Adequate Health Literacy Levels Research Articles

Association between Health Literacy and Disability in Activities of Daily Living among Older Adults with Multimorbidity: Findings from the Korean Health Panel Survey in 2021

Purpose: This study investigated the relationship between health literacy and disability in activities of daily living (ADL) in older adults with multimorbidity. Methods: Using data from the Korea Health Panel Survey (KHPS), 2,153 older adults with multimorbidity were analyzed in this cross-sectional study. The <i>x</i><sup>2</sup> test was performed to determine differences in ADL disability according to demographic and health-related characteristics. In addition, multiple logistic regression analysis was performed to assess the risk of ADL disability according to the level of health literacy, and the results are presented as odds ratios (OR) and 95% confidence intervals (CI). Data were analyzed using SPSS version 23.0. Results: For the young-old group (65-74 years), compared with an adequate level of health literacy, the risk of ADL disability was 2.02 times (95% CI 1.20~3.42) higher in those with a marginal level, and 2.53 times (95% CI 1.54~4.16) higher in those with an inadequate level after adjusting for covariates. Conclusion: In older adults under 75 with multimorbidity, a lower level of health literacy was associated with a higher risk of ADL disability. This highlights that health literacy is an important factor closely associated with ADL disability in older adults with multimorbidity, extending beyond the basic ability to understand and apply information.

Exploring the barriers to the development of organizational health literacy in health institutions to meet the needs of older patients from multiple perspectives: a mixed-methods study

BackgroundThe latest evidence on health literacy in China revealed that only 8% of individuals aged 65–69 years, a segment of the geriatric population, possess adequate health literacy levels, indicating a low level in China. Studies have demonstrated that improving the organizational health literacy of healthcare institutions is a crucial approach to addressing low health literacy among older patients.ObjectiveTo explore the obstacles hindering the advancement of organizational health literacy in healthcare institutions in meeting the needs of older patients.DesignA mixed-methods approach was employed to investigate both the status and barriers to the establishment of organizational health literacy within two healthcare institutions.ParticipantsParticipants included older individuals aged over 60, clinical staff, and managerial personnel from these two health institutions.MethodsThis research utilized the social-ecological model as its theoretical foundation and utilized a mixed-methods approach to examine the current status and challenges in developing organizational health literacy within healthcare institutions. Initially, a survey using a questionnaire (n = 178) was conducted among older patients to evaluate the establishment of organizational health literacy from their perspective. Following this, interviews (n = 22) were carried out with administrators, clinical personnel, and elderly patients to identify the barriers hindering the development of organizational health literacy within healthcare institutions.ResultsQuantitative research indicates that health institutions have been less accommodating to the requirements of older patients, with health information dissemination and communication emerging as the weakest areas. Qualitative investigations revealed three key influencing factors: patient-related factors, including physiological and cognitive decline, as well as low educational attainment among older patients; organizational factors, including inadequate clinical staff numbers, deficient long-term systematic training, and a digital divide resulting from health institutions’ digital advancements; and policy-related factors indicating a lack of regulations governing the establishment of organizational health literacy within healthcare institutions.ConclusionThe two most vulnerable aspects of OHL in medical institutions regarding the needs of older patients are health information and communication. The factors influencing the construction of OHL in medical institutions are multifaceted, encompassing micro, meso, and macro levels. At the macro level, it is essential for medical institutions to enhance leadership awareness of OHL and to incorporate its development into institutional strategic plans. At the meso-level, medical institutions should be made to optimize the medical environment for elderly patients and to prioritize health literacy training for medical staff. At the micro level, attention must be given to the characteristics and needs of elderly patients. Ultimately, by implementing a comprehensive construction of intervention strategies, the response ability of medical institutions to the needs of elderly patients can be enhanced.

