Egészségműveltséget mérő kérdőívek validálása hazai felnőttmintán

Összefoglaló. Bevezetés: Az eredményes gyógyítás, rehabilitáció, egészségre nevelés és egészségfejlesztés elengedhetetlen feltétele, hogy az egyén az egészségműveltségének megfelelő módon jusson hozzá az egészségével kapcsolatos információkhoz. Célkitűzés: A kutatás célja két, az egészségműveltséget objektíven (Newest Vital Sign) és szubjektíven (Brief Health Literacy Screening Tool) mérő skála validálása volt. Ezen nemzetközi felmérésekben elterjedt és önmagukban is alkalmazható rövid tesztek segítségével vizsgálható az általános populáció egészségműveltsége. Módszer: A skálák tesztelése országos keresztmetszeti vizsgálat keretében zajlott a felnőtt lakosság körében. A kérdőívek megbízhatóságát és validitását az egyes kérdőíveken belüli Cronbach-α, Spearman–Brown és korrigált item-totál korrelációs együtthatók, valamint feltáró faktorelemzés (főkomponens-elemzés, varimax rotáció) segítségével értékeltük. Eredmények: A kérdőívek belső konzisztenciáját mérő Cronbach-α-érték a Newest Vital Sign kérdőív esetében 0,72, a Brief Health Literacy Screening Tool kérdőív esetében 0,87, míg a Spearman–Brown-féle korrigált korrelációval számított „split-half” megbízhatóság 0,76, illetve 0,88 volt. Az item-totál korrelációs vizsgálat során kapott korrelációs együtthatók minden esetben magasabbnak bizonyultak az elvárható 0,3-as értéknél. A faktorszerkezet feltárása rávilágított, hogy a két teszt az egészségműveltség más-más dimenzióit méri. Megbeszélés: Eredményeink alapján mindkét teszt megbízhatónak bizonyult; a Brief Health Literacy Screening Tool skála belső validitása magasabb, mint az eredeti kérdőívé. A faktorelemzés alapján a két kérdőív együttes alkalmazása is lehetséges, ha a cél a szubjektív és az objektív műveltség egyszerre történő vizsgálata. Következtetés: Eredményeink alapján javasoljuk a Brief Health Literacy Screening Tool és a Newest Vital Sign kérdőívek általunk validált változatának használatát kérdezőbiztosok által felvett, egészségműveltséget vizsgáló felmérések részeként. Orv Hetil. 2021; 162(39): 1579–1588. Summary. Introduction: Accessing health information adapted to one’s health literacy level is a prerequisite for effective healing, rehabilitation, health education, and health promotion. Objective: This research aimed to validate the Hungarian version of two instruments measuring health literacy: the performance-based Newest Vital Sign and the self-reported Brief Health Literacy Screening Tool. These short instruments, which are frequently used in international surveys, can be applied to measure health literacy among the general population. Method: The two instruments were tested in a nationwide cross-sectional study in the general population. The questionnaires’ reliability and validity were evaluated using Cronbach-α, Spearman–Brown, corrected item-total correlation coefficients, and exploratory factor analysis (principal components analysis, varimax rotation). Results: The internal consistency measured by the Cronbach-α was 0.72 for the Newest Vital Sign and 0.87 for the Brief Health Literacy Screening Tool, and the split-half reliabilities calculated with the Spearman–Brown correlation were 0.76 and 0.88, respectively. The correlation coefficients obtained during the item-total correlation analysis proved to be higher than the expected 0.3 value in all cases. Exploring the factor structure revealed that the two tests measure different dimensions of health literacy. Discussion: Both tests proved to be reliable; the internal validity of the Brief Health Literacy Screening Tool is higher than that of the original questionnaire. Based on the factor analysis, their application is possible together if the goal is to examine subjective and objective health literacy together. Conclusion: Using the validated Hungarian version of these questionnaires is recommended as part of health literacy surveys conducted by interviewers. Orv Hetil. 2021; 162(39): 1579–1588.

