Adequate Health Literacy Levels Research Articles

The relationship between health literacy and self-care in patients with heart failure

Background/Aims Research has shown that health literacy can influence an individual's ability to practise self-care, particularly for patients with heart failure. This study aimed to assess health literacy and its relationship with heart failure knowledge and self-care practices in this patient group. Methods An observational sub-study was conducted with the data from a large randomised control trial that evaluated the relationship between patients' health literacy, general literacy, knowledge of heart failure and self-care. Results A total of 36 participants were recruited, of which 33 (89.9%) had adequate levels of health literacy. Health literacy was positively associated with heart failure knowledge. However, 67.7% of participants with adequate health literacy were found to have inadequate levels of self-care management. Conclusions Health literacy may facilitate better heart failure knowledge, but it does not necessarily lead to improved self-care management in patients with heart failure. This suggest that clinicians need to put more emphasis on translating knowledge into behavioural changes for self-care in this patient group.

Assessing parents, youth athletes and coaches subjective health literacy: A cross-sectional study

ObjectivesThe aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches, parents/caregivers) in Swedish Athletics. DesignCross-sectional. MethodsData on subjective HL were collected using the Swedish Communicative and Critical Health Literacy (S-CCHL) instrument for mentors and for youth the School-Aged Children (HLSAC) instrument. Questions assessing mentors’ literacy on sports injury and return to play were also included. ResultsThe surveys were completed by 159 (91%) mentors and 143 youth athletes (87%). The level of S-CCHL was sufficient in 53% of the mentors. Of youth athletes, 28% reported a high level of HL and the item with least perceived high HL (21%) was critical thinking. Ninety-four percent of the mentors believed that it is quite possible to prevent injuries in athletics and 53% perceived having a very good knowledge about how to prevent injuries. Forty-six percent of the mentors perceived having a very good knowledge of return to sport criteria. ConclusionsThe level of health literacy was low with about half of the mentors and one out of three youth athletes having adequate HL levels. Only half of the mentors stated having a good knowledge of various injury prevention strategies. To reduce health consequences in youth sport and enable talent development more work is needed to understand the facilitators and barriers for the uptake of various health promotion and injury prevention strategies.

The relationship between general health behaviors and general health literacy levels in the Turkish population.

The purpose of our study was to determine the health literacy level of the study participants and examine the relationship between health literacy levels and sociodemographic characteristics, health self-assessment levels and health protective behaviors. We recruited 826 individuals into the study, selecting the participants by using a systematic random sampling method. Data were collected with a descriptive information form, the European Health Literacy Scale and a General Health Behaviors Scale. The analysis of the data was carried out using numbers and percentages, the Chi Square test and ordinal regression analysis. We found that the level of health literacy was inadequate in 25.9% of the study participants, problematic/limited in 41.4% had, adequate in 23.6% and excellent in 9.1%. A statistically significant correlation was found between an adequate level of health literacy and being relatively more educated, having a chronic disease, being able to follow up on health news, reading publications on health and being better able to evaluate one's own health (p < 0.05). Additionally, a statistically significant correlation was observed between adequate health literacy levels and being in the later stages of the transtheoretical model in terms of general health behaviors in the domains outside of monitoring one's own weight and avoiding the sun (p < 0.05). The level of adequate health literacy was discovered to be lower in our study than in Europe. Health protective behaviors show an increase among individuals who display an adequate level of health literacy.

