scholarly journals Regional heterogeneities of health literacy in China: a population-based study

2020 ◽  
Author(s):  
Zhenhua Li ◽  
Yongquan Tian ◽  
Shuiyuan Xiao ◽  
Zhicheng Gong ◽  
Long Qian

Abstract Background: Few studies described the geographic variations of health literacy in China. This study aimed to investigate the regional heterogeneities of health literacy level in Chinese population, in order to formulate targeted health literacy promotion strategies in different economic and cultural contexts.Methods: Multi-stage stratification, clustering, and random sampling methods were used to select 70 study sites from 25 provinces or municipalities in China. Health literacy was measured using the National Resident Health Literacy Monitoring Questionnaire. MapInfo software was used to map the geographic distribution. Multiple logistic regression was used to adjust for the factors associated with the health literacy level in the total and regional samples.Results: A total of 3,482 participants were included in the study, including 1,792 (51.5%) males and 1,690 (48.5%) females. A notable geographic variation was observed in the health literacy level. The proportion of respondents with adequate health literacy was 22.3%, including 33.0% in the eastern region, 23.1% in the central region, and 17.6% in the western region. The proportion of adequate health literacy in different provinces or municipalities ranged from 10.5%(Xinjiang) to 47.0%(Beijing). Being female (odds ratio [OR]=1.360, 95% confidence interval [CI]: 1.153-1.605), having a higher education level (OR=1.860, 95% CI: 1.671-2.070), having better economic status (OR=1.353, 95% CI: 1.220-1.502), having better self-rated health status (OR=1.263, 95% CI: 1.081-1.476), and having more community health education (OR=1.192, 95% CI: 1.034-1.374) were independently associated with adequate health literacy.Conclusions: The health literacy level of Chinese people is still low, with heterogeneities among different regions, between urban and rural areas, and among different social groups. With respect to health literacy promotion efforts, more attention should be given to behavioural changes and the continuous exploration of methods of developing healthy behaviours and lifestyles. Ways of improving the health literacy levels of people in different regions should be adapted to local conditions. Health education should be strengthened for low-income people in the central and eastern regions. Special emphasis should be placed on the intensity of health knowledge publicity and the accessibility of health knowledge and skills in the central and western regions.Keywords: Health literacy; Regional heterogeneities; Health Literacy Questionnaire

2020 ◽  
Author(s):  
Zhenhua Li ◽  
Yongquan Tian ◽  
Shuiyuan Xiao ◽  
Zhicheng Gong ◽  
Long Qian

Abstract Background: Few studies have described the geographic variation in health literacy in China. This study aimed to investigate the regional heterogeneities in health literacy levels in the Chinese population, in order to formulate targeted health literacy promotion strategies in different economic and cultural contexts.Methods: Multi-stage stratification, clustering, and random sampling methods were used to select 70 study sites from 25 provinces or municipalities in China in 2017. Health literacy was measured using the National Resident Health Literacy Monitoring Questionnaire. MapInfo software was used to map the geographic distribution. Multiple logistic regression was used to adjust for the factors associated with the health literacy level in the total and regional samples.Results: A total of 3,482 participants were included in the study, including 1,792 (51.5%) males and 1,690 (48.5%) females. Notable geographic variation was observed in the health literacy level. The proportion of respondents with adequate health literacy was 22.3% overall, 33.0% in the eastern region, 23.1% in the central region, and 17.6% in the western region. The proportion of adequate health literacy in the different provinces or municipalities ranged from 10.5%(Xinjiang) to 47.0%(Beijing). Being a female (odds ratio [OR]=1.360, 95% confidence interval [CI]: 1.153-1.605), having a higher education level (OR=1.860, 95% CI: 1.671-2.070), having a better economic status (OR=1.353, 95% CI: 1.220-1.502), having a better self-rated health status (OR=1.263, 95% CI: 1.081-1.476), and having more community health education (OR=1.192, 95% CI: 1.034-1.374) were independently associated with adequate health literacy.Conclusions: The health literacy level of Chinese people is still low, and there are heterogeneities among different regions, between urban and rural areas, and among different social groups. The methods used to improve the health literacy levels of people in different regions should be adapted to local conditions. In the central and eastern regions, low-income people are the focus of health literacy improvement efforts. Special emphasis should be placed on the degree of health knowledge publicity and the accessibility of health knowledge and skills in the central and western regions.


