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

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.

Digitale Gesundheitskompetenz der Bevölkerung in Deutschland Ergebnisse des HLS-GER 2

Zusammenfassung Ziel Durch die Digitalisierung gewinnen digitale Informationen zum Thema Gesundheit zunehmend an Bedeutung. Neben vielfältigen Chancen bringt diese Entwicklung auch Herausforderungen mit sich, denn mit dem wachsenden Angebot steigt zugleich der Bedarf an digitaler Gesundheitskompetenz (DGK). Im nachfolgenden Beitrag werden das Ausmaß der DGK in der Bevölkerung in Deutschland, zentrale Determinanten der DGK und Folgen für die Nutzung digitaler gesundheitsbezogener Informationsangebote analysiert. Methodik Die Analyse basiert auf Daten des zweiten Health Literacy Survey Germany (HLS-GER 2), bestehend aus einer repräsentativen Stichprobe mit n=2151. Die Erfassung der DGK, der Determinanten sowie der Nutzung digitaler gesundheitsbezogener Informationsangebote erfolgte mit einem im Rahmen der internationalen Vergleichsstudie HLS19 erarbeiteten Fragebogens. Es wurden bivariate und multivariate Analysen durchgeführt. Ergebnisse Insgesamt verfügen 75,8% der Bevölkerung über eine geringe DGK. Vor allem geringe literale Fähigkeiten, ein höheres Alter, eine niedrige Bildung sowie ein niedriger Sozialstatus gehen mit einer geringen DGK einher. Die multivariate Analyse weist zudem auf einen starken Zusammenhang zwischen DGK und allgemeiner Gesundheitskompetenz (GK) hin. Geringe DGK ist folgenreich und führt zu einer geringeren Nutzung digitaler gesundheitsbezogener Informationsangebote. Schlussfolgerung Die Ergebnisse unterstreichen die Wichtigkeit der Förderung von DGK der Bevölkerung und besonders von Gruppen mit geringer DGK. Entsprechende Bemühungen sollten die allgemeine GK einbeziehen, denn sie steht in engem Zusammenhang mit der DGK. Auch um die noch geringe Nutzung digitaler Informationsangebote in Deutschland zu erhöhen und generell, um der zunehmenden Digitalisierung des Gesundheitswesens zu entsprechen, stellt die Stärkung der DGK eine gesellschaftlich wichtige Aufgabe dar.

Psychometric Properties of the Health Literacy Survey European Questionnaire-12

The importance of health literacy has increased as the public awareness of health has increased. Health Literacy Survey European Questionnaire-47 (HLS-EU-Q47) is a representative assessment tool for evaluating health literacy, and its psychometric properties have been examined in various countries. This study analyzed the item-level psychometric properties of a short version of the HLS-EU-Q47 using a Rasch measurement model. We collected 254 Korean adults who completed the 12 items of the HLS-EU-Q47 in hospital settings. We used confirmation factor analysis (CFA) to examine the unidimensionality assumption of the HLS-EU-Q12. We analyzed item fit, precision, and differential item functioning (DIF) across sex, age and education groups. The CFA model confirmed that HLS-EU-Q12 satisfies the unidimensionality assumption (CFI = 0.96, TLI = 0.96, RMSEA = 0.09) and no local independence in the 12 test items (residual correlations ranged from -0.16 to 0.19). The HLS-EU-Q12 demonstrated high reliability (Cronbach’s α = 0.90) and no DIF across sex, age and education groups (p > 0.05). The person strata by the instrument were 3.80, which is equivalent to a traditional reliability value of 0.87. In short, the study findings indicate that the HLS-EU-Q12 has good psychometric properties with the 254 Korean adults. Since the HLS-EU-Q12 can accurately and precisely evaluate the health literacy of Korean adults, this instrument could be used in clinical settings.

Age, gender, and financial literacy in Japan

Objective The aim of this study is to investigate the association between financial literacy and age as well as gender differences in financial literacy. Methods We analyse a sample of 25,000 individuals from ‘The Financial Literacy Survey 2016’ conducted by the Central Council for Financial Services Information (Bank of Japan). The analysis focuses on the relationship of age and financial literacy as well as that of age and self-rated financial knowledge. To consider factors accounting for gender differences in financial literacy, we use the Blinder-Oaxaca decomposition method. To further our understanding of financial literacy, we conduct additional analyses on financial behaviour and attitude. Results Although age is associated with increased financial literacy (Men, β: 0.249, standard error [SE]: 0.030; Women, 0.354, SE: 0.026), the growth rate decreases among the older respondents (Men, β: -0.002, SE: 0.000; Women, -0.003, SE: 0.000). However, the association between age and self-rated financial knowledge among men moves in the opposite direction (Age, β: -0.021, SE: 0.009, Age2, β: 0.000, SE: 0.000). Furthermore, female respondents are likely to be less financially literate than their male counterparts (β: -0.586, SE: 0.095) due to gender differences in the distribution of the factors that affect financial literacy (specifically education), their responses to financial literacy, and the interactions of these effects. In contrast to knowledge-based financial literacy, financial behaviour and attitudes among women are more preferable to those among men, namely, more premeditated. Conclusion Financial literacy increases until about one’s early 60s, after which it declines, while confidence in financial literacy reflects the inverse trend, especially among men. Additionally, men are more financially literate than women; however, these differences could be mitigated through education. Meanwhile, financial behaviour and attitudes among men are less premeditated. Thus, policies are needed that can help older adults with their financial decision-making, enhance women’s financial literacy, and improve men’s financial behaviours and attitudes.