Health literacy as a predictor of road traffic injury prevention

Abstract Background Road traffic injuries impose a substantial health burden among children. Health literacy is one of the most important determinants of non-communicable disease prevention. Parent health literacy is connected with their knowledge and behaviors regarding children road traffic injuries (CRTI) prevention. The aim of this study was to explore health literacy, knowledge and behaviors of mothers' in Croatia regarding CRTI prevention. Methods This population based cross-sectional questionnaire study was done during 2019 in convenient sample of mothers of school aged children. Sociodemographic data and data about knowledge and behaviors of mothers regarding CRTI prevention were collected by the use of specially designed questionnaire. Croatian version of the Newest Vital Sign screening test (NVS-HR) was used for heath literacy determination. Results There were 814 mothers' median age 36.0 (interquartile range 32.0. - 39.0). According to NVS-HR there were 17.7%, 26.5% and 55.8% of mothers with low, intermediate and adequate health literacy level, respectively. The higher levels of health literacy were connected with younger age of mothers (37 years old or less) (P = 0.027); urban area of settlement (P &amp;lt; 0.001); living with a partner (P = 0.018); higher educational level of mothers (P &amp;lt; 0.001) and with better self-perceived economic status (P = 0.009). The study revealed poor positive correlation between mothers' health literacy and their knowledge regarding CRTI prevention (rho=0.170; P &amp;lt; 0.001). The study further showed that there was no correlation between mothers' health literacy and their behavior regarding CRTI prevention (rho=0.072; P = 0.041). Finally, the study revealed poor positive correlation between mothers' knowledge and behavior regarding CRTI prevention (rho=0.193; P &amp;lt; 0.001). Conclusions The level of health literacy affects mothers' knowledge about CRTI prevention. Further studies are needed to better understand the underlying reasons for established association. Key messages Low parent health literacy is one of the predictors of poor parent knowledge about children road traffic injuries prevention. It is necessary to identify and to address low parent health literacy in preventive strategies directed towards children road traffic injury prevention.

Health literacy: Prevalence and determinants in Lagos State, Nigeria

BackgroundPoor health literacy has been associated with poorer physical and mental health function, and higher emergency department and hospital utilizations. The study was conducted to measure the prevalence of health literacy and its determinants among Lagos State residents.MethodsA descriptive cross-sectional study was conducted in three local government areas in Lagos State. Health literacy was assessed using the Brief Health Literacy Screening tool (BHLS), a three-item tool with possible scores ranging between 3 and 15. Health literacy was classified as inadequate (≤ 9) or adequate (>9).ResultsA total of 1831 respondents participated in the study, among whom, 952 (52%) were women. The mean age of respondents was 31.7 (±10.5) years. Three-quarters (74.8%) of respondents had adequate health literacy. Adequate levels of health literacy were associated with being female (OR, 1.35; 95% CI, 1.07–1.71), frequent use of the broad cast media as source of information (OR, 1.33; 95% CI, 1.03–1.70), frequent use of the internet as source of information (OR, 1.49; 95% CI, 1.13–1.96). Adequate health literacy was also associated with having knowledge of a frequently prescribed antibiotic (OR, 1.67; 95% CI, 1.32–2.12) and being more comfortable with the use of the English language (OR, 1.71; 95% CI, 1.32–2.22).ConclusionGender, the use of broadcast media and the internet are predictive of adequate health literacy and should be taken into consideration in planning health interventions.

Information Seeking Behavior About Cancer and Associated Factors Among University Students, Ethiopia: A Cross-Sectional Study.

IntroductionCancer is among the leading cause of death in sub-Saharan Africa over the last few years, putting a tremendous physical, emotional, and financial strain on individuals, families, and health systems. Many health systems in sub-Saharan Africa are least prepared to manage this burden, and a large number of individuals do not have access to quality cancer-related information to prevent and manage cancer. Understanding the information seeking behavior of individuals, especially university students who are more likely to seek health information than other people, can be seen as an opportunity to provide resources to improve lifestyle or prevent possible health-threatening behaviors of individuals.ObjectiveThis study aimed to assess cancer information seeking behavior (CISB) and its associated factors among students in Debre Tabor University, Ethiopia.MethodsAn institution-based cross-sectional study design was conducted among students at Debre Tabor University from March 01 to March 30, 2019. A total of 844 students were selected using a multistage stratified sampling technique. Data were collected using a structured and pre-tested questionnaire by trained data collectors. Data entry and analyses were performed using Epi info version 7.2 and SPSS version 20, respectively. Descriptive and inferential statistics were used to explore the socio-demographic information and cancer information seeking behavior. Binary logistic regression was used to identify factors associated with cancer information seeking.ResultsThe proportion of cancer information seeking by students in the past 12 months was 30.1%. Their preferred source of information about cancer was health-care providers (48%) followed by the Internet (27.6%). Year of study, Internet access (AOR=6.07, 95% CI= 4.05, 9.10), health literacy level (AOR=1.8, 95% CI=1.21, 2.68), self-reported health condition (AOR=1.85, 95% CI=1.25, 2.73), perceived susceptibility to cancer (AOR=2.48, 95% CI=1.47, 4.2), and perceived severity of cancer (AOR=3.33, 95% CI=1.85, 6.0) were the factors associated with cancer information seeking.ConclusionThe proportion of cancer information seeking among university students was low. Being 3rd- and 4th-year student, internet access, being healthy, adequate health literacy level, concerning about cancer, and higher perceived severity of cancer were significantly associated with cancer information seeking. Increase health literacy and awareness creation about cancer for students will help to seek cancer information.

