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Gill S, Zeki R, Kaye S, Zingirlis P, Archer V, Lewandowski A, Creighton G, Shaw C, Bowman J. Health literacy strengths and challenges of people in New South Wales prisons: a cross-sectional survey using the Health Literacy Questionnaire (HLQ). BMC Public Health 2023; 23:1520. [PMID: 37563584 PMCID: PMC10413686 DOI: 10.1186/s12889-023-16464-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/06/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Health literacy is an important factor for enabling people to manage their health and live long fulfilling lives. People in prison are frequently from marginalised communities, often out of reach of conventional community based health organisations, and have poorer health outcomes. It is essential to understanding the health literacy profiles of people in prison, and its contribution to the well-established health inequities and outcomes of this population. This study aimed to use a multi-dimensional health literacy measurement tool to describe the strengths and challenges of adults incarcerated in NSW prisons. METHODS A cross-sectional survey was conducted for people in prison across 14 publicly operated metropolitan prisons. Data were collected from 471 participants using the Health Literacy Questionnaire (HLQ). Participant characteristics and health conditions were also collected. Data were analysed using descriptive statistics. Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between participant characteristic groups. RESULTS Participants' median age was 38.0 (range 19 - 91) years. Males comprised 81% of the sample, 21% identified as Aboriginal and/or Torres Strait Islander, and 53% reported a health problem. People in prison had lower scores for all nine HLQ scales when compared to the general Australian population. Small to medium ES were seen for mean differences between most demographic groups. Compared to males, females had lower scores for several of the HLQ scales including 'having sufficient information to manage health' (ES 0.30 [95% Confidence Interval (CI) 0.07, 0.53]), 'ability to actively engage with health care professionals' (ES 0.30 [95% CI 0.06, 0.53]), 'navigating the healthcare system' (ES 0.30 [95% CI 0.06, 0.53]), and, 'ability to find good health information' (ES 0.33 [95% CI 0.10, 0.57]). Differing health literacy scale scores with small to medium ES were found when comparing participants by legal status. Mainly small ES were seen when comparing other participant characteristic groups. CONCLUSIONS This study provides insights into the health literacy strengths and challenges for people in NSW prisons. These findings highlight the important role health literacy could have in addressing health disparities in this vulnerable population and can inform prison health services.
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Affiliation(s)
- Scott Gill
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia
| | - Reem Zeki
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Panayiota Zingirlis
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Australia
| | - Vicki Archer
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Amy Lewandowski
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Grantley Creighton
- Aboriginal Health, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Caron Shaw
- Adolescent Health, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Julia Bowman
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
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Delphine B, Mahthiam N, Stéphane B, Bonkana M, Ibrahim N, Ousmane K, Youssouf K, Ali S, Richard O, Mélanie H, Xavier D. Explorer la littératie en santé des personnes malades chroniques atteintes de diabète au Mali : adaptation culturelle et linguistique du « Health Literacy Questionnaire ». Glob Health Promot 2022; 29:17579759221081151. [PMID: 35491861 DOI: 10.1177/17579759221081151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Affiliation(s)
- Ballet Delphine
- PhD en sciences de l'éducation, INSPE/Université de La Réunion/Laboratoire Icare, Saint-Denis de La Réunion
| | | | | | - Maiga Bonkana
- Coordinateur local du projet HLQ - ONG Santé Diabète, Bamako, Mali
| | | | | | | | | | - Osborne Richard
- Professeur en santé publique, Swinburne University of Technology, Centre for Global Health and Equity, Hawthorn, Victoria, Australia
| | - Hawkins Mélanie
- Postdoctorante en santé publique, Swinburne University of Technology, Centre for Global Health and Equity, Hawthorn, Victoria, Australia
| | - Debussche Xavier
- Praticien hospitalier, endocrinologie, diabète, nutrition, Centre hospitalier universitaire de La Réunion, Saint-Denis Messag, Réunion
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Tilahun D, Abera A, Nemera G. Communicative health literacy in patients with non-communicable diseases in Ethiopia: a cross-sectional study. Trop Med Health 2021; 49:57. [PMID: 34256862 PMCID: PMC8276450 DOI: 10.1186/s41182-021-00345-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Health literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia. Methods A cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations. Result Descriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains. Conclusion The overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.
