-
Journal of Health Communication 2016Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the...
Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forgo needed care or to report difficulty finding a provider, even after we controlled for other factors, including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after we controlled for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way.
Topics: Aged; Cohort Studies; Female; Health Literacy; Health Services Accessibility; Humans; Male; Middle Aged; Self Report; Socioeconomic Factors; Time-to-Treatment
PubMed: 27043757
DOI: 10.1080/10810730.2015.1131776 -
Definitions and measurement of health literacy in health and medicine research: a systematic review.BMJ Open Feb 2022The way health literacy is understood (conceptualised) should be closely linked to how it is measured (operationalised). This study aimed to gain insights into how...
OBJECTIVES
The way health literacy is understood (conceptualised) should be closely linked to how it is measured (operationalised). This study aimed to gain insights into how health literacy is defined and measured in current health literacy research and to examine the relationship between health literacy definitions and instruments.
DESIGN
Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
DATA SOURCES
The MEDLINE, PsycINFO, ERIC and CINAHL databases were searched for articles published during two randomly selected months (March and October) in 2019.
ELIGIBILITY CRITERIA
We included articles with a quantitative design that measured health literacy, were peer-reviewed and original, were published in the English language and included a study population older than 16 years.
DATA EXTRACTION AND SYNTHESIS
Six researchers screened the articles for eligibility and extracted the data independently. All health literacy definitions and instruments were considered in relation to category 1 (describing basic reading and writing skills, disease-specific knowledge and practical skills) and category 2 (social health literacy competence and the ability to interpret and critically assess health information). The categories were inspired by Nutbeam's descriptions of the different health literacy levels.
RESULTS
120 articles were included in the review: 60 within public health and 60 within clinical health. The majority of the articles (n=77) used instruments from category 1. In total, 79 of the studies provided a health literacy definition; of these, 71 were in category 2 and 8 were in category 1. In almost half of the studies (n=38), health literacy was defined in a broad perspective (category 2) but measured with a more narrow focus (category 1).
CONCLUSION
Due to the high degree of inconsistency between health literacy definitions and instruments in current health literacy research, there is a risk of missing important information about health literacy considered be important to the initial understanding of the concept recognised in the studies.
PROSPERO REGISTRATION NUMBER
CRD42020179699.
Topics: Databases, Factual; Health Literacy; Humans
PubMed: 35165112
DOI: 10.1136/bmjopen-2021-056294 -
Brain and Behavior Dec 2022In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can...
BACKGROUND
In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals' development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders.
METHODS
The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL.
RESULTS
Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS.
CONCLUSION
The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.
Topics: Humans; Health Literacy; Mental Health; South Africa; Zambia; Cross-Sectional Studies; Health Personnel
PubMed: 36326480
DOI: 10.1002/brb3.2807 -
Public Health Reports (Washington, D.C.... 2022Community health assessments have typically not measured health literacy at the community level. We developed the Community Health Literacy Assessment (CHLA) framework...
OBJECTIVE
Community health assessments have typically not measured health literacy at the community level. We developed the Community Health Literacy Assessment (CHLA) framework to describe county and regional health literacy activities, assets, gaps, and opportunities in Maryland.
METHODS
We implemented the CHLA framework in Maryland from January to August 2018. We conducted an environmental scan of Maryland's 24 counties to identify community resources, health indicators, and organizations. We targeted local health improvement coalitions and health departments for interviews in each county. We conducted qualitative interviews to understand what key community organizations throughout Maryland are doing to implement health literacy best practices and policies. We used summative content analysis to review, quantify, and interpret interview data.
RESULTS
We conducted 57 interviews with participants from 56 organizations representing all 24 counties in Maryland. We captured data on multiple dimensions of health literacy and identified 3 main themes: health literacy assets and activities, health literacy gaps, and health literacy opportunities. The most cited asset was collecting data to inform health literacy practices, the most cited gap was using jargon with community members, and the most cited opportunity was increasing public awareness of existing health programs through improved outreach and teaching health information-seeking behaviors.
CONCLUSION
A systematic community health literacy assessment is a feasible way to collect a large amount of health literacy data, which can inform strategic planning, determine community interventions, and ultimately lead us toward a health-literate society. We recommend that others replicate the CHLA framework to operationalize health literacy as a health indicator and include it as a community health assessment measure.