Health Literacy among patients with end‐stage kidney disease and kidney transplant recipients

Self-management is essential for patients both before and after kidney transplantation and requires an adequate level of health literacy (HL), that is the ability to comprehend and process health information. Low HL is associated with poor clinical outcome and an increased risk of death. In Europe, HL has been scarcely studied. The aim of this study was to investigate the levels of HL in a Swedish cohort of kidney transplant (KTx) candidates and KTx recipients. A single centre cross-sectional cohort study. Participants; n=50 KTx candidates and n=49 KTx recipients. HL was measured with the Newest Vital Sign instrument (NVS). Statistical analysis was made using the chi-square, Mann-Whitney U- or t-test. Study participants; n=99, 61.6% male, mean age 52 years. Low or possible inadequate HL was seen in 20%. There was no statistical difference in the levels of HL related to sex, educational level, ability to work or between KTx candidates and KTx recipients. In this cohort, one fifth had low or possible inadequate HL measured by the NVS. Screening is needed to identify persons with poor HL. These persons require tailored education and person-centred care to cope with self-management.

Medication self-management support for people with diabetes and low health literacy: A needs assessment.

IntroductionAn adequate level of health literacy is regarded as a prerequisite for adequate medication self-management. Low health literacy skills are relatively more common in people with Diabetes Mellitus type 2. The aim of this study was to explore the needs regarding medication self-management of people with type 2 diabetes and low (functional, communicative and critical) health literacy, and their preferences for medication self-management support.Materials and methodsA two-stage qualitative needs assessment study was performed using in-depth individual interviews and focus groups.ResultsThe participants preferred to be supported with reliable and easily understandable information, adequate interactive communication with health care professionals and fellow people with diabetes and tools for medication self-management support.DiscussionFuture interventions should be created in co-creation with people with low health literacy and fulfill the expressed needs on information, communication and tools to improve self-management.

Health literacy and diabetes control in pregnant women.

Background:Low health literacy (HL) is associated with an extensive range of health outcomes.Objective:The present study was performed to inquire about the relationship between HL and glycemic control in gestational diabetes in order to design interventional future preventing programs.Methods:This cross-sectional study was performed on 104 Iranian pregnant women with gestational diabetes mellitus (GDM) referred from urban and rural areas to endocrinology clinic of Hamadan Beheshti Hospital, in 2017. Iranian Health Literacy Questionnaire (IHLQ) and a sociodemographic checklist were distributed among women. Correlation between HL and glycemic control was examined using SPSS. The significance level was set at P < 0.05.Results:Among women, 48.1% (50) were affected by uncontrolled diabetes and only 22% (11) had an adequate level of HL. An adequate level of HL were 50% and 22% in glycemic controlled and uncontrolled women, respectively. In univariate analysis, there was a significant relationship between diabetes control and adequate HL. So, problematic HL could increase the chance of uncontrolled diabetes more than three times (odds ratio: 3.5; CI: 1.5–8.3; P value: 0.004). Among all related variables, education and being housewife were considered as protective and risk factors for problematic HL, respectively.Conclusion:In conclusion, this study has provided evidence of limited HL and its relationship with low glycemic control in pregnant women with GDM. The problem was more serious in low educated, rural, housekeepers, and older-aged women. This deficit needs to be addressed by health planners and policymakers who are responsible for promoting the health of people and decreasing health inequalities community.