Associations between maternal health literacy and prenatal micronutrient intake in Hungarian women

Abstract Background Adequate level of health literacy (HL) is an important factor in pregnancy. Low HL may increase the risk of maternal and fetal complications (e.g., gestational diabetes mellitus, low birth weight). This study aimed to measure the levels of maternal HL and its associations with the consumption of folic acid (FoA), vitamin D (VD), and omega-3 fatty acids (FAs) during pregnancy in Hungarian women. Methods The questionnaire-based study was conducted at the Department of Obstetrics and Gynecology, University of Szeged among women who gave birth between June and September 2023 (N = 294). Sociodemographic, lifestyle, conception and pregnancy related questions were asked. HL was measured by the Maternal Health Literacy Inventory in Pregnancy (MHELIP) questionnaire (after the Hungarian adaptation); it contains 48 items representing four subscales (maternal health knowledge, search for maternal health information, assessment of maternal health information, and maternal health decision making and behavior). Data analysis was performed by SPSS 29.0. (Ethical permission: 5351) Results The mean age of women was 31.53 +-4.75 years. During pregnancy 84.5% of women consumed FoA, 61.8% VD and 41.8% omega-3 FAs. The total mean score of MHELIP on a scale 0-100 was 78.93 (95%CI: 77.77-80.08); the score of “search for maternal health information” subscale was the lowest [57.68 (95%CI: 56.20-59.16)], and the score of “maternal health decision making and behavior” was the highest [86.75 (95%CI: 85.62-87.87)]. Omega-3 FAs and VD consumption was significantly higher in women with higher total and subscales mean scores (except “search for maternal health information”), while FoA consumption was significant in case of “assessment of maternal health information”. (The results are preliminary.) Conclusions The association between micronutrient consumption and HL supports that using this tool during pregnancy the mothers who needs more support and health information can be identified. Key messages • The Maternal Health Literacy Inventory in Pregnancy questionnaire is a reliable tool for measuring health literacy in Hungarian pregnant women. • Maternal health literacy plays an important role in the healthier lifestyle, including prenatal vitamin/micronutrient consumption.

Empowering health literacy: Turkiye’s Health Literacy Action Plan 2022-2026

Abstract Issue/Problem The ‘Health Literacy Action Plan 2022-2026’ of the Turkish Ministry of Health addresses the critical public health issue of limited health literacy, leading to increased hospital admissions, inappropriate emergency department use, and poor health outcomes. This underscores a significant challenge in individual health self-management and higher healthcare expenditure within the country. Description of the Problem The Health Literacy Action Plan aims to tackle disparities in health literacy levels among people. It employs customized teaching schemes, digital communication, and inclusive healthcare practices to reach every demographic group. The plan seeks to enhance health knowledge and empowerment among Turkish people by increasing access to medical information, simplifying clinician instructions, and promoting closer communication between patients and healthcare professionals. Results Comparative evaluation of nationwide surveys conducted in 2017 and 2023 with 15,000 participants shows remarkable improvements. Despite delays due to the pandemic, the action plan led to a notable increase in adequate health literacy levels from 31.9% in 2017 to 46.1% in 2023. Additionally, significant improvements were observed in ailment prevention and health promotion, with health literacy levels in disease prevention increasing from 28.4% to 45.7%. Lessons The Health Literacy Action Plan plays a crucial role in developing and implementing multifaceted public health strategies based on data and stakeholder participation. These interventions, requiring continuous monitoring and adjustment, are essential steps toward achieving high-level health literacy. Key messages • Strategic health literacy interventions are essential for improving health outcomes and optimizing the use of public resources. • Evidence-based interventions and ongoing evaluation are key to promoting health literacy.

Health literacy and health-related outcomes among preschool educators: a cross-sectional survey

Abstract Background Given the increasing use of childcare services and the shortage of skilled workers, preschool educators are under particular pressure. Health literacy has previously been shown to be an asset for stress and well-being in school principals. Within the organizational health literacy in preschools project, the Health-Literate Preschools Survey aims to assess educators’ health literacy levels and investigate differences in health-related outcomes based on these levels. Methods Preschool educators from a Bavarian county participated in a cross-sectional online survey in February 2024. Sociodemographic information, health literacy, and health-related outcomes (well-being, exhaustion, psychosomatic complaints) were assessed using established self-report tools. Descriptive statistics and variance analyses were carried out using SPSS. Results The sample consists of N = 114 preschool educators from a Bavarian region (94.6% female, Ø 41.5 years). Of the educators, 23.7% showed adequate, 50.0% problematic, and 26.3% inadequate health literacy levels. Kruskal-Wallis H analyses indicated statistically significant differences in well-being (H(2, n = 113) = 14.200, p < 0.001), exhaustion (H(2, n = 114) = 6.098, p = 0.047), and psychosomatic complaints (H(2, n = 114) = 8.910, p = 0.012) across health literacy levels. Conclusions The survey provides first-time insights into preschool educators’ health literacy and health-related outcomes in Germany. Only one-quarter of preschool educators demonstrated adequate health literacy levels. Further, the findings confirm the link between health literacy and well-being and stress already shown for other samples. Health promotion initiatives for preschool staff should focus on strengthening educators’ health literacy, especially given their role model function for children. Key messages • This survey is the first assessment of health literacy among preschool educators, which is an important target group given their role model for young children. • Preschool educators demonstrated overall low levels of health literacy, which is associated with well-being, exhaustion, and psychosomatic complaints.

