Health literacy and associated factors among undergraduates: A university-based cross-sectional study in Nepal

Health literacy is one of the most critical aspects of health promotion. Limited health literacy is also accounted for adverse health outcomes and a huge financial burden on society. However, a gap exists in the level of health literacy, especially among undergraduates. This study aimed to assess the levels of health literacy and its socio-demographic determinants among undergraduate students of Tribhuvan University, Nepal. A web-based cross-sectional survey was conducted among 469 undergraduate students from five institutes of Tribhuvan University, Nepal. The 16-item short version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) was used to measure students’ health literacy levels. Associated factors were examined using Chi-square tests followed by multivariate logistic regression analyses at the level of significance of 0.05. Nearly 61% of students were found to have limited health literacy (24.5% had “inadequate” and 36.3% had “problematic” health literacy). Female students (aOR = 1.6, 95% CI: 1.1–2.5), students from non-health related majors (aOR = 1.9, 95% CI: 1.2–3.0), students with unsatisfactory health status (aOR = 2.8, 95% CI: 1.7–4.5), students with poor financial status (aOR = 2.9, 95% CI: 1.2–6.8) and students with low self-esteem (aOR = 2.5, 95% CI: 1.5–4.1) were significantly more likely to have limited health literacy. The majority of the undergraduates were found to have limited health literacy. Gender, sector of study, self-rated health status, self-rated financial status, and self-esteem were significantly associated with limited health literacy. This study indicates university students should not be assumed to be health-literate and interventions to improve students’ health literacy especially for those whose majors are not health-related should be implemented. Further studies using a longer version of the health literacy survey questionnaire and qualitative methods to explore more on determinants of health literacy are recommended.

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Health literacy index in relation to drug information received from pharmacists

BIO Web of Conferences ◽

10.1051/bioconf/20214103001 ◽

2021 ◽

Vol 41 ◽

pp. 03001

Author(s):

Niken Nur Widyakusuma ◽

Chairun Wiedyaningsih ◽

Bella Hazana ◽

Shirrin Shafira Azzahra ◽

Triyani Dinityaswati ◽

...

Keyword(s):

Health Literacy ◽

Drug Information ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Potential Health ◽

Limited Health Literacy ◽

Literacy Survey ◽

Limited Health ◽

Yogyakarta City

Despite the significance of health literacy to health outcomes, there remains limited data on it in Indonesia, or whether drug information services provided by pharmacists can improve patients’ health literacy. This study aimed to measure the health literacy indices of health care visitors in Yogyakarta, Indonesia, and to identify whether the amount of drug information received from pharmacists, among other factors, is a determinant of health literacy. The research was a cross-sectional study using the Health Literacy Survey-Europe-Asia-Questionnaire (HLS-EU-Asia-Q) that was distributed to 400 respondents in pharmacies, hospitals, and primary health centres in Yogyakarta City. The relationships between respondents’ characteristics, including the amount of drug information received from pharmacists, and their health literacy index were analysed using Chi Square. Results: As many as 67.3 % of respondents had limited health literacy index scores. There was evidence that the scores were relative to the amount of drug information they had received from pharmacists (p ≤ 0.05). This study complements health literacy index data in Yogyakarta City, Indonesia, and provides evidence of potential health literacy determinants.

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Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-039864 ◽

2020 ◽

Vol 10 (11) ◽

pp. e039864

Author(s):

Adina Abdullah ◽

Chirk Jenn Ng ◽

Su May Liew ◽

Subashini Ambigapathy ◽

Paranthaman V ◽

...