Nutrition Literacy is Associated with Income and Place of Residence but not with Diet behavior and Food Security in the Palestinian Society

Introduction: Palestinian society is going through health transition associated with increase in chronic diseases due to poor dietary habits so adequate integration of nutrition information is important.Aims: The aim of this study is to find the association between nutrition literacy and diet behavior among a group of Palestinian participants.Methods: A sample of 101 Palestinian participants were recruited to participate in the study. Using an online survey which was distributed through educational and social internet platforms was used to collect data on sociodemographic variable. Newest Vital Sign quiz was used to collect information on nutrition literacy and Short Format of the Diet Health and Knowledge Survey (SFDHKS) was used to collect information on diet behavior and USDA food security questionnaire was used to collect data on food security. Data was analyzed by SPSS 21.Results: This study included 101 participants, mean age 22.7 y± 8.7 y, mainly females. 5.7% of the study participants were obese, 13.8% overweight and 10.3% were underweight. The prevalence of adequate nutrition literacy was 24%. There was minimal association between diet behavior and nutrition literacy, food security and BMI categories, but significant association with income and living in city relative to village (p< 0.05). Only 11 participants had some form of food insecurity.Conclusion: There is low prevalence of adequate nutrition literacy. Nutrition literacy depends on social and economic aspect but further research is need to understand relationship to diet behavior.

The Online Use of the Newest Vital Sign in Adolescents

Seventy percent of premature adult deaths are caused by adolescent behaviors. Data suggests that health literacy may influence adolescent behaviors. However, adolescent health literacy research is scarce; and, timely, more robust data is imperative. Nonetheless, many potential study samples are currently inaccessible due to the pandemic. Thus, there is an immediate need to evaluate online adolescent health literacy research modalities to further the science. The purpose of this study is to explore the psychometric properties of online administration of the Newest Vital Sign (NVS) health literacy instrument in adolescents. A total of 105 adolescents completed the study via Qualtrics. Internal consistency reliability of the online NVS was good (α = .77). There was, however, no significant correlation between online and in-person comparison scores ( r = .05, p = .59). This study yields clinically significant results showing insight into the online NVS for adolescents, providing a foundation for future adolescent health literacy research.

Cultural Adaptation of Health Literacy Measures: Translation Validation of the Newest Vital Sign in Arabic-Speaking Parents of Children With Type 1 Diabetes in Kuwait

Purpose The purpose of the study was to assess the feasibility of use and reliability of the Arabic version of the Newest Vital Sign (NVS-Ar) in parents of children with type 1 diabetes (T1D). Methods The final translated version of NVS-Ar was administered to 175 adult caregivers of children with T1D who are native Arabic speakers. The association between NVS-Ar scores for the parents/legal guardians and A1C for their children was assessed. The internal consistency was evaluated by Cronbach’s α, and reliability was assessed by test-retest method. Results The median (interquartile range) score was 4.0 (3-5). The internal consistency of the NVS-Ar was moderate (α = .58). The intraclass correlation coefficient was .61. There was no correlation between NVS-Ar score and A1C (Spearman’s ρ = .055; P = .62). Furthermore, there was significant inverse association between adequate health literacy and optimal glycemic control among the children, which remained evident even after adjusting for the duration of T1D, age, or education of the parents/guardians. However, it lost statistical significance after adjustment for treatment regimen. Conclusion Study findings indicate that the NVS is unlikely to be a predictive tool for functional health literacy in Arabic settings and that there is a need to properly translate and validate other tools such as the Test of Functional Health Literacy in Adults or, alternatively, to develop a reliable tool.

Functional Health Literacy: Psychometric Properties of the Newest Vital Sign for Portuguese Adolescents (NVS-PTeen)

Self-management of health requires skills to obtain, process, understand, and use health-related information. Assessment of adolescents’ functional health literacy requires valid, reliable, and low-burden tools. The main objective of this study was to adapt and study the psychometric properties of the Newest Vital Sign for the Portuguese adolescents’ population (NVS-PTeen). Classic psychometric indicators of reliability and validity were combined with item response theory (IRT) analyses in a cross-sectional survey, complemented with a 3-month test-retest assessment. The NVS-PTeen was self-administered to students enrolled in grades 8 to 12 (12 to 17 years old) in a school setting. Overall, 386 students (191 girls) from 16 classes of the same school participated in the study (mean age = 14.5; SD = 1.5). Internal reliability of the NVS-PTeen was α = 0.60. The NVS-PTeen total score was positively and significantly correlated with Portuguese (r = 0.28) and mathematics scores (r = 0.31), school years (r = 0.31), and age (r = 0.19). Similar to the original scale (for the U.S.), the NVS-PTeen is composed of two dimensions, reading-related literacy and numeracy. Temporal reliability is adequate, though with a learning effect. IRT analyses revealed differences in difficulty and discriminative capacity among items, all with adequate outfit and infit values. Results showed that the NVS-PTeen is valid and reliable, sensible to inter-individual educational differences, and adequate for regular screening of functional health literacy in adolescents.