Promoting Health Literacy in the Workplace Among Civil Servants: Cross-Sectional Study.

In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population. This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces. A cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed. A total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores. Some French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases.

Evaluation of health literacy levels and COVID-19 awareness among tuberculosis patients.

For Tuberculosis (TB) and COVID-19 infections, whose transmission modes and preventive measures are similar, compliance with preventive measures and treatment is closely related to Health Literacy (HL) levels. This study aimed to evaluate the HL levels, and COVID-19 awareness of TB patients treated and followed up in TB Dispensaries serving under the Çankaya District Health Directorate of Ankara Province. A questionnaire including socio-demographic characteristics, COVID-19 knowledge level questions, and Health literacy scale-European union-Q16 questions were applied face-to-face to the registered TB patients. Mann-Whitney U and Spearman Correlation tests were used in the analysis. The mean age of the 107 participants (response rate: 89.1%) was 48.4 years; 42.1% were women. 56.5% of the patients were newly diagnosed, and 11.1% had resistant TB. 43.5% of the participants have had COVID-19; 23.1% thought they had disruptions in their TB treatment period due to the pandemic. The HL level of 23.1% was adequate. There was a moderate positive correlation between the HL scale score and the COVID-19 knowledge level questions (r = 0.468; p < 0.001). COVID-19 knowledge level was higher in those with adequate HL levels (p < 0.001). The higher level of knowledge about COVID-19 in TB patients with sufficient HL levels suggests the importance of increasing the HL order in the effective fight against the pandemic and possible new outbreaks.

Levels of Health Literacy and Associated Factors Among Adults in a Rural Municipality of Nepal: A Cross-sectional Study.

Health literacy is crucial in maintaining good health and well-being, yet community-based studies on health literacy in Nepal are scarce. This study aimed to assess the level of health literacy and identify associated factors among adults in Rasuwa, Nepal. A community-based cross-sectional study was conducted among 253 adults aged above 18 years residing in Kalika Rural Municipality, Rasuwa. Data were collected through face-to-face interviews using the Psychometric Assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Multivariable logistic regression was used to evaluate independent correlates of health literacy levels. The mean ± SD age of participants was 46.3 ± 16 years. Only about a quarter (23.3%) of participants had adequate health literacy. The participants aged ≤ 45 years (aOR:1.9,95% CI: 1.0-3.6), people who perceived their health status as satisfactory (aOR: 3.1,95% CI: 1.5-6.3), had satisfactory self-rated financial status (aOR: 2.9,95% CI: 1.5-5.5), had satisfactory level of self- related esteem (aOR = 2.7,95% CI: 1.2-6.2), had a stable income (aOR = 1.9, 95% CI:1.0-3.5) were more likely to demonstrate adequate health literacy level. Conversely, illiterate participants (aOR: 0.1, 95% CI: 0.04-0.4) and those engaged in agriculture (aOR: 0.49, 95% CI: 0.2-0.9) had lower odds of having adequate health literacy. This study highlights inadequate health literacy status among approximately three-quarters of the participants. Factors such as age, self-rated health status, financial stability, self-esteem, and income were associated with health literacy levels. These findings underscore the importance of addressing socio-economic and individual factors in promoting health literacy initiatives, particularly targeting vulnerable populations, to improve overall health outcomes and healthcare utilization.

Coronavirus-related health literacy level of Turkish adults: psychometric properties of the scale.

