Health literacy the perspective of primary care providers: their health literacy, attitudes and influence on communication with patients

Abstract

Introduction: Health literacy is an essential component of efficient communication in the health system, influencing the health of individuals and society. Primary care physicians and administrative staff in primary care clinics and hospitals are important players as sources of health information and navigators of patients in the health system. Little is known of the association between the health literacy of providers and their performance with regard to health literacy of their patients. The objective of the study was to examine the correlation between the level of health literacy of service providers, their awareness of and attitudes towards health literacy promotion, and how they communicate with patients with low health literacy. Methods: A cross-sectional analytic research study was conducted among 50 physicians and 50 administrative staff members working in primary care community clinics in the Maccabi Health Maintenance Organization (HMO) in Israel. The level of health literacy was measured using the HLS-EU Q16 tool previously validated in Israel. Awareness of health literacy, of health and economic ramifications of low health literacy, attitudes towards health literacy promotion and the appropriateness of communication related to low health literacy, were measured using validated self-administered tools. Results: Among physicians, the level of awareness was higher than among administrative service staff. Over 42% of the providers showed good level of awareness regarding the effects of low health literacy, once defined, while 67% had never heard of the term health literacy, 26% heard of health literacy but were not familiar with its meaning. Significant positive associations were found (p ＜ .05) between the providers’ health literacy, their attitudes towards health literacy promotion and their use of communication techniques. Significant associations were found (p＜ .01) between awareness and the attitudes about health literacy promotion, and the degree to which communication techniques were adopted. No mediation variables were found between the research variables. Conclusions/Implications: This is the first research study of its kind in Israel that examined health literacy among health service providers. The results indicate gaps in health literacy which can be narrowed through guidelines for improving providers' understanding about health literacy, and for improving processes in health systems, focusing on the medical and administrative staff for promoting health literacy, and for using recommended tools for health communication. The health literacy of health services providers has implications for the degree of awareness of the importance of health literacy in treating and serving patients.