacy despite English proficiency, college education, employment, and connection to a health system. Further research is needed to determine the value of aligning the measurement of health literacy with the cultural-linguistic identities of the population being assessed versus the need to understand their health literacy within the dominant culture.
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Okan O, Rowlands G, Sykes S, Wills J. Shaping Alcohol Health Literacy: A Systematic Concept Analysis and Review. Health Lit Res Pract 2020; 4:e3-e20. [PMID: 31935296 PMCID: PMC6960007 DOI: 10.3928/24748307-20191104-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 03/18/2019] [Indexed: 11/20/2022] Open
Abstract
Background: This study uses an innovative methodology to understand the implications of applying the emerging concept of health literacy to other contexts using the example of alcohol. Methods: An evolutionary concept analysis combined with the principles and standards of the systematic review process enables a rigorous analysis of the conceptual representation of alcohol health literacy. Key Results: Alcohol health literacy includes a wide range of attributes that encompass many different health literacies beyond simply the capacity to understand alcohol-related harms and use that information in decision-making. Alcohol health literacy empowers people to understand alcohol marketing and messages and how alcohol information is distributed through social networks. It is an outcome of media-related alcohol education, and its consequences include health action skills and realistic expectancies of alcohol. Discussion: The focus on health literacy, which emphasizes not only individual skills but also draws attention to the social determinants of alcohol use and how alcohol health literacy is shaped by social networks and interactions, provides important lessons for alcohol health promotion interventions. Health literacy when applied to alcohol includes many different domains and the innovative method used here provides a framework to develop interventions that build health literacy in different contexts. [HLRP: Health Literacy Research and Practice. 2020;4(1):e3–e20.]
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Affiliation(s)
- Orkan Okan
- Address correspondence to Orkan Okan, Interdisciplinary Centre for Health Literacy Research, P.O. Box 10 01 31, Bielefeld University, D-33501 Bielefeld, Germany;
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Tian CY, Xu RH, Mo PKH, Dong D, Wong ELY. Generic Health Literacy Measurements for Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7768. [PMID: 33114157 PMCID: PMC7660647 DOI: 10.3390/ijerph17217768] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND Generic health literacy measurement (GHLM) is an important tool to identify individuals with limited health literacy and can assist the design of tailored interventions for improving public health literacy. However, there is no consensus on measuring generic health literacy. The present study aims to review current GHLM used for adults in the literature. METHODS A scoping review was undertaken to map the available measurements designed to assess generic health literacy. RESULTS The review identified 19 GHLM for adults. Most of them applied a multidimensional definition of health literacy with a focus on individuals' abilities to access, appraise, understand, and apply health information and services. Nutbeam's conceptual model and Sørensen's integrated model were widely used among the identified measures as the theoretical foundation. While the social determinants of health (SDH) were acknowledged in the two models, it remains unmentioned in many of the identified measures based on the Nutbeam's model and needs further development in the measure based on the Sørensen's model. A total of 39 different domains were assessed in the 19 measurements: prose was identified in 8 measurements and was the most prominent domain; followed by numeracy (n = 7) and interactive (n = 7). SDH related domains such as social support (n = 3), social capital (n = 1) were seldom included in the identified measurements. CONCLUSIONS Although current GHLM adopted a multidimensional construct, they mainly focused on individuals' abilities and SDH has not been well-developed in the assessment. Further research is required to advance the measuring of the interaction between SDH and health literacy.
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Affiliation(s)
- Cindy Yue Tian
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
| | - Richard Huan Xu
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Phoenix Kit-Han Mo
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
| | - Dong Dong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Eliza Lai-Yi Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
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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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Sentell T, Agner J, Pitt R, Davis J, Guo M, McFarlane E. Considering Health Literacy, Health Decision Making, and Health Communication in the Social Networks of Vulnerable New Mothers in Hawai'i: A Pilot Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2356. [PMID: 32244326 PMCID: PMC7177506 DOI: 10.3390/ijerph17072356] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/22/2020] [Accepted: 03/26/2020] [Indexed: 12/04/2022]
Abstract
Health literacy is understudied in the context of social networks. Our pilot study goal was to consider this research gap among vulnerable, low-income mothers of minority ethnic background in the state of Hawai'i, USA. Recruitment followed a modified snowball sampling approach. First, we identified and interviewed seven mothers ("egos") in a state-sponsored home visiting program. We then sought to interview individuals whom each mother said was part of her health decision-making network ("first-level alters") and all individuals whom the first-level alters said were part of their health decision-making networks ("second-level alters"). Health literacy was self-reported using a validated item. A total of 18 people were interviewed, including all mothers (n = 7), 35% of the first-level alters (n = 7/20), and 36% of the second-level alters (n = 4/11). On average, the mothers made health decisions with 2.9 people (range: 1-6); partners/spouses and mothers/mothers-in-law were most common. One mother had low health literacy; her two first-level alters also had low health literacy. Across the full sample, the average number of people in individuals' health decision networks was 2.5 (range: 0-7); 39% of those interviewed had low health literacy. This can inform the design of future studies and successful interventions to improve health literacy.
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Affiliation(s)
- Tetine Sentell
- Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA; (R.P.); (E.M.)
| | - Joy Agner
- Community and Cultural Psychology Department, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA;
| | - Ruth Pitt
- Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA; (R.P.); (E.M.)
| | - James Davis
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI 96813, USA;
| | - Mary Guo
- School of Nursing and Dental Hygiene, University of Hawai‘i School of Nursing and Dental Hygiene, Honolulu, HI 96822, USA;
| | - Elizabeth McFarlane
- Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA; (R.P.); (E.M.)
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Gessler D, Juraskova I, Sansom‐Daly UM, Shepherd HL, Patterson P, Muscat DM. Clinician‐patient‐family decision‐making and health literacy in adolescents and young adults with cancer and their families: A systematic review of qualitative studies. Psychooncology 2019; 28:1408-1419. [DOI: 10.1002/pon.5110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Danielle Gessler
- School of PsychologyThe University of Sydney Sydney New South Wales Australia
- Centre for Medical Psychology and Evidence‐Based Decision‐Making (CeMPED)The University of Sydney Sydney New South Wales Australia
- Psycho‐Oncology Cooperative Research Group (PoCoG), School of PsychologyThe University of Sydney Sydney New South Wales Australia
| | - Ilona Juraskova
- School of PsychologyThe University of Sydney Sydney New South Wales Australia
- Centre for Medical Psychology and Evidence‐Based Decision‐Making (CeMPED)The University of Sydney Sydney New South Wales Australia
- Psycho‐Oncology Cooperative Research Group (PoCoG), School of PsychologyThe University of Sydney Sydney New South Wales Australia
| | - Ursula M. Sansom‐Daly
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's HealthUNSW Sydney Sydney New South Wales Australia
- Sydney Youth Cancer ServicePrince of Wales Hospital Randwick New South Wales Australia
| | - Heather L. Shepherd
- School of PsychologyThe University of Sydney Sydney New South Wales Australia
- Centre for Medical Psychology and Evidence‐Based Decision‐Making (CeMPED)The University of Sydney Sydney New South Wales Australia
- Psycho‐Oncology Cooperative Research Group (PoCoG), School of PsychologyThe University of Sydney Sydney New South Wales Australia
| | - Pandora Patterson
- Cancer Nursing Research UnitThe University of Sydney Sydney New South Wales Australia
- Research, Evaluation, and Social Policy Unit, CanTeen Australia Newtown New South Wales Australia
| | - Danielle Marie Muscat
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and HealthThe University of Sydney Sydney New South Wales Australia
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