2021 ◽  
Vol 9 ◽  
Author(s):  
Zhenhua Li ◽  
Yongquan Tian ◽  
Zhicheng Gong ◽  
Long Qian

Background: Health literacy is essential to population health, yet few studies have described the geographic variation in health literacy in China. This study aimed to investigate the level of health literacy, its regional heterogeneities, as well as influencing factors of health literacy in 25 provinces or municipalities in China.Methods: The study was conducted among residents aged 15–69 years from 25 provinces or municipalities in China in 2017. Health literacy was measured using the Chinese Health Literacy Scale. MapInfo software was used to map the geographic distribution. Multiple logistic regression was used to adjust for the factors associated with the health literacy level in the overall and regional samples.Results: A total of 3,482 participants were included in the study, comprising 1,792 (51.5%) males and 1,690 (48.5%) females. Notable geographic variation was observed in health literacy levels. The proportion of respondents with adequate health literacy was 22.3% overall, 33.0% in the eastern region, 23.1% in the central region, and 17.6% in the western region. The proportion of adequate health literacy in the different provinces and municipalities ranged from 10.5% (Xinjiang) to 47.0% (Beijing). Being a female [odds ratio (OR) = 1.353; 95% confidence interval (CI): 1.146–1.597], having a high education level [OR ranging from 2.794 (CI: 1.469–5.314) to 9.458 (CI: 5.251–17.036)], having a high economic status [OR ranging from 1.537 (CI: 1.248–1.891) to 1.850 (CI: 1.498–2.284)], having a good self-rated health status [OR ranging from 2.793 (CI: 1.534–5.083) to 3.003 (CI: 1.672–5.395)], and having frequent community health education (OR = 1.588; 95% CI: 1.066–2.365) were independently associated with adequate health literacy.Conclusions: The health literacy level in the 25 provinces or municipalities of China is relatively low compared to the developed countries, and there are heterogeneities among different regions, between urban and rural areas, and among different social groups. Tailored health education and promotion strategies are needed for different subgroups of residents.


2020 ◽  
Author(s):  
Zhenhua Li ◽  
Yongquan Tian ◽  
Shuiyuan Xiao ◽  
Zhicheng Gong ◽  
Long Qian

Abstract Background: Few studies have described the geographic variation in health literacy in China. This study aimed to investigate the regional heterogeneities of health literacy levels in the Chinese population to formulate targeted health literacy promotion strategies in different economic and cultural contexts.Methods: Multi-stage stratification and cluster sampling were used to select 70 study sites from 25 provinces or municipalities in China in 2017. Health literacy was measured using the National Resident Health Literacy Monitoring Questionnaire. Multiple logistic regression was used to adjust for the factors associated with the health literacy level in the overall and regional samples.Results: A total of 3,482 participants were included in the study, comprising 1,792 (51.5%) males and 1,690 (48.5%) females. Notable geographic variation was observed in health literacy levels. The proportion of respondents with adequate health literacy was 22.3% overall, 33.0% in the eastern region, 23.1% in the central region, and 17.6% in the western region. The proportion of adequate health literacy in the different provinces and municipalities ranged from 10.5%(Xinjiang) to 47.0%(Beijing). Being a female (odds ratio [OR]=1.360; 95% confidence interval [CI]: 1.153-1.605), having a high education level (OR=1.860; 95% CI: 1.671-2.070), having a high economic status (OR=1.353; 95% CI: 1.220-1.502), having a good self-rated health status (OR=1.263; 95% CI: 1.081-1.476), and having extensive community health education (OR=1.192; 95% CI: 1.034-1.374) were independently associated with adequate health literacy.Conclusions: The health literacy level of Chinese people is still low, and there are heterogeneities among different regions, between urban and rural areas, and among different social groups. Tailored health education and promotion strategies are needed for different subgroups of residents.