Topics: Health Literacy; Humans; Maryland; Public Health
PubMed: 33706612
DOI: 10.1177/00333549211002767 -
Annali Dell'Istituto Superiore Di Sanita 2016The aim of this study is to make a critical analysis of the different definitions of health literacy to provide a framework of the concept. (Review)
Review
BACKGROUND
The aim of this study is to make a critical analysis of the different definitions of health literacy to provide a framework of the concept.
METHODS
A literature search was conducted in PubMed, Embase, PsycINFO, ERIC, Health Evidence, Centre for Reviews and Dissemination and Cochrane Library. Google and OpenGrey were searched to find additional papers and unpublished works.
RESULTS
Among 7000 papers founded, we selected 26 works. During the 1990s, authors began to systematically study the relationship between health literacy and health status, according to a public health view. In the first decade of the new century, a new fundamental definition established three progressive degrees of health literacy: functional, interactive and critical health literacy. Sørensen (in 2012) provided a framework for the development of new assessment tools and interventions.
CONCLUSION
The improvement of health literacy is a powerful tool for the development of a new type of relationship between individuals and the health system.
Topics: Health Literacy; Health Services; Health Status; Humans
PubMed: 27033626
DOI: 10.4415/ANN_16_01_18 -
Health Literacy Research and Practice Apr 2022Difficulty in understanding and using health information can harm the patient and increase the cost of care provided. So, this study classified and mapped the... (Review)
Review
BACKGROUND
Difficulty in understanding and using health information can harm the patient and increase the cost of care provided. So, this study classified and mapped the characteristics and interventions that make health care professionals responsive to the patient's health literacy.
METHODS
Medline (PubMed), CINAHL (EBSCO), PsycInfo, ERIC (ProQuest), Lilacs (BVS) and EMBASE (Elsevier) were searched using a combination of controlled descriptors. The selected studies needed to address the concept or main focus of the study among health care professionals in the care or academic environment.
KEY RESULTS
After reviewing 34 articles, 14 definitions and 10 subcategories of responsiveness were identified, and a broad characterization of health professional responsiveness to health literacy was proposed. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy, classified as (A) expository ( = 18; 94.7%), (B) interactive ( = 9; 47.4%), (C) practice with educational materials ( = 2; 10.5%), (D) practice with standardized patient or simulation ( = 8; 42.1%), and (E) practice with actual patients ( = 4; 21.1%).
DISCUSSION
These characteristics and interventions provide a useful taxonomy for the development of curricula and professional education programs, and for the validation and use of measures to evaluate the health workforce. [] Plain Language Summary: We found 14 definitions and 10 categories of professional responsiveness to health literacy. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy.
Topics: Curriculum; Health Literacy; Health Personnel; Humans
PubMed: 35522856
DOI: 10.3928/24748307-20220418-02 -
Journal of Health Communication 2018There is a need to investigate which health information sources are used and trusted by people with limited health literacy to help identify strategies for addressing...
There is a need to investigate which health information sources are used and trusted by people with limited health literacy to help identify strategies for addressing knowledge gaps that can contribute to preventable illness. We examined whether health literacy was associated with people's use of and trust in a range of potential health information sources. Six hundred participants from a GfK Internet survey panel completed an online survey. We assessed health literacy using the Newest Vital Sign, the sources participants used to get health information, and the extent to which participants trusted health information from these sources. We performed multivariable regressions, controlling for demographic characteristics. Lower health literacy was associated with lower odds of using medical websites for health information and with higher odds of using television, social media, and blogs or celebrity webpages. People with lower health literacy were less likely to trust health information from specialist doctors and dentists, but more likely to trust television, social media, blogs/celebrity webpages, friends, and pharmaceutical companies. People with limited health literacy had higher rates of using and trusting sources such as social media and blogs, which might contain lower quality health information compared to information from healthcare professionals. Thus, it might be necessary to enhance the public's ability to evaluate the quality of health information sources. The results of this study could be used to improve the reach of high-quality health information among people with limited health literacy and thereby increase the effectiveness of health communication programs and campaigns.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Consumer Health Information; Female; Health Literacy; Humans; Male; Middle Aged; Trust; Young Adult
PubMed: 30160641
DOI: 10.1080/10810730.2018.1511658 -
Current Allergy and Asthma Reports Nov 2020Inadequate health literacy is common among American adults, but little is known about the impact of health literacy in rheumatic diseases. The purpose of this article is... (Review)
Review
PURPOSE OF REVIEW
Inadequate health literacy is common among American adults, but little is known about the impact of health literacy in rheumatic diseases. The purpose of this article is to review studies investigating health literacy and its association with clinical outcomes in systemic lupus erythematosus (SLE).
