Exploring health literacy categories among an Iranian adult sample: a latent class analysis

General and electronic health literacy are important factors engaging in healthy behaviors and maintaining good health. The present study explored demographic factors associated with general and electronic health literacy in the Iranian adult population. Via stratified cluster sampling, trained interviewers visited adult residents in Qazvin Province, Iran between January, and April 2022. The participants (N = 9775; mean age = 36.44 years; 6576 [67.3%] females) completed the Health Literacy Instrument for Adults (HELIA) assessing health literacy and the eHealth Literacy Scale (eHEALS) assessing electronic health literacy. Demographic data, including age, gender, educational level, marital status, and living location (city or rural), were collected. Latent class analysis (LCA) was used to classify the participants into different health literacy/electronic health literacy levels. The relationships between health literacy/electronic health literacy levels and demographic factors were examined using χ2 or analysis of variance. The LCA used HELIA scores to suggest five classes of health literacy and eHEALS scores to suggest three classes of electronic health literacy. For general and electronic health literacy, similar relationships were with demographic factors: females as compared with males had better general/electronic health literacy; younger people as compared with older people had better general/electronic health literacy; higher educational level was associated with better general/electronic health literacy; and city residents as compared with rural residents had better general/electronic health literacy. In conclusion, Iranian governmental agencies may wish to target on males, older adults, people with low educational level, and rural residents to improve their health literacy.

Sleep hygiene behaviours mediate the association between health/e-health literacy and mental wellbeing

BACKGROUND

Health literacy and e-health literacy are important factors helping people shape awareness of health behaviours in different aspects, including sleep hygiene behaviours. Good sleep hygiene behaviours promote sleep quality and are beneficial to overall mental wellbeing.

OBJECTIVE

We aimed to examine if sleep hygiene behaviours may mediate the association between health literacy/e-health literacy and mental wellbeing.

METHODS

Adult Iranian subjects (n = 9775; mean [SD] age = 36.44 [11.97] years; 67.3% females) completed the Health Literacy Instrument for Adults, eHealth Literacy Scale, three items on sleep hygiene behaviour that have been used in prior research and the Short Warwick Edinburgh Mental Wellbeing Scale. Data were then subjected to structural equation modelling (SEM) including 500 bootstrapping resampling to examine whether sleep hygiene is a mediator in the relationship between health literacy/e-health literacy and mental wellbeing.

FINDINGS

Both health literacy and e-health literacy were significantly associated with mental wellbeing (r = .63 for health literacy and .39 for e-health literacy; p < .001) and sleep hygiene behaviours (r = .58 for health literacy and .36 for e-health literacy; p < .001). Sleep hygiene behaviours were significantly associated with mental wellbeing (r = .42; p < .001). Moreover, SEM that incorporated bootstrapping approaches indicated that sleep hygiene behaviours were significant mediators in the association between health literacy/e-health literacy and mental wellbeing.

CONCLUSIONS

We conclude that health literacy and e-health literacy are associated with mental health wellbeing in the Iranian population. Additionally, the association could be mediated via sleep hygiene behaviours.

PATIENT OR PUBLIC CONTRIBUTION

The study was co-designed with healthcare providers from the vice-Chancellor's Office for Health Affairs of Qazvin University of Medical Sciences as equal partners. Moreover, the women's health volunteers were involved in the design of the study.

Large-scale dataset on health literacy, sleep hygiene behaviors, and mental well-being in the general population of Qazvin, Iran

The collected data included socio-demographic information and measurements of health literacy, e-health literacy, mental well-being, and sleep hygiene behaviors. The study aimed to provide insights regarding health literacy status and related factors in the general population residing in Qazvin province, Iran. The findings of the study will assist health authorities and policy makers in developing and implementing effective interventions, which in turn, improving health literacy in the community. Additionally, the findings can also aid health sector workers, including non-communicable disease researchers, public health experts, health education specialists, epidemiologists, and sociologists, in their work to improve health literacy and overall health outcomes among general population. Therefore, the present study used paper-pencil method with multi-stage cluster sampling to collect data. Trained research associates (n=25) collected data from 9775 people living in Qazvin province between January and April 2022. All the participants completed the study questionnaires using self-reported paper-pencil mode.

Oxidative degradation of sulfamethoxazole from secondary treated effluent by ferrate(VI): kinetics, by-products, degradation pathway and toxicity assessment

Sulfamethoxazole (SMX) is a typical antibiotic in the world, which is frequently detected in the aquatic environment. The current study was aimed to investigate the SMX degradation in secondary treated wastewater using potassium Ferrate [Fe(VI)]. The effects of various experimental conditions, EDTA and phosphate as chelating agents, and toxicity assessment were also considered. Secondary treated effluent was spiked with predefined SMX concentrations, and after desired reaction time with Fe(VI), residual SMX was measured using HPLC. Results indicated that SMX degradation by Fe(VI) was favored under acidic condition, where 90% of SMX degradation was achieved after 120 min. Fe(VI) and SMX reaction obeyed first-order kinetic; meantime, the SMX degradation rate under pH 3 was 7.6 times higher than pH 7. The presence of phosphate (Na₂HPO₄) and EDTA declined SMX degradation, while Fe (III) effect was contradictory. In addition to promising demolition, 10% TOC removal was achieved. Eighteen major intermediates were identified using LC-MS/MS and the degradation pathways were suggested. Transformation products (TPs) were formed due to hydroxylation, bond cleavage, transformation after bond cleavage, and oxidation reactions. The ECOSAR analysis showed that some of the SMX oxidation products were toxic to aquatic organisms (fish, daphnia and green algae).

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40201-021-00769-9.