Alfabetización en salud en la comunidad

Este articulo trata sobre la alfabetización en salud en la comunidad. En primer lugar se clarifica que se entiende la salud como un derecho de todos los seres humanos y tiene que ser sostenida por la sociedad. Se introduce la promoción de la salud como enfoque teniendo en cuenta que se define como un proceso que permite a las personas incrementar el control sobre su salud y la importancia de la alfabetización en salud como uno de los pilares básicos. Se desarrolla el concepto de alfabetización en salud a partir de múltiples definiciones, se revisan algunas por su significación y se recogen tres elementos claves a partir del análisis de la mayoría de ellas. Se reconoce que el concepto es multidimensional, complejo y heterogéneo. Se recopilan los conocimientos sobre el tema a partir de los estudios realizados. Se presentan algunos de los instrumentos para la medida de la alfabetización en salud. Por su relevancia en el contexto europeo se presenta el modelo de Sorensen y su desarrollo en el cuestionario European Health Literacy Survey que permitió conocer el nivel de alfabetización en salud en ocho países europeos. Finalmente se introducen los entornos saludables como estrategia para facilitar la alfabetización en salud de las personas en la comunidad y se comentan los aspectos más relevantes de cada uno de ellos.

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.

Will the Widespread Use of Cashless Payments Reduce the Frequency of the Use of Cash Payments?

Will the widespread use of cashless payments reduce the frequency of the use of cash payments? This question is important because the major costs of cash use are fixed costs that would only be reduced if the frequency of cash payments substantially decreased, and thus the extent of the reduction of the cost of cash use depends on the frequency of cash use after the widespread use of cashless payment methods. Using the data from the Financial Literacy Survey 2019 in Japan, this paper shows that the frequency of cash use for those who use both cash and noncash payment methods and that of those who exclusively use cash are about once in 2.3 days and about once in 2 days, respectively, and thus there is only a slight difference. The result did not change even if a regression model for cash usage was used that considers the endogenous choice of payment methods or if counterfactual simulations of the decrease in consumers’ willingness to use cash were conducted. The results suggest that the benefit of reducing the cost of cash use due to the widespread use of cashless payment methods is overestimated because the frequency of the use of cash payments is unlikely to decrease despite the use of cashless payment methods.

The Influence of Robot-Assisted Learning System on Health Literacy and Learning Perception

Healthy aging is a new challenge for the world. Therefore, health literacy education is a key issue in the current health care field. This research has developed a robot-assisted learning system to explore the possibility of significantly improving health literacy and learning perception through interaction with robots. In particular, this study adopted an experimental design, in which the experiment lasted for 90 min. A total of 60 participants over the age of 50 were randomly assigned to different learning modes. The RobotLS group learned by interacting with robots, while the VideoLS group watched health education videos on a tablet computer. The content dealt with hypertension related issues. This study used the European Health Literacy Survey Questionnaire (HLS-EU-Q16), Health Knowledge Questionnaire, Reduced Instructional Materials Motivation Survey (RIMMS), and Flow Scale as evaluation tools. The result shows no significant difference in the pre-test scores between the two groups. Compared with the video-assisted learning system, the robot-assisted learning system can significantly improve health knowledge, health literacy, learning motivation, and flow perception. According to the findings of this study, a robot-assisted learning system can be introduced in the future into homes and care institutions to enhance the health literacy of the elderly.

Trends in Educational and Skill Mismatch in the United States

We examined trends in the incidence and correlates of educational and skill mismatch in the United States. We focused on trends over time in the associations between various types of mismatch and a range of factors including contextual conditions. We explored whether contextual conditions at the transitional period from school to jobs increase or decrease the probability of mismatch and whether such relationships persist throughout the working career. Our central questions were how the incidence of and relationship between educational and skill mismatch in the U.S. changed between 1994, 2003, and 2012 and how this differed by age, gender, immigration status, educational attainment, and occupation. We used three cross-sectional surveys that had not previously been implemented for such an effort. These were the International Adult Literacy Survey (IALS) in 1994, the Adult Literacy and Life-skills (ALL) survey in 2003, and the Program for the International Assessment of Adult Competencies (PIAAC) in 2012. Repeated cross-sectional data provided us with substantial analytic leverage. Our findings point toward the key role of occupational or positional factors rather than individual worker characteristics as being most implicated in trends in mismatch. We describe the importance of our results for labor market theories.