RECENT FINDINGS
Several validated health literacy measures have been examined in SLE patients. Low health literacy is associated with worse patient-reported outcomes and lower numeracy with higher disease activity. Two studies found no association of low health literacy with medication adherence. One randomized controlled trial tested a medication decision aid among patients with low health literacy. We found a paucity of studies exploring health literacy in SLE. Low health literacy is associated with worse patient-reported outcomes and limited numeracy with higher disease activity in SLE. Further studies are needed exploring the impact of low health literacy on clinical outcomes and the effectiveness of literacy-sensitive interventions.
Topics: Adult; Female; Health Literacy; Humans; Lupus Erythematosus, Systemic; Male
PubMed: 33184709
DOI: 10.1007/s11882-020-00978-6 -
International Journal of Environmental... Jan 2020Health literacy (HL) is perceived as one of the most important concepts for modern health promotion activities to be successful. The research undertaken in the context...
BACKGROUND
Health literacy (HL) is perceived as one of the most important concepts for modern health promotion activities to be successful. The research undertaken in the context of HL usually focuses on its antecedents and consequences, either for specific groups of patients or society or for the whole population.
OBJECTIVES
The main aim of this study was to assess the antecedents and consequences of limited health literacy (HL) in a nationally representative sample of the Polish population.
METHODS
The analysis was carried out on the data obtained from a sample of 1000 Polish citizens through a telephone-based survey undertaken using a short, 16-item questionnaire developed within the European Health Literacy Project (HLS-EU). The total HLS score was calculated according to the guidelines published by the HLS-EU project. Chi2 test and logistic regression models were used for the analysis of the relationships between the variables.
RESULTS
The mean HL score (standard deviation) in the study sample was 12.99 (3.11). HL was related to age, marital and vocational status. Limited HL was associated with a lower self-assessment of health (OR, 95% CI: 2.52, 1.54-4.13), the prevalence of obesity and disability (1.71, 1.13-2.57, and 1.92, 1.25-2.94, respectively), less frequent physical activity (0.70, 0.49-0.99), a lower consumption of fruits and vegetables (0.47, 0.34-0.65), and with more frequent hospitalisations (2.02, 1.38-2.95).
CONCLUSIONS
The assessment of HL using the16-item HLS-EU questionnaire may be a useful tool to enable health behaviours and utilisation of health care resources by society to be predicted.
Topics: Adult; Aged; Aged, 80 and over; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Health Literacy; Humans; Male; Middle Aged; Poland; Young Adult
PubMed: 31963834
DOI: 10.3390/ijerph17020642 -
Frontiers in Public Health 2023Health literacy (HL) is a protective factor for some chronic diseases. However, its role in the Coronavirus Disease 2019 (COVID-19) pandemic has not been clarified. This...
BACKGROUND
Health literacy (HL) is a protective factor for some chronic diseases. However, its role in the Coronavirus Disease 2019 (COVID-19) pandemic has not been clarified. This study aims to explore the association between HL and COVID-19 knowledge among residents in Ningbo.
METHODS
A total of 6,336 residents aged 15-69 years in Ningbo were selected by multi-stage stratified random sampling method. The "Health Literacy Questionnaire of Chinese Citizens (2020)" was used to evaluate the relationship between COVID-19 knowledge and HL. Chi-square test, Mann-Whitney test and logistic regression were used to analyze the data.
RESULTS
The HL and COVID-19 knowledge levels of Ningbo residents were 24.8% and 15.7%, respectively. After adjusting for confounding factors, people with adequate HL were the more likely to have adequate COVID-19 knowledge compared with those with limited HL ( = 3.473, 95% CI = 2.974-4.057, <0.001). Compared with the limited HL group, the adequate HL group had a higher rate of COVID-19 knowledge, a more positive attitude, and a more active behavior.
CONCLUSION
COVID-19 knowledge is significantly associated with HL. Improving HL may influence people's knowledge about COVID-19, thereby changing people's behaviors, and finally combating the pandemic.
Topics: Humans; COVID-19; Cross-Sectional Studies; Health Literacy; Pandemics; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice; China; Health Behavior
PubMed: 36891332
DOI: 10.3389/fpubh.2023.1058029