Oral health literacy: A practical strategy towards better oral health status among adult population of Ghaziabad district.

Background and Aims:Despite tremendous considerable effort by health professionals to promote oral health to create beautiful smiles, gap between oral health knowledge and practice undoubtedly still remains. Thus the aim of this study was to assess the Oral health literacy level and its impact on socioeconomic and oral health status among adult population in Ghaziabad district.Methods:A total of 600 study subjects aged 18-64 years from all 4 blocks of Ghaziabad visiting various outreach programmes using a multistage random sampling technique were included in the study. A specially designed questionnaire assessed the demographic variables. Oral health literacy level (OHL) was assessed with help of a bilingually adapted Hindi OHL tool. Clinical examination was recorded using WHO (World Health Organization) Oral Health Assessment Form 2013.Results:The mean age of the study subjects was 43.9 ± 14.36 years. Majority 300 (50%) study subjects had inadequate oral health literacy level followed by Marginal oral health literacy level which was seen among 180 (30%) subjects and 120 (20%) subjects had adequate oral health literacy level. Oral health literacy level was slightly higher among females as compared to male subjects although the results were not statistically significant. A statistically significant difference was found between oral health literacy and oral health status as well as socioeconomic status. (P value ≤ 0.05).Conclusion:A significant association between OHL and oral health status was found stating Oral health literacy as an efficient role in influencing oral health outcome of any individual.

Links between Adolescents’ Health Literacy and their Physical Activity and Body Mass Index

Background. The aim of the study was to identify links between health literacy, health information literacy and physical activity as well as body mass index in adolescents.Methods. The study was carried out from September till the end of November, 2018. Research participants were 167 14–18-year-old students from Kaunas, Klaipeda and Vilnius (n = 107 females, n = 60 males). Participants were asked to fill in an anonymous online questionnaire, which consisted of basic demographics, physical activity, health information literacy and health literacy. Adolescents’ body mass index was calculated using ISO-BMI calculations. Physical activity was assessed by Petronytė’s physical activity questionnaire. To determine adolescents’ everyday health information literacy, we used self-assessed 10-item screening tool (EHIL-10) and to determine health literacy, we used Newest Vital Sign (NVS) screening test. Data analysis was performed using SPSS 23.0 program for Windows.Results. Health literacy did not have association with body mass index or the level of physical activity. Health literacy scores gave important data of the level of health literacy. The scores indicated that 21.6% of Lithuanian adolescents had adequate level of health literacy. It was found that age correlated positively with health literacy. Self-assessed everyday health information literacy was higher since 85% of the students had medium high or high level of health information literacy. The data revealed that adolescents were not sure where they could find health related information and who they could trust in health-related issues. For males, finding health information and knowing who they could trust in health issues was easier than for females. Health information literacy did not have association with ISO-BMI. Sufficient evaluation of health-related information was higher among normally weighted adolescents. Physically active students had higher health information literacy and participation in sports club activities had positive relation with better health information literacy. Additionally, involvement in organized activities associated with superior understanding of terms and sentences of health information. Evaluation of health information was higher among those who were actively involved in organized physical activities.Conclusions. Health information literacy did not have association with ISO-BMI. Those, who were involved in sports club activities or were more actively involved in organized physical activities had better health information literacy and evaluation of health information. Nevertheless, there was no connection between health literacy and physical activity. Keywords: health literacy, health information literacy, physical activity, body mass index.

Health Literacy Risk in Older Adults With and Without Mild Cognitive Impairment.