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Affiliation(s)
- Desalew Tilahun
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Abebe Abera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gugsa Nemera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Rademakers J, Waverijn G, Rijken M, Osborne R, Heijmans M. Towards a comprehensive, person-centred assessment of health literacy: translation, cultural adaptation and psychometric test of the Dutch Health Literacy Questionnaire. BMC Public Health 2020; 20:1850. [PMID: 33267834 PMCID: PMC7709439 DOI: 10.1186/s12889-020-09963-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/23/2020] [Indexed: 11/29/2022] Open
Abstract
Background Many health literacy instruments focus on reading skills, numeracy and/or information processing aspects only. In the Netherlands, as in other countries, the need for a comprehensive, person-centred measure of health literacy was observed and consequently the decision was made to translate the Health Literacy Questionnaire (HLQ) into Dutch. The HLQ has nine health literacy domains covering people’s experiences and skills. This research sought to translate, culturally adapt and psychometrically test the HLQ. Methods The translation and adaptation was done using a systematic approach with forward translation guided by item intents, blind back translation, and a consensus meeting with the developer. The Dutch version of the HLQ was applied in a sample of non-hospitalized, chronically ill patients. Descriptive statistics were generated to describe mean, standard deviation and floor and ceiling effects for all items. A Confirmatory Factor Analysis (CFA) model was fitted to the data. Scores on the nine domains of the HLQ were compared across demographic and illness characteristics as a form of known-groups validity. Psychometric analyses included Cronbach’s alpha, item-rest and item-remainder correlations. Results Using CFA, the Dutch HLQ psychometric structure was found to strongly align with the hypothesised (original) nine independent domains of the English version. The nine scales were found to be highly reliable (all scales had alpha between 0.83 and 0.94). Six of the nine HLQ-scales had items that show ceiling-effects. There were no ceiling effects present at the scale level. Scores on the scales of the HLQ differed according to demographic and illness characteristics: people who were older, lower educated and living alone and patients with multiple chronic diseases generally scored lower. Conclusions The Dutch version of the HLQ is a robust and reliable instrument that measures nine different domains of health literacy. The questionnaire was tested in a sample of chronically ill patients, and should be further tested in the general population as well as in different disease groups. The HLQ is a major addition to currently available instruments in the Netherlands, since it measures health literacy from a multi-dimensional perspective and builds on patients’ experiences and skills.
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Affiliation(s)
- Jany Rademakers
- Nivel, Netherlands Institute for Health Services Research, PO Box 1568, 3500, BN, Utrecht, The Netherlands. .,CAPHRI (Care and Public Health Research Institute), Department of Family Medicine, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Geeke Waverijn
- Nivel, Netherlands Institute for Health Services Research, PO Box 1568, 3500, BN, Utrecht, The Netherlands
| | - Mieke Rijken
- Nivel, Netherlands Institute for Health Services Research, PO Box 1568, 3500, BN, Utrecht, The Netherlands
| | - Richard Osborne
- Centre for Global Health and Equity, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Monique Heijmans
- Nivel, Netherlands Institute for Health Services Research, PO Box 1568, 3500, BN, Utrecht, The Netherlands
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Rajabi F, Pirdehghan A, Sanaie Z, Ghadirian L, Sayarifard A, Esna-Ashari F. Designing and Investigating the Validity and Reliability of the Health Literacy Questionnaire in Iran: Recognizing the Risk Factors for Cardiovascular Diseases, Diabetes, and Cancer. Int J Prev Med 2020; 11:110. [PMID: 33088438 PMCID: PMC7554550 DOI: 10.4103/ijpvm.ijpvm_280_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 04/09/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Health literacy (HL) has been recognized as an important concept in patient education and disease prevention. The rising burden of noncommunicable diseases (NCDs) in Iran is significant. Hence, we designed and validated an HL questionnaire on the most important domains of NCDs, including cardiovascular diseases, diabetes, and cancer. Methods: Literature review was conducted to examine the definition and dimensions of HL. After reaching consensus about the HL dimensions and conceptual models in focus group discussions with experts, they designed questions in each domain. Then, face, content, and construct validity as well as reliability were determined by a pilot study on 72 participants. At the end, a cross-sectional study was implemented on 206 Hamedan university employees, to finalize the questionnaire. Results: After doing the pilot study and analyzing the collected data and according to the Bartlett's test of sphericity and Kaiser–Meyer–Olkin = 0.421 with P < 0.001, factor analysis was used. Considering the eigenvalue >1.4, a 27-item questionnaire in seven domains was obtained which included attitude toward health, understanding information, social support, socioeconomic conditions, access to health services, and application of health information. Cronbach's alpha was more than 0.70 in all domains except the last one (0.47). The second phase showed that overall 75.2% of the individuals had inadequate HL with lowest scores in the application of health information. Conclusions: The designed tool seems appropriate for measuring the HL level among the Iranian population in the field of prevention of cardiovascular disease, cancer, and diabetes. The results can help policy makers to improve health promotion interventions.