An adequate level of health literacy enables people to adopt protective behaviors to cope with the COVID-19 pandemic. Validated instruments are desired to assess such reactions. This study aims to determine the level of health literacy and validity and reliability of the Coronavirus-Related Health Literacy Questionnaire (HLS-COVID-Q22) adapted to Turkish. The present study was carried out with 452 participants in Turkey using an online survey. The scale was translated from English to Turkish using the back-translation technique. The cultural adaptation was outlined in the context of establishing the validity and reliability of the instruments. A coronavirus-related health literacy measure was validated (HLS-COVID-Q22) for the Turkish population through exploratory factorial analysis, followed by a confirmatory factorial analysis. The coronavirus-related health literacy level of the participants was found to be 2.92 (± 0.51). Cronbach's alpha internal consistency coefficient was found to be 0.95. A four-factor solution was confirmed with eigenvalues > 1.0, suggesting a four-factor solution and explaining 68.84% of the total variance. It was determined that the χ2/df and root mean square residual, root mean square error of approximation and comparative fit index values in the last model had a good fit and that the normed fit index, goodness-of-fit index and adjusted goodness-of-fit index values were acceptable. The coronavirus-related health literacy level of Turkish adults was moderate. HLS-COVID-Q22 was a reliable and valid instrument for measuring coronavirus-related health literacy in the Turkish population. Promoting population-based health literacy and making decisions on accurate and reliable information are important in coping with the epidemic.

Health literacy among pregnant women in the United Arab Emirates: The Mutaba'ah study.

Health literacy is the degree to which individuals can obtain, process, understand, and communicate health-related information. Health literacy among pregnant women, in particular, may have a significant impact on maternal and child health. In the United Arab Emirates, no previous studies have been carried out to investigate the health literacy levels of pregnant women. This study aimed to investigate antenatal health literacy levels and identify associated factors among pregnant Emirati women in the United Arab Emirates. This analysis was based on the baseline cross-sectional data for pregnant women participating in the prospective cohort Mutaba'ah Study, recruited between May 2017 and August 2022. Participants completed a self-administered questionnaire during their antenatal visits that collected sociodemographic and pregnancy-related information. Adequacy of health literacy was assessed using the BRIEF health literacy screening tool with adequate health literacy defined as a score ⩾ 17. Regression modeling investigated the association between the pregnant women characteristics with having adequate health literacy level (ability to read and comprehend most patient education materials). A total of 2694 responses to the BRIEF health literacy screening tool were analyzed. Approximately, three-quarters (71.6%) of respondents showed adequate health literacy, followed by marginal (22.8%), and limited (5.6%) health literacy levels, respectively. Higher education levels (adjusted odds ratio (aOR) = 1.74, 95% confidence interval = 1.46-2.08), employment (adjusted odds ratio = 1.35, 95% confidence interval = 1.10-1.65), and adequate social support (adjusted odds ratio = 1.69, 95% confidence interval = 1.26-2.28) were associated with adequate health literacy levels. Participants who expressed worry about birth were less likely to have adequate literacy levels (adjusted odds ratio = 0.70, 95% confidence interval = 0.58-0.85). Nearly three-quarters of pregnant women have adequate health literacy. Nevertheless, measures including policies to sustain and enhance health literacy levels among all expectant mothers are required, with a specific focus on those having limited health literacy.

Relationship between health literacy and health-related quality of life in Korean adults with chronic diseases.

Inadequate health literacy is a risk factor for poor health outcomes and health-related quality of life (HRQoL). So far, the impact of health literacy on HRQoL has been examined for only a few chronic conditions. In this contribution, the relationship between health literacy and HRQoL in Korean adults with chronic conditions is examined using data of the cross-sectional Korea Health Panel Survey from 2021. Health literacy was measured with the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16) and HRQoL with the European Quality of Life-5 Dimensions (EQ-5D). Multiple linear regression model was run for the EQ-5D index as the dependent variable. Multiple logistic regression models were implemented for responses to the individual EQ-5D items. 30.8%, 24.6%, and 44.6% of participants had inadequate, marginal, and adequate levels of health literacy, respectively. The EQ-5D index increases with marginal (B = 0.018, p<0.001) and adequate literacy (B = 0.017, p<0.001) compared to inadequate literacy. People with adequate or marginal literacy were more likely to report no problem with mobility (odds ration [OR] = 1.5; p<0.001), self-care (OR = 1.6; p<0.05), and usual activities (OR = 1.6 for adequate; OR = 1.4 for marginal; p<0.01) than those with inadequate literacy. Adequate health literacy was associated with an increased likelihood of having no problem with anxiety and depression (OR = 1.4; p<0.05). In conclusion, inadequate health literacy is prevalent among Korean adults with chronic diseases. Adequate health literacy is associated with better HRQoL and a protective factor for four dimensions of EQ-5D (mobility, self-care, usual activities, and anxiety/depression).