2021 ◽  
Author(s):  
Doan Thi Kim Cuc ◽  
Nonglak Methakanjanasak ◽  
Ho Thi Thuy Trang

Background: Asthma is a significant health issue among Vietnamese adults in both urban and rural areas. The disease needs serious concern to minimize impact and improve the situation.Objective: This study aimed to describe the level of health literacy, symptom control, and medication management and determine the relationships among them in patients with asthma in Da Nang, Vietnam.Methods: A cross-sectional descriptive study was conducted among 84 patients with asthma. The questionnaires were used in this study, including demographic form, the Short-Form Health Literacy questionnaire (HL-SF12), Asthma Control Test (ACT), and Medication Adherence Reporting Scale for Asthma (MARS-A). Pearson product-moment correlation was applied to determine the relationship between health literacy, symptom control, and medication management.Results: The score revealed for general-health literacy, symptom control, and medication management were 28.70 (SD = 9.66), 17.72 (SD = 4.67), and 3.63 (SD = 0.75), respectively. Health literacy level had moderate positive relationships with symptom control (r = 0.41) and medication management (r = 0.44).Conclusion:  The patients had limited health literacy, partially controlled symptom, and poor adherence to the medication. Health literacy level had moderate positive relationships with symptom control  and medication management. These findings are crucial for effective treatment and management of the disease in Vietnam. To improve medication management and symptom control among patients with asthma, nurses should concern patients’ health literacy level.Funding: This research was funded by the Research and Training Center for Enhancing Quality of Life of Working-Age People and the Department of Student Development and Alumni Affairs at the Faculty of Nursing, Khon Kean University, Thailand.


2019 ◽  
Author(s):  
Hanna Vollbrecht ◽  
Vineet Arora ◽  
Sebastian Otero ◽  
Kyle Carey ◽  
David Meltzer ◽  
...  

BACKGROUND Technology is a potentially powerful tool to assist patients with transitions of care during and after hospitalization. Patients with low health literacy who are predisposed to poor health outcomes are particularly poised to benefit from such interventions. However, this population may lack the ability to effectively engage with technology. Although prior research studied the role of health literacy in technology access/use among outpatients, hospitalized patient populations have not been investigated in this context. Further, with the rapid uptake of technology, access may no longer be pertinent, and differences in technological capabilities may drive the current digital divide. Thus, characterizing the digital literacy of hospitalized patients across health literacy levels is paramount. OBJECTIVE We sought to determine the relationship between health literacy level and technological access, use, and capability among hospitalized patients. METHODS Adult inpatients completed a technology survey that asked about technology access/use and online capabilities as part of an ongoing quality of care study. Participants’ health literacy level was assessed utilizing the 3-question Brief Health Literacy Screen. Descriptive statistics, bivariate chi-squared analyses, and multivariate logistic regression analyses (adjusting for age, race, gender, and education level) were performed. Using Bonferroni correction for the 18 tests, the threshold <i>P</i> value for significance was &lt;.003. RESULTS Among 502 enrolled participants, the mean age was 51 years, 71.3% (358/502) were African American, half (265/502, 52.8%) were female, and half (253/502, 50.4%) had at least some college education. Over one-third (191/502, 38.0%) of participants had low health literacy. The majority of participants owned devices (owned a smartphone: 116/173, 67.1% low health literacy versus 235/300, 78.3% adequate health literacy, <i>P</i>=.007) and had used the Internet previously (143/189, 75.7% low health literacy versus 281/309, 90.9% adequate health literacy, <i>P</i>&lt;.001). Participants with low health literacy were more likely to report needing help performing online tasks (133/189, 70.4% low health literacy versus 135/303, 44.6% adequate health literacy, <i>P</i>&lt;.001). In the multivariate analysis, when adjusting for age, race, gender, and education level, we found that low health literacy was not significantly associated with a lower likelihood of owning smartphones (OR: 0.8, 95% CI 0.5-1.4; <i>P</i>=.52) or using the internet ever (OR: 0.5, 95% CI 0.2-0.9; <i>P</i>=.02). However, low health literacy remained significantly associated with a higher likelihood of needing help performing any online task (OR: 2.2, 95% CI 1.3-3.6; <i>P</i>=.002). CONCLUSIONS The majority of participants with low health literacy had access to technological devices and had used the internet previously, but they were unable to perform online tasks without assistance. The barriers patients face in using online health information and other health information technology may be more related to online capabilities rather than to technology access. When designing and implementing technological tools for hospitalized patients, it is important to ensure that patients across digital literacy levels can both understand and use them.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Aleda M. H. Chen ◽  
Karen S. Yehle ◽  
Nancy M. Albert ◽  
Kenneth F. Ferraro ◽  
Holly L. Mason ◽  
...  