Keyword(s):

Social Support ◽

Health Literacy ◽

Perceived Social Support ◽

Diabetes Education ◽

Cross Sectional Study ◽

Diabetes Knowledge ◽

Language Fluency ◽

Cross Sectional ◽

Limited Health Literacy ◽

Limited Health

ObjectiveLimited health literacy in patients with type 2 diabetes mellitus (T2DM) led to poorer diabetes knowledge, less medication adherence and increased healthcare cost. The purpose of this paper was to report the prevalence of limited health literacy in patients with T2DM and to identify factors that are associated with it.DesignA cross-sectional study was conducted from January to March 2018; data on patients’ sociodemographic characteristics, diabetes knowledge, perceived social support and health literacy level were collected. Health literacy level was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47).SettingPatients were recruited from four primary care clinics in Perak, Malaysia.ParticipantsAdult patients diagnosed with T2DM who attended the study clinics during the study period.Primary outcome variablePatients with HLS-EU-Q47 General Index of ≤33 points were classified as having limited health literacy.ResultsThe prevalence of limited health literacy was 65.3% (n=279). In bivariate analysis, patients’ ethnicity (p=0.04), highest education level (p<0.001), monthly income (p=0.003), having health insurance (p=0.007), English language fluency (p<0.001), Malay language fluency (p=0.021), attending diabetes education sessions (p<0.001), perceived social support (p<0.001) and diabetes knowledge (p=0.019) were factors associated with limited health literacy. In logistic regression, not being fluent in English was associated with limited health literacy (OR=2.36, 95% CI 1.30 to 4.30) whereas having high perceived social support (OR=0.52, 95% CI 0.40 to 0.69) and having attended diabetes education sessions (OR=0.42, 95% CI 0.27 to 0.68) were associated with adequate health literacy.ConclusionThe prevalence of limited health literacy is high among patients with T2DM in Perak, Malaysia. Strategies to improve health literacy in these patients must consider the influences of English fluency, attendance at diabetes education sessions and social support, and may need to adopt a universal approach to addressing limited health literacy.

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Health literacy assessment of Vidzeme statistical region

10.22616/esrd.2021.55.047 ◽

2021 ◽

Author(s):

Baiba Kondrica ◽

◽

Ilze Ivanova ◽

Tamara Grizane ◽

◽

...

Keyword(s):

Health Literacy ◽

Strong Positive Correlation ◽

Literacy Assessment ◽

Limited Health Literacy ◽

Telephone Interviews ◽

Confirmatory Factor ◽

Literacy Survey ◽

Impacting Factors ◽

European Health ◽

Limited Health

Data on Health Literacy in the population of Latvia is limited. The aim of the study was to determine the Health Literacy impacting factors of inhabitants of Vidzeme Statistical region in Latvia (LV008). Respondent survey (n = 383), using a paper-and-pencil self-administered approach and telephone interviews, was conducted based the European Health Literacy Survey Questionnaire (HLS-EU-Q47). In order to ensure internal consistency and reliability, the authors used Cronbach’s α test (α = 0.965). The confirmatory factor analysis (CFA) allowed to determine that factor results differentiate between genders and there is a strong positive correlation (r = 0.945), that impacts results. Factors Access, Appraise and Apply explained each 30 % of the variance, and factors Understand explained 31 %. HL index division by gender indicated that 47.4 % of female respondents and 46.6 % of male respondents have “limited health literacy” (“inadequate” + “problematic”). The largest age group among respondents are 18-39-year old where there is lower level of education and lower income. However, cases have been observed when respondents even with higher education have “limited health literacy,” which indicates towards a need for further HL research in Latvia, because compared to HL of other member states, LV008 HL index is by 38.9 % larger than the EU average (47.6 %).

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Limited health literacy increases the risk of orthorexia nervosa among urban schoolteachers

Zinc supplementation improves heme biosynthesis in rats exposed to lead ◽

10.18051/univmed.2020.v39.162-170 ◽

2020 ◽

Vol 39 (3) ◽

pp. 162

Author(s):

Gulay Yilmazel ◽

Serpil Bozdogan

Keyword(s):