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Affiliation(s)
- Fatemeh Rajabi
- Community Based Participatory Research Center, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Science, Tehran, Iran.,Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Azar Pirdehghan
- Department of Community Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,School of Public Health and Research Center for Health Sciences, Hamadan university of Medical Sciences, Hamadan, Iran
| | - Zahra Sanaie
- Department of Community Medicine, Education Development Office, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Laleh Ghadirian
- Knowledge Translation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Sayarifard
- Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Esna-Ashari
- Department of Community Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,School of Public Health and Research Center for Health Sciences, Hamadan university of Medical Sciences, Hamadan, Iran
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Svendsen MT, Bak CK, Sørensen K, Pelikan J, Riddersholm SJ, Skals RK, Mortensen RN, Maindal HT, Bøggild H, Nielsen G, Torp-Pedersen C. Associations of health literacy with socioeconomic position, health risk behavior, and health status: a large national population-based survey among Danish adults. BMC Public Health 2020; 20:565. [PMID: 32345275 PMCID: PMC7187482 DOI: 10.1186/s12889-020-08498-8] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 03/10/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Health literacy concerns the ability of citizens to meet the complex demands of health in modern society. Data on the distribution of health literacy in general populations and how health literacy impacts health behavior and general health remains scarce. The present study aims to investigate the prevalence of health literacy levels and associations of health literacy with socioeconomic position, health risk behavior, and health status at a population level. METHODS A nationwide cross-sectional survey linked to administrative registry data was applied to a randomly selected sample of 15,728 Danish individuals aged ≥25 years. By the short form HLS-EU-Q16 health literacy was measured for the domains of healthcare, disease prevention, and health promotion. Adjusted multinomial logistic regression analyses were used to estimate associations of health literacy with demographic and socioeconomic characteristics, health risk behavior (physical activity, smoking, alcohol consumption, body weight), and health status (sickness benefits, self-assessed health). RESULTS Overall, 9007 (57.3%) individuals responded to the survey. Nearly 4 in 10 respondents faced difficulties in accessing, understanding, appraising, and applying health information. Notably, 8.18% presented with inadequate health literacy and 30.94% with problematic health literacy. Adjusted for potential confounders, regression analyses showed that males, younger individuals, immigrants, individuals with basic education or income below the national average, and individuals receiving social benefits had substantially higher odds of inadequate health literacy. Among health behavior factors (smoking, high alcohol consumption, and inactivity), only physical behavior [sedentary: OR: 2.31 (95% CI: 1.81; 2.95)] was associated with inadequate health literacy in the adjusted models. The long-term health risk indicator body-weight showed that individuals with obesity [OR: 1.78 (95% CI: 1.39; 2.28)] had significantly higher odds of lower health literacy scores. Poor self-assessed health [OR: 4.03 (95% CI: 3.26; 5.00)] and payments of sickness absence compensation benefits [OR: 1.74 (95% CI: 1.35; 2.23)] were associated with lower health literacy scores. CONCLUSIONS Despite a relatively highly educated population, the prevalence of inadequate health literacy is high. Inadequate health literacy is strongly associated with a low socioeconomic position, poor health status, inactivity, and overweight, but to a lesser extent with health behavior factors such as smoking and high alcohol consumption.
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Affiliation(s)
- Majbritt Tang Svendsen
- Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800 Hjørring, Denmark
- Centre for Clinical Research, North Denmark Regional Hospital / Clinical Institute of Medicine, Aalborg University , Hjørring, Denmark
| | - Carsten Kronborg Bak
- Department of Research and Development, University College South, Kolding, Denmark
| | | | | | - Signe Juul Riddersholm
- Department of Anesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
| | - Regitze Kuhr Skals
- Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | | | - Helle Terkildsen Maindal
- Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, Aarhus, Denmark
| | - Henrik Bøggild
- Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Gitte Nielsen
- Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800 Hjørring, Denmark
| | - Christian Torp-Pedersen
- Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Abstract
BACKGROUND Health literacy is a multidimensional concept that is considered a primary public health concern. This concept is often neglected in research, and the evidence regarding health literacy in college students is limited. The aim of this study was two-fold: to determine the needs and limitations of health literacy among college students and to explore the relationships among the nine dimensions of health literacy and sociodemographic factors, including age, gender, nationality, year of study, field of study, smoking status, history of chronic diseases, use of on-campus gym, and the intention to exercise on-campus. METHODS This study was conducted using a cross-sectional approach. A total of 520 college students participated in this study. The average age was 21.03 years (SD = 2.29), with 47.5% males and 52.5% females. Data were collected using a demographics questionnaire and the Health Literacy Questionnaire (HLQ). In addition to descriptive statistics, multivariate analysis of variance (MANOVA) and follow-up analyses were performed to explore any statistically significant mean differences among levels of health literacy and sociodemographic factors. RESULTS The levels of health literacy on the nine HLQ scales were lower than the levels reported in the literature. Multivariate analysis showed a significant effect of age, gender, smoking status, year of study, and field of study on the level of health literacy. Follow-up analyses revealed that female students, students from the health-related faculties, and those who do not smoke have higher levels of health literacy compared to their counterparts. A detailed comparison between the levels of the HLQ scales was made based on students' demographic characteristics. The field of study had the most prominent effect on the level of college students' health literacy; mean differences were statistically significant (p < .001), and effect sizes were large (ranging from .66 to 1.35 for the nine scales of the HLQ). CONCLUSION College students' health literacy is influenced by demographic characteristics. Such variations could amplify some of the existing health disparities. The implications of the findings on health, health promotion, and interprofessional education are discussed.