BackgroundThe relationship between an increasing elderly population and wide-ranging neurological conditions has led to heightened rates of cognitive function impairment. Some researchers have found that health literacy risk may be associated with cognitive impairment in older adults.ObjectivesThe purpose of this study was to delineate the difference in health literacy risk between older adults with mild cognitive impairment and those with normal cognitive function.MethodsWe conducted a survey study to explore the health literacy risk in older adults with and without mild cognitive impairment. Data were collected from 412 subjects between 60 and 91 years of age (260 without and 152 with mild cognitive impairment) between June and December 2016 in China. Cognitive function was measured using the Mini-Mental Status Examination, Montreal Cognitive Assessment, Global Deterioration Scale, Activities of Daily Living, and Hamilton Depression Rating Scale. Health literacy was measured using the Chinese Citizen Health Literacy Questionnaire.ResultsThe scores of total health literacy and its three dimensions (basic health knowledge and mind, basic skills, and health lifestyle and behavior) were lower in those with mild cognitive impairment. Older adults with normal cognitive function had adequate or marginal health literacy levels, whereas those with mild cognitive impairment had marginal or inadequate health literacy levels. Using multiple logistic regression analysis, we found that health literacy risk, education level, age, marital status, and body mass index were independent risk factors for mild cognitive impairment.DiscussionThese results suggest that low health literacy may be a predictor of mild cognitive impairment. Screening for lower health literacy risk should be included in multidimensional geriatric evaluation.

Role of Health Literacy on Menstrual Hygiene Practice among the Girl Students

The main aim of this study was to find out the role of health literacy on menstruation hygiene practice of campus girls. The population of this study were girls studying health and physical education in Surkhet Campus and HA/Staff Nurse in SEDA Campus. Surkhet was selected by proportional stratified sampling. This study followed descriptive and cross-sectional design. The study used two tools Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Self Administrated Questionnaire for collecting data. It was found that health literacy among girls of study area is not satisfactory. The findings indicate that 53.93 percent respondents have adequate health literacy. Adequate health literacy level of girls of HA/Staff nurse, aged 16-18 years and 19-21 years and Chhetri and Janajati had adequate health literary. The findings support that higher proportions of the adequate health literate respondents have good menstruation hygiene practice than inadequate health literate respondents. Finally, the results indicated that health literacy among the girls is inadequate, that calls more concern to the matter of health literacy in educational programs.

Study on the relationship between smoking behavior and health literacy among grade 4-6 primary students in Shandong province

Objective: To investigate the associations between smoking and literacy on health among 4-6 grade primary school students. Methods: A questionnaire survey was conducted to research on health literacy and smoking among 4-6 grade pupils in Shandong province, through a multi-stage stratified cluster random sampling method. Sociodemographic characteristics, health literacy level and smoking rate were collected from respondents. Binary logistic regression analysis was used to evaluate the association of smoking and health literacy. Results: A total of 9 240 questionnaires were distributed, with the rate of valid response as 99.7%. The current smoking rate of the students was 2.6%, on higher in boys (3.1%) than in girls (2.0%). 60.8% of 4-6 grade students were found to have adequate health literacy level. Levels of literacy health in both boy and girl school students appeared 56.7% and 64.9%, respectively. Results indicated that health literacy in smokers (14.4%) was lower than that in non-smokers (62.0%). Results from the binary logistic regression analysis showed that the independent influencing factors would include grade, father's education level, economic situation of the family, self-assessment on the school record and literacy on health (P<0.01). After controlling the other independent variables, the smoking rate was 8.62 (1/0.116) times in students with low literacy level on health, than those with high literacy level. Conclusions: Literacy on health was significantly associated with smoking in the 4-6 grade pupils of Shandong province.

The association of health literacy with glycemic control in Saudi patients with type 2 diabetes.