Health Literacy ◽

School Health ◽

Binary Logistic Regression ◽

Female Gender ◽

Cross Sectional Study ◽

Orthorexia Nervosa ◽

Cross Sectional ◽

Black Sea Region ◽

Limited Health Literacy ◽

Limited Health

Background Orthorexia nervosa (ON) describes a pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. Limited health literacy may play a role in the onset and progression of orthorexia. The aim of this study was to determine the relationship between health literacy and ON among urban schoolteachers. Methods This cross-sectional study was conducted in central Black Sea region of Turkey with 420 primary and secondary schoolteachers aged between 18 and 51 years. A questionnaire form including socio-demographic characteristics was used. The Orthorexia Nervosa Questionnaire (ORTO-15) was used to assess orthorexia nervosa behavior and the Turkey Health Literacy Scale (TSOY-32) to assess health literacy. Simple binary and multiple binary logistic regression analyses were carried out to verify the associations between the variables. Results Of the study group 46.4% were in the 40-49 year age group, 53.8% were male, 78.6% had ON and 93.6% had limited health literacy. Nearly all of the orthorexics (96.4%) had limited health literacy. Female gender, Instagram use and limited health literacy was significantly associated with ON. Limited health literacy increases the risk of ON 4.85 times among teachers (aOR=4.85;95% C.I. : 2.15-10.94;p=0.000). Conclusion The current findings suggest that limited health literacy is the strongest risk factor for ON among urban schoolteachers. School health literacy and social media literacy programs can open a new window into revealing ON.

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A short-form suggestion for the Turkish version of the European Health Literacy Survey Questionnaire: a development and validation study in university students

Global Health Promotion ◽

10.1177/17579759211064261 ◽

2021 ◽

pp. 175797592110642

Author(s):

Mehmet Ali Sungur ◽

Zerrin Gamsizkan ◽

Demet Hanife Sungur

Keyword(s):

Factor Analysis ◽

Health Literacy ◽

Short Form ◽

Cross Sectional Study ◽

Survey Questionnaire ◽

Sectional Study ◽

Turkish Version ◽

Cross Sectional ◽

Literacy Survey ◽

European Health

The European Health Literacy Survey Questionnaire was translated into Turkish following a validity and reliability study, but there is no comprehensive short form available. We aimed to suggest a short form of the 47-item Turkish version of European Health Literacy Survey Questionnaire in this study. Data were obtained from a cross-sectional study that included a total of 686 students, 345 male and 341 female, conducted in nine different faculties of a university using the Turkish version of European Health Literacy Survey Questionnaire. The development process of the short form was conducted using principal component analysis with exploratory factor analysis, and correlation and regression analyses. The validation process was done using confirmatory factor analysis and regression analysis. Based on the results, a 12-item short form was developed, retaining the conceptual framework of the European Health Literacy Survey Questionnaire. The short form was shown to have adequate psychometric properties with high reliability, good validity, a high and moderate level of correlation, and a good model fit with the independent dataset in this cross-sectional study. The short form developed in this study was demonstrated to be a valid and reliable tool to measure health literacy easily and rapidly in Turkey.

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Factors Associated with Health Literacy Competencies: Analysis of Thai Health Literacy Survey 2019

10.21203/rs.3.rs-60016/v1 ◽

2020 ◽

Author(s):

Roongnapa Khampang ◽

Saichon Kloyiam ◽

Rukmanee Butchon

Keyword(s):