Literacia em Saúde e o Autocuidado e Autocontrolo no Idoso com Diabetes Tipo 2

Introdução. A diabetes como doença crónica, representa um grave problema de saúde pública a nível mundial, pela sua incidência, e pela elevada taxa de morbilidade e mortalidade com fortes repercussões na vida das pessoas. Objetivo. Conhecer efeito de programa de educação para a saúde sobre o conhecimento da diabetes, capacitação para o autocuidado e literacia em saúde no idoso diabético. Método. Estudo quasi-experimental de grupo único, com amostra de 40 participantes diabéticos tipo 2, com 65 ou mais anos de idade, autónomos. Instrumentos: Questionário Sociodemográfico e Clínico; Questionário de Avaliação de Conhecimentos (DKQ-24) (α = 0.83); Escala Atividades de Autocuidado com a Diabetes (α = 0.62); Questionário Literacia Newest Vital Sign (α = 0.76). Realizou-se uma análise estatística descritiva e inferencial. Resultados. Diferenças estatisticamente significativas no conhecimento sobre diabetes entre o 1º e 2º momento de avaliação. Nas atividades de autocuidado com a diabetes encontramos diferenças estatisticamente significativas nas atividades Alimentação, Alimentação Específica e Cuidados com os Pés. A literacia em saúde, na 1ª avaliação, situou-se a um nível de alta probabilidade de literacia limitada e após intervenção evoluiu positivamente, demonstrando um aumento do nível de literacia. Conclusão. Este estudo comprovou a importância dos programas de educação para a saúde como uma ferramenta potente para a capacitação da pessoa diabética. Verificou-se que o nível de conhecimentos sobre a doença na pessoa diabética tipo 2 com mais de 65 anos aumentou de forma significativa, e interferiu positivamente na capacitação do diabético idoso para a gestão das atividades de autocuidado aumentando o nível de literacia em saúde.

‘The newest vital sign among pregnant women attending women wellness and research Centre in Qatar: a cross-sectional study’

Background Health literacy is a vital strategy to consider when designing health-promoting programs, and health literacy is a priority in Qatar’s national health agenda. In the context of pregnancy, inadequate health literacy has been linked to several adverse outcomes among pregnant women such as unplanned conception, smoking, and lack of multi-vitamin intake. Given the paucity of data, this study aimed to assess the level of health literacy and its determinants among pregnant women in the State of Qatar. Methods An analytical cross-sectional design was utilized. First, we piloted the measurement tools on 10% of the calculated sample size. Accordingly, the items of the measurement tools were revised. Next, we utilized a structured questionnaire to interview the participants about their socio-demographic characteristics, pregnancy-related factors, and the Newest Vital Sign Tool. A chi-square test was employed to investigate the association level among variables, with significance set to P < 0.05. A logistic regression model was used to identify the factors associated with a low literacy level. Results We found that almost four in 10 pregnant women (n = 138,45.4%) had inadequate health literacy. Furthermore, the insufficient level of health literacy was significantly associated with low educational background, decreased household income, and primigravida. However, uncontrolled glycaemia was the only significant predictor of inadequate health literacy through logistic regression. The scale was found to be reliable, with a calculated Cronbach’s alpha of 0.8. Conclusions Low health literacy is common among pregnant women in the State of Qatar. Thus, public health officials should focus on delivering tailored health literacy interventions to pregnant women in the country.

Patient Perceived Involvement in Their Treatment is Influenced by Factors Other Than Independently Rated Clinician Communication Effectiveness

We analyzed (1) the correspondence of patient and clinician perceived patient involvement in decision making and ratings made by independent observer's independent ratings, as well as (2), factors associated with patient-perceived involvement, among patients seeking hand specialty care. During 63 visits, the patient, their hand specialist, and 2 independent observers each rated patient involvement in decision making using the 9-item shared decision-making questionnaire for patients and clinicians, and the 5-item observing patient involvement scale (OPTION-5). We also measured health literacy (Newest Vital Sign), patient and visit characteristics (gender, age, race, years of education, occupation, marital status, and family present). There was no correlation ( ρ = 0.17; P = .17) between patient (median 42, IQR 36-44.5) and clinician (38, IQR 35-43) ratings of patient involvement in decision making. Independently rated patient involvement correlated moderately with a specialist ( ρ = 0.35, P <.01), but not patient ( ρ = 0.22, P = .08) ratings. The finding that patient perception of their involvement in decision making has little or no relationship to independently rated clinician communication effectiveness and effort, suggests that other aspects of the encounter—such as empathy and trust—may merit investigation as mediators of the patient agency.