Prevalence and determinants of health literacy among the adult population of Qatar.

Health literacy (HL) is both a direct determinant and a mediator of health outcomes. Research on the prevalence and determinants of HL in terms of its functional, communicative, and critical domains is scarce in the state of Qatar and its surrounding regions. Thus, this study aims to fill the knowledge gap in this area, estimate the levels of functional, communicative, and critical health literacy among the general adult population, and identify its determinants in the state of Qatar. An analytical cross-sectional study with a disproportionate stratified random sampling technique was conducted in 2022. A representative sample of phone numbers was obtained from the Cerner database at Hamad Medical Corporation and approached via well-trained data collectors. A socio-demographic and health-relevant factor questionnaire and the validated All Aspects of Health Literacy scale (AAHLS) were used to collect the data on functional, communicative, and critical HL and their determinants. Descriptive analysis, independent sample t-test, ANOVA, and linear regression were used and yielded the outcomes on HL levels as low, adequate, and high in percentages and the HL determinants. A total of 770 participants were included. The study found that 41.5%, 29.3%, and 29.2% of them have adequate, high, and low overall HL levels consecutively. People who participated in the study are older adult, are of Arabic ethnicity, are of Qatari ethnicity, have a lower level of education, have close relatives with a lower level of education, have a lower income, are non-migrants, are not living within a family, sought medical care within the last week, and who do not know if they have a chronic disease or do not have lower overall HL levels compared to the other groups. After linear regression analysis, only the participant's level of education and "last time sought medical care within last week" variable predict the overall HL score. Almost half of Qatar's adult population has an adequate HL level, comparable to the HL levels in other regions, despite the limitation in comparison due to variation in context and the HL measurement tools used. The possible determinants are amenable factors to focus on while designing HL interventions and providing healthcare.

The relationship between parental health literacy levels and anthropometric measurements of children in Turkey

ObjectiveThe aim of this study was to identify the relationship between parental health literacy levels and anthropometric measurements of children in Turkey.MethodsThe research was of cross-sectional/correlational design and carried out with 378 consenting parents registered at a Family Health Center. A Sociodemographic Data Form and the Health Literacy Scale for Turkey-32 was used to collect the study data. Data collection was completed at face-to-face interviews held in the consultation department of the family health center. The data were analyzed with the chi-square test and Ordinal Logistic Regression Analysis.ResultsIt was determined that parental health literacy levels were associated with level of education, income status and the state of the parents’ employment (p < .05). A relationship was also found between adequate levels of parental health literacy and the health status, weight and height standard deviation scores by age of the parents’ children (p < .05).ConclusionThis study found that adequate levels of parental health literacy were significantly lower than the European average. The study found that adequate parental health literacy had a positive effect on children’s anthropometric measurements. Health institutions and health professionals should plan training programs to improve the health literacy of parents when they apply to health institutions.

Findings of the German COVID-19 Health Literacy school principal study

Abstract Background The education sector faced tremendous challenges during the Covid-19 pandemic, requiring adjustments to meet the needs of an unprecedented public health emergency, while also maintaining school health promotion measures. School principals are key actors to lead, drive, and implement school health promotion activities in their setting. Higher school principal health literacy is known to be a predictor for the implementation of school health promotion. The international COVID-HL school principal study was implemented to assess corona-specific health literacy of principals and investigate assocaitions with school health promotion. Methods Findings from Germany, that were generated by employing an online survey in school principals during the third infection wave from March to April 2021 in four federal states, will be discussed. Sociodemographics, health literacy, and implementation of school health promotion were measured using self-report tools. Descriptive statistics and variance analyses were conducted. Results The survey was completed by N = 2186 school principals. While 60.5% showed an adequate health literacy level, 31.4% showed problematic, and 8.1% even inadequate levels. For the subscale finding, 75.4% showed an adequate level, whereas only 50.5% demonstrated adequate levels regarding information appraisal. Welch's ANOVA indicated significant differences between the health literacy levels and the implementation rate of school health promotion and prevention measures regarding students (p &amp;lt; 0.001; η2=0.054), school staff (p &amp;lt; 0.001; η2=0.015) and school (p &amp;lt; 0.001; η2=0.017). Conclusions School principals demonstrated adequate corona-specific health literacy. The most difficulties were indicated when appraising health information in the context of the pandemic. Principals with higher health literacy are more likely to implement school health promotion measures than those with lower levels, making health literacy an important public health and education target.