Background. Inadequate health literacy may be a barrier to gaining knowledge about heart failure (HF) self-care expectations, strengthening self-efficacy for self-care behaviors, and adhering to self-care behaviors over time.Objective. To examine if health literacy is associated with HF knowledge, self-efficacy, and self-care adherence longitudinally.Methods. Prior to education, newly referred patients at three HF clinics (N=51, age:64.7±13.0years) completed assessments of health literacy, HF knowledge, self-efficacy, and adherence to self-care at baseline, 2, and 4 months. Repeated measures analysis of variance with Bonferroni-adjusted alpha levels was used to test longitudinal outcomes.Results. Health literacy was associated with HF knowledge longitudinally (P<0.001) but was not associated with self-efficacy self-care adherence. In posthoc analyses, participants with inadequate health literacy had less HF knowledge than participants with adequate (P<0.001) but not marginal (P=0.073) health literacy.Conclusions. Adequate health literacy was associated with greater HF knowledge but not self-efficacy or adherence to self-care expectations over time. If nurses understand patients’ health literacy level, they may educate patients using methods that promote understanding of concepts. Since interventions that promote self-efficacy and adherence to self-care were not associated with health literacy level, new approaches must be examined.


Author(s):  
Perihan Şenel Tekin

Background:  Health literacy has a measure of capacity to access, understand, assess, and apply health information in individuals’ decision-making processes to maintain and improve life-quality quality of life. Research is a descriptive study aiming to determine the health literacy level of medical secretary’ students who are health professionals and the influencing factors of health literacy in the future.  Method: The research was conducted between April 30 and June 1, 2018, and the study group consisted of 55 medical secretary students who study in Ankara University Vocational School of Health in Turkey. The participants were given the questionnaire which was composed of 3 sections (socio-demographic information, health status, and the Health Literacy Survey-European Union/HLS-EU scale) and 70 questions used for data collection purposes. Results: The average age of the group was 21.4±4.1. The average score of participants’ general health literacy index was calculated as 33.9±7.42 (n=55). Approximately 70% of participants (n=55) were found to have adequate health literacy. Conclusions: It is very important that the medical secretaries working as secretarial and patient orientation personnel in the health sector are health literate in terms of their own health and health service quality. Health literacy can't be considered independent of the general literacy level. Hence, in the lifelong learning process, individuals need to be supported in school and work life.


Author(s):  
Suhaib M Muflih ◽  
Hadeel N Bashir ◽  
Yousef S Khader ◽  
Reema A Karasneh