Health Literacy ◽

Consumer Protection ◽

Healthcare Providers ◽

Social Characteristics ◽

Herbal Products ◽

Limited Health Literacy ◽

Logistic Regression Models ◽

Literacy Survey ◽

Health Related ◽

Vulnerable Consumers

Abstract Background The consumption of health-related products has been increasing continuously. Information on health-related products can make it difficult for some people with limited health literacy to use. This study investigated the extent to which health literacy competencies in the aspect of consumer protection related to demographic and socio-economic factors, using data from the Thai Health Literacy Survey (THL-S) among Thai citizens aged 15 years and above (2019). Methods The THL-S used a stratified three-stage-sampling to draw a sample of Thais aged 15 years and above. Participants were interviewed with a questionnaire of 34 items measuring health literacy and 8 items measuring behavioural practices. Proportions of responses (the 6-Likert scales) in accessing, understanding, communicating and making decisions related to the consumer protection aspect were performed. Logistic regression models were used to explore the association between health literacy competencies and participant’s socioeconomic, demographic, health and social characteristics.Results Levels of difficulties in the consumer protection aspect varied among health competencies, with the most difficult in communicating and the least difficult in understanding. Half of Thais (around 42%) felt difficult to ask for information from healthcare providers. One-third of Thais (38%) experienced difficulties in accessing reliable information about medicine, cosmetic products, herbal products and food supplements. Participants who had a lower level of education, cannot read, did not have health screenings, were living in poverty, did not hold leading roles in the community, were male, had hearing impairment, or were at an older age, experienced more difficulties in practising health literacy competencies.Conclusions Vulnerable consumers face significant barriers in accessing, understanding, communicating and making decisions in the consumer protection aspect. Health literacy programs that aim to build competencies and empower vulnerable consumers should be developed. There is also a need to adapt current information on health related products to be as clear an accessible as possible but reliable to meet health literacy needs.

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Psychometric Assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) for Arabic/French-Speaking Migrants in Southern Europe

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218181 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8181

Author(s):

Pilar Bas-Sarmiento ◽

Miriam Poza-Méndez ◽

Martina Fernández-Gutiérrez ◽

Juan Luis González-Caballero ◽

María Falcón Romero

Keyword(s):

Health Literacy ◽

Sign Test ◽

Survey Questionnaire ◽

Three Dimensional Model ◽

Cross Sectional Survey ◽

Structural Validity ◽

Cross Sectional ◽

French Speaking ◽

Literacy Survey ◽

European Health

Improving health literacy (HL) is critical for addressing health inequalities. Low literacy rates are believed to be more prevalent in ethnic minorities, which may have an impact on people’s health. For measures to be implemented in this regard, HL must be evaluated to obtain specific indicators. Our aim, therefore, was to develop a version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16), which is recommended to be used with vulnerable populations, suited to Arabic/French-speaking migrants who reside in south-eastern Spain, and to explore its psychometric properties for assessing health literacy in this population. A cross-sectional survey was carried out in a convenient sample of 205 migrants. The structural validity was calculated by a confirmatory factorial analysis (CFA), which suggested appropriate adjustment indicators, and which indicated that the three-dimensional model is adequately adjusted to the data obtained in the study. The coefficient omega showed high internal consistency in the three HL dimensions (health care, disease prevention, and health promotion). Concurrent validity presented a significant correlation with the Newest Vital Sign test (r = 0.390; p < 0.001). The multigroup CFA showed that the heterogeneity of the sample used was not a problem for establishing the structural validity of the scale. The Arabic/French version showed good construct validity.

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Malaysian Health Literacy: Scorecard Performance from a National Survey

10.20944/preprints202103.0635.v1 ◽

2021 ◽

Author(s):

Norrafizah Jaafar ◽

Komathi Perialathan ◽

Manimaran Krishnan ◽

Nurashma Juatan ◽

Masitah Ahmad ◽

...

Keyword(s):

Health Literacy ◽

Nationwide Survey ◽

Population Based ◽

Average Score ◽

Limited Health Literacy ◽

The People ◽

Health Literacy Level ◽

Literacy Survey ◽

Literacy Level ◽

Limited Health

Health literacy is an indicator of a society’s ability to make better health judgement for themselves and the people around them. This study investigates the prevalence of health literacy among Malaysian adults and provides an overall picture of the current health literacy state of the society. The study also highlights socio-demographics markers of communities with limited health literacy which may warrant future intervention. A population based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above participated in the study. The health literacy score was divided into three levels; limited, sufficient and excellent. Findings showed that majority Malaysian population has sufficient health literacy level, albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups are associated with respondents with older age, lower education level and lower household income. Overall health literacy state for Malaysia is categorized at a lower sufficient level. Health literacy improvements should focus on communities with limited health literacy level.