Health Literacy and Preventive Behaviors towards COVID-19 among Village Health Volunteers and Residents in Urban and Rural Areas of Upper Southern Thailand

This study aimed to assess health literacy (HL), preventive behaviors (PBs), and the factors associated with PBs toward COVID-19 among village health volunteers (VHVs) and residents in urban and rural areas in the upper south of Thailand. A cross-sectional study was conducted using valid questionnaires administered using an online platform. Data were analyzed using descriptive statistics, t-tests, and binary logistic regression analysis. A total of 846 people participated in this study, and 62.8% of participants had an adequate level of HL. Furthermore, 55.0% of participants had an adequate level of PBs. Among VHVs, PB levels were adequate, whereas among residents, they were inadequate. Moreover, among VHVs, underlying diseases (adjusted odds ratio (OR): 1.77, 95% CI: 1.13–2.76), access to HL (adjusted OR: 4.28, 95% CI: 1.42–12.88), appraisal of HL (adjusted OR: 3.09, 95% CI: 1.90–5.02), and application of HL (adjusted OR: 2.51, 95% CI: 1.52–4.12) were associated with COVID-19 PB. Additionally, among residents, only marital status (adjusted OR: 1.59, 95% CI: 1.04–2.44), appraisal of HL (adjusted OR: 1.78, 95% CI: 1.18–2.84), and application of HL (adjusted OR: 3.85, 95% CI: 2.39–6.20) were associated with PBs towards COVID-19. Furthermore, individuals with inadequate HL demonstrated noteworthy significance in all dimensions of PBs. To prioritize and optimize preventive programs aimed at enhancing PBs, the government must take proactive initiatives in implementing robust health communication strategies across diverse media platforms, both in the present and future.

Investigating Health Literacy Level and Related Factors Among Adults in Qom

Background: Health literacy (HL) is one of the main determinants of health behaviors. It is influenced by various individual and social factors. Inadequate health literacy is generally prevalent though its levels may vary among people in different societies. Objectives: This study aimed to investigate the health literacy level of adult people in Qom, Iran. Methods: This cross-sectional survey was conducted in 2020 in Qom to investigate the HL level among adult people. Due to the outbreak of the COVID-19 epidemic, the questionnaire was distributed using social media and small message service (SMS) to obtain the most heterogeneous sample possible. Then, a total of 488 individuals were recruited. Data analysis was performed using SPSS version 22 and adopting a linear regression model to determine the factors influencing HL. P-values &lt; 5% were considered statistically significant. Results: Results showed that inadequate, moderate, and adequate levels of HL among participants were 14.3%, 60.5%, and 25.2%, respectively. Gender and level of education were significantly associated with HL at a 95% confidence interval. Conclusions: It was concluded that the majority of the study population enjoyed moderate and high HL levels. Due to the exclusion of illiterate individuals from this study, however, HL remained a challenge to adopting the health behaviors. Therefore, it was recommended that an effective training program should be developed and conducted to educate individuals with lower education levels and older people about HL.

Health Literacy Among University Students in Shaanxi Province of China: A Cross-Sectional Study.