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Affiliation(s)
- Jehad A. Rababah
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110 Jordan
| | - Mohammed M. Al-Hammouri
- Community and Mental Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Mohammed Aldalaykeh
- Community and Mental Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Degan TJ, Kelly PJ, Robinson LD, Deane FP, Wolstencroft K, Turut S, Meldrum R. Health literacy in people living with mental illness: A latent profile analysis. Psychiatry Res 2019; 280:112499. [PMID: 31398576 DOI: 10.1016/j.psychres.2019.112499] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 10/26/2022]
Abstract
Health literacy comprises cognitive and social skills that enable people to understand health information and maintain good health. Research examining the health literacy of people living with mental illness is scarce. The aim of the present study was to identify distinct subgroups of health literacy in individuals attending mental health treatment and determine if profiles and health literacy levels differ from other populations accessing healthcare services and on health characteristics. Participants (N = 325) were attending Neami National Australia services. Participants completed the multidimensional Health Literacy Questionnaire. Latent profile analysis was conducted to identify health literacy profiles. Participants reported lowest health literacy scores in appraising health information, navigating the healthcare system, and finding good health information. Three health literacy profiles were identified; low (20.4%), moderate (61.3%), and high (18.3%). Compared to the other populations (i.e. private hospital patients, men with prostate cancer, older individuals with diabetes, general population, people attending substance dependence treatment), the current sample tended to have lower health literacy scores. The findings highlight the need to increase overall health literacy and consider an individualised approach to enhance specific health literacy domains.
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Affiliation(s)
- Tayla J Degan
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Australia.
| | - Peter J Kelly
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Australia
| | - Laura D Robinson
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Australia
| | - Frank P Deane
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Australia
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Rheault H, Coyer F, Jones L, Bonner A. Health literacy in Indigenous people with chronic disease living in remote Australia. BMC Health Serv Res 2019; 19:523. [PMID: 31349842 PMCID: PMC6659262 DOI: 10.1186/s12913-019-4335-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/08/2019] [Indexed: 11/16/2022] Open
Abstract
Background Health literacy is strongly associated with health outcomes and is important for health policy and service delivery. Low health literacy was reported in 59% of Australian adults, however, there is no national data on the health literacy of Aboriginal and Torres Strait Islander (ATSI) peoples. The ATSI population in Australia experience a notable gap in health outcomes compared with non-Indigenous Australians which is due, in part to a higher prevalence of chronic diseases. The health outcome gap is more pronounced in rural and remote locations. This study aims to establish the health literacy profile of ATSI adults with chronic disease living in remote North-West Queensland Australia, and to investigate associations between the Health Literacy Questionnaire (HLQ) domains and self-reported chronic disease and demographic characteristics. Methods Using a cross-sectional design, 200 ATSI adults with a diagnosis of chronic disease/s (cardiovascular disease, diabetes, respiratory disease and/or chronic kidney disease) were recruited from two sites with the assistance of Aboriginal Health Workers. Data were collected using the HLQ, a multidimensional 44 item instrument to assess nine domains of health literacy. Demographic and health data were also collected. Analysis of variance using backwards modelling was used to determine predictors of health literacy. Results Participants were mostly male (53.5%) and aged between 19 and 89 years. The most prevalent chronic disease was cardiovascular disease (74%) followed by diabetes (67.5%). More than half (62%) had two or more chronic diseases. There was at least one independent predicator for each of the nine health literacy domains. Age, number of chronic diseases, gender, and level of education were all highly significant predictors of health literacy. Conclusion Improved health literacy will enable individuals to take an active role in their health. Understanding the health literacy of ATSI adults is a crucial first step. Our findings can assist Australian healthcare organisations to review their health literacy responsiveness and examine ways to improve patients’ needs and health capabilities to better support people to engage in effective self-management for chronic diseases. Electronic supplementary material The online version of this article (10.1186/s12913-019-4335-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haunnah Rheault
- School of Nursing, Queensland University of Technology, Brisbane, Australia. .,Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia.
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology, Brisbane, Australia.,Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Lee Jones
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Ann Bonner
- School of Nursing, Queensland University of Technology, Brisbane, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Australia.,NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Brisbane, Australia
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