Abstract Although health literacy practices have been increasingly recommended in public health literature, there is a lack of studies that examine the relationships between health literacy and self-medication. Background This research project aims to measure and evaluate the impact of health literacy on self-medication and to achieve a better understating of patients’ behaviors. Methods A cross-sectional approach was conducted and participants were recruited outpatient clinics through convenience sampling. Health literacy was measured by Single Item Literacy Screener. Results A total of 194 participants agreed to participate (63.9% were females). The results showed that more than half (57.2%) had adequate health literacy. Almost 30% of the participants were over the age of 50. The prevalence of self-medication was 74.2%. Nearly, two-thirds of the total participants reported self-administration of antibiotics. There was a significant relationship between the overall health literacy level and practice of self-medication. Conclusions Improving the health literacy level of the public can reduce inappropriate self-medication, especially the self-medication with antibiotics, which represented a high prevalence situation in our sample. Appropriate reading skills are important for accessing health information, using health care services, and achieving desirable health outcomes.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Yalcin ◽  
I C Cavuslu ◽  
B Firinci ◽  
N Yalcinkaya ◽  
E Pehlivan

Abstract Background Health literacy (HL) is defined as the capacity to acquire, interpret and understand basic health information and services in a way to improve person's health. Population health literacy level was found to be inadequate or limited with 64,4% Ä°n Turkey Health Literacy Research (2015). The aim of this study is to determine the HL levels of students attending health vocational high schools and the related factors. Methods The population of this cross-sectional study was students who attended to the vocational school in the center of Malatya. The sample size was determined as 337 by using the power analysis based on Turkish data. Official permission was obtained for the research. In May and June 2019, Turkish Health Literacy Questionnaire-32 (THLQ) developed by the Ministry of Health was applied to the accepting students in this study.The score obtained from the scale is considered to be insufficient of 25 and below, limited to &gt; 25-33 points and a score of &lt; 33 and above is sufficient or excellent. In the analysis of the data, Kolmogorov Smirnov, Mann Whitney U and Kruskal Wallis tests were used and p &lt; 0.05 was chosen as the level of error. Results 68% of the students is female and 32% is male. The average age of the research group is 16.6 ± 1.1 (min. 14, max. 20). 18.3% of male students stated that 6.6% of female students smoke. The THLQ score of the study group was found to be 33.7 ± 8.9. 53.7% of male students and 39.5% of female students had insufficient or limited HL different from each other significantly (p &lt; 0,025). 56.4% of students in 9th and 10th grades and 37.4% of 11th and 12th grade students were found to have insufficient or limited HL significantly (p &lt; 0,0001). There was no difference between HLL scores and other socio-demographic characteristics(p &gt; 0,05). Conclusions The frequency of adequate or excellent HL in the study group is higher among females (60.5%) than males (46.3%). It can be said that female students value health more. Key messages The limited level of health literacy of health vocational high school students indicates the insufficiency of health education in schools. Health topic campaigns should be organized frequently for awareness on health education during school education.


2018 ◽  
Vol 52 (3) ◽  
Author(s):  
Hygeia Grace C. Agosto ◽  
Marla Vina A. Briones ◽  
Maylin C. Palatino

Objective. A number of studies worldwide have shown that health literacy is vital in the improvement of health status of individuals as well as in the effective implementation of health programs. In the Philippines, however, data regarding the level of health literacy among Filipino adults are yet to be gathered. This study then aimed to describe the health literacy level and to determine the correlates of health literacy among Filipino adults aged 50 to 70 years old belonging to the lower socioeconomic class in a selected community. Methods. An analytical cross-sectional study was conducted, utilizing data from the study of Briones, M. et. al in 2015, among selected Filipino adults in a barangay in Pasig City. Results. Ninety-four percent of the study participants had problematic/inadequate health literacy level. The factors found to be statistically associated with having problematic / inadequate health literacy were having at most high school level education, and not being able to visit a medical doctor in the past 12 months. Nonetheless, being self-employed made an individual less likely to have a problematic/inadequate health literacy. Conclusions. There was a high proportion of individuals who had problematic/inadequate health literacy among 50 to 70 years old in the study area. Socio-economic characteristics such as educational attainment and healthcare access were shown to be associated with an individual’s level of health literacy. Despite the extensive health information available to the public, the level of health literacy still remained to be poor. This indicates that there is a need to evaluate if said information are easily accessed, understood, appraised and applied by individuals to make sound health decisions.


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