An adequate level of health literacy will help university students to better respond to public health emergencies and reduce unintended harm caused by public health events. The objective of this study was to assess the health literacy levels of students from Universities of Shaanxi province of China, in order to provide a basis for the development of health literacy promotion plan for university students. An online cross-sectional questionnaire survey was conducted at five universities in Shaanxi Province of China on the Wen-Juan-Xing online platform. A purposive sampling method was used to 1578 students via self-administered questionnaire. Comparisons of means were made using the t-test and ANOVA, and comparisons of ratios or composition ratios were made using the χ2 test. The mean score for health literacy was (105.33±10.14) out of 135, and the mean scores for the three dimensions of health knowledge, attitudes and practices were (36.093±4.192), (34.178±4.227) and (35.059±4.515) respectively. Of the total sample, 39.2% were classified as sufficient in health literacy. Female students had higher health literacy level than male students (t=4.064, p=0.044), lower grade students scored higher than higher grade (F=3.194, p=0.013), students from urban cities scored higher than those who came from rural areas (t=16.376, p<0.001), and university students with health education experience scored higher than those without (t=24.389, p<0.001). University students' health literacy is closely related to their gender, grades, family location and health education experience.

HEALTH LITERACY LEVEL OF A PROVINCE AND FACTORS AFFECTING IT

Objective: In this study, it was aimed to determine the level of health literacy and related factors in Bursa. Methods: It was determined by the simple random random sampling method from the population of the Family Physicians in Bursa and the 17 districts of Bursa were weighted according to their populations, and the districts where less than 50 questionnaires would be applied were excluded from the scope of the study. In June-July 2018, 2200 people were surveyed, 188 surveys were excluded from the research due to inadequacies in the data and a total of 2012 surveys were evaluated. Results: As a result of the logistic regression analysis of the factors age, education, health status, income level and reading habits were found to be associated with having sufficient health literacy level. Accordingly, adequate level of health literacy; in individuals aged 15- 44, 1.25 times compared to individuals aged 45 and over, 1.36 times more than those with a high school or higher education, secondary school and below, 1.81 times more than those with good health and poor health, it was observed that it was 1.32 times higher in those with a good income level than those with a low income level and 1.45 times more in those with a habit of reading books than in those without a habit of reading. Conclusion: In our health literacy study conducted in Bursa province, we showed the relationship between age, education status, income level, education level, reading habits and health literacy. Health literacy; a concept that has been put forward for the last twenty years for health service delivery, is known to be effective in a wide process ranging from cost-effective patient-physician satisfaction, where it can change the results of health service expectations. In order to protect the society without the need for rehabilitation without getting sick for a total welfare, screening and education activities should increasingly continue

Relationship between health literacy and self care management in people with type 2 diabetes mellitus in Indonesia

Health literacy is considered one of the influencing factors to self-care management in people with type 2 Diabetes Mellitus. American Diabetes Association stated that complications in people with type 2 diabetes mellitus tend to increase and get worse due to the inability to manage the disease independently. This study aimed to determine the relationship between health literacy and self-care management in the Health Centers in Makassar City. Measurements using the HLS-Q16 instrument for health literacy and diabetes self-management questionnaire (DSMQ) for self-care management. Data was analyzed by using fisher’s exact test. The results showed an adequate level of health literacy with 71 respondents and a low level of self-care management with 74 respondents from 126 respondents and there was a relationship between health literacy and self-care management with p-value = 0.004 &lt;0.05. These findings can be additional information material to design programs and training that support the improvement

Colorectal cancer screening: understanding the needs of the pre-screening group.

For the last three decades, although colorectal cancer incidence has been decreasing in those over 50 years of age, it has been increasing in those under 50 included in the pre-screening group (PSG). The present study aims to explain the screening-related factors and compliance of individuals in PSG who are not included in the colorectal cancer screening programme. This cross-sectional study was conducted with a total of 323 participants, 143 of whom were from the pre-screening group (40-49 years), and 180 from the screening included group (SIG) (50-70 years). Individuals included in PSG were more likely to have accepted that both faecal occult blood test (FOBT) (2.23 ± 1.22 vs. 1.89 ± 1.33, p = 0.018) and colonoscopy (2.37 ± 0.97 vs. 2.02 ± 1.14, p = 0.003) were useful and suitable screening tests in colorectal cancer. Adequate health literacy (OR = 4.3, 95% CI: 1.8-10.0, p = 0.001) and better education level (OR = 3.3, 95% CI: 1.3-8.4, p = 0.010) were factors of increased knowledge of colorectal cancer screening. The findings show that PSG has different characteristics than SIG and may be more fitting in the colorectal cancer screening programme if included.