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Determining Health Literacy Level and Its Related Factors Among Pregnant Women Referred to Medical and Health Centers of Tehran in 2019: A Cross-sectional Study

Shiraz E-Medical Journal ◽

10.5812/semj.109592 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Safoura Taheri ◽

Mahmoud Tavousi ◽

Zohre Momenimovahed ◽

Ashraf Direkvand-Moghadam ◽

Nazanin Rezaei ◽

...

Keyword(s):

Health Literacy ◽

Pregnant Women ◽

Health Information ◽

Cross Sectional Study ◽

Health Centers ◽

Related Factors ◽

Cross Sectional ◽

Limited Health Literacy ◽

The Mean ◽

Limited Health

Background: The ability to acquire, process, and understand health information to make informed decisions about health is defined as health literacy. A low level of health literacy disrupts women’s ability to understand and use health information in order to take appropriate and timely measures during pregnancy. Objectives: Due to the importance of health literacy during pregnancy and its direct impact on fetal health, this study was conducted to determine the level of health literacy and its related items among the pregnant women referred to medical and health centers in Tehran. Methods: This descriptive-analytical study was conducted on 270 pregnant women referred to the medical and health centers of Tehran in 2019. The participants in this study were selected by the mixed sampling method (cluster and random methods to select health centers and the convenience method to select participants). Data collection tools included a questionnaire for demographic and midwifery characteristics and a specialized questionnaire for maternal health literacy in pregnancy (MHELIP). Data analysis was performed by SPSS-19 software. Results: The mean age of the participants was 28.16 ± 5.70 years, and the mean gestational age was 24.50 ± 9.25 weeks. The mean score of health literacy among pregnant women was 63.14 ± 9.63, and 48.9% of them had limited (inadequate and insufficient) health literacy. The results showed positive correlations between the total score of health literacy and the demographic variables of age (P = 0.025), education (P = 0.003), and income (0.008), but no significant relationship was found between the mean total score of health literacy and employment status (P = 0.614) or parity (P = 0.614). Conclusions: It was found that limited health literacy had a high prevalence among pregnant women. Given the importance of pregnancy, it seems necessary for healthcare policymakers to design programs to promote women’s health literacy during pregnancy.

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Assessment of Written Patient Information Pertaining to Cirrhosis and Its Complications: A Pilot Study

Journal of Patient Experience ◽

10.1177/2374373519858025 ◽

2019 ◽

Vol 7 (4) ◽

pp. 499-506

Author(s):

Lea Ladegaard Grønkjær ◽

Kirsten Berg ◽

Rikke Søndergaard ◽

Majbritt Møller

Keyword(s):

Health Literacy ◽

Patient Information ◽

Information Quality ◽

Cross Sectional Study ◽

Sectional Study ◽

Mixed Methods Design ◽

Cross Sectional ◽

Limited Health Literacy ◽

Limited Health ◽

Made In

Background: Written patient information may play an important role in the compliance of the cirrhosis disease, but little is known on the quality and patients’ understanding of them. Objectives: To assess the written patient information leaflet pertaining to cirrhosis and its complications. Methods: The Baker Able Leaflet Design (BALD) criteria and the Ensuring Quality Information for Patients (EQIP) questionnaire were applied to assess design, layout characteristics, and information quality. Readability was calculated using the Læsbarhedsindex (LIX) and the Simple Measure of Gobbledygook (SMOG). A cross-sectional study with a mixed methods design was carried out, using a questionnaire consisting of closed- and open-ended questions. Results: The BALD score was 24 and the EQIP score 70%. The LIX score was 46 and the SMOG score 15.8. Sixteen phrases from the leaflet were selected to explore patients’ understanding. Four phrases were understood by 100% of the patients, 6 phrases by more than 50% of the patients, and 6 phrases were understood by less than 50% of the patients. The meaning condensation showed that knowledge and understanding of cirrhosis and its complications were not enhanced by the availability of the leaflet. Conclusion: The leaflet had a good design, layout, and information quality but was difficult to read. Patients appeared to relate poorly to the leaflet and demonstrated limited health literacy. These results suggest that an assessment of written patient information ought to be made in an effort to improve readability. Further studies on intervention to improve patients’ health literacy are recommended.

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