Objectives:To identify the prevalence of health literacy among adult Saudi with type 2 diabetes mellitus (T2DM) patients and determine the clinical factors that are associated with health literacy scores including glycemic control.Method:A cross-sectional study that included 249 adult Saudi patients with T2DM (99 males and 150 females) who visited the Diabetes Clinic of the Endocrine Center at King Fahad Medical City, Riyadh, Saudi Arabia between September 2017 and January 2018. The short test of Functional Health Literacy in Adults (Arabic version) was used to classify patients into 3 levels of functional health literacy: inadequate, marginal, and adequate. Demographic characteristics were noted and glycosylated hemoglobin was assessed routinely. Regression analysis was carried out to determine whether health literacy is associated with glycemic control.Results:Majority of the participants had adequate literacy rate (68.7%). The adequate group is significantly younger (48.4±12.8) than the marginal (54.2±13.3) and inadequate group (54.1±9.1). Females in the adequate group were significantly lesser (54.6%) than the marginal (66.7%) and inadequate (81.8%) groups. Being female has a lesser odds of having an adequate health literacy level (odds ratio [OR] -1.24, confidence interval [CI] -1.97-0.50; p=0.001). Body mass index was positively associated with adequate health literacy level, but the significance was modest (OR 0.04; CI 0.003-0.09; p=0.045).Conclusion:Health literacy is high among Saudi T2DM patients and is not associated with glycemic control.

The Relationship Between Patients' Safety-Related Behaviors and Safety Events and Patient Experiences in Korean Hospitals.

There is increasing interest in patient participation in healthcare aimed at enhancing safety. The purposes of this study were to examine levels of patients' safety-related behaviors and to determine their relationships with safety events and care experiences. A cross-sectional survey was conducted with 360 patients in two tertiary general hospitals in Korea. The final dataset consisted of 341 patient responses. A questionnaire was developed to collect information concerning patients' safety-related behaviors, care experiences, and the occurrence of safety events. Univariate and multivariate analyses were performed. On average, patients participated in 10.0 (SD 5.4) safety-related behaviors. Sixty-five (19.1%) patients reported experiencing at least one adverse event related to medical management. The mean problem score for care experience was 39.4 (SD 27.8) out of 100.0. Multiple logistic analysis showed that patients with adequate health literacy and higher activation levels were more likely to have high safety-related behavior participation levels. High participation in safety-related behaviors was negatively associated with the occurrence of safety events. However, no significant relationship was found between patient participation and the total problem scores for care experience. These findings suggest that efforts to support patients with limited health literacy and low activation levels are needed to facilitate patient participation. Active participation in safety-related behaviors can contribute to improving patient safety.

Assessing the Prevalence and Association of Acculturation and Health Literacy Levels in Spanish-Speaking Hispanic Patients at Midwestern Community Health Centers in the USA

Predictions from the US census indicate that by 2060 one of every three individuals living in the nation will be of Hispanic origin. Hispanics experience health disparities manifested with higher rates of chronic conditions such as hypertension and diabetes in contrast with other US population groups. Health literacy and acculturation have been well identified as key contributors for this issue. However, very few studies have examined the association between health literacy and levels of acculturation in Spanish-speaking Hispanics living in rural and urban areas of the USA. To assess the prevalence and association of acculturation with low levels of health literacy and demographic variables in Spanish-speaking Hispanics in the US Midwest. We measured levels of acculturation in Spanish-speaking adult Hispanics (N = 401) accessing community health centers in rural and urban Nebraska. We used a survey that included the Bidimensional Acculturation Scale for Hispanics/Linguistic Proficiency Subscale (BAS/LP) and the Short Assessment of Health Literacy in Spanish (SAHL-S). We observed similar acculturation levels with rural and urban status participants. A total of 85% of the total participants had low levels of acculturation to US culture. Of the 15% of the participants who showed themselves to be bicultural, 81% reported adequate levels of health literacy in Spanish. Our findings are consistent with previous studies that report the associations between acculturation and health literacy levels are significant. This study underscores the importance of considering the cultural aspects of the Hispanic community for the development of health literacy interventions and education programs.

Adult Functional Health Literacy and its Related Factors: A Cross-Sectional Study

Background and aims: Health literacy (HL) can affect individual health, health communication and error in taking medicine. The aim of this study was to determine the level of HL and associated factors among Iranian adults. Methods: In this cross-sectional study, 240 participants over 18 years of age referring to health centers in Hamadan, west of Iran in 2015 were selected by multistage random sampling. HL was assessed by the Test of Functional Health Literacy in Adults (TOFHLA). The questionnaire was completed by a trained interviewer. The independent variables were structural and intermediate social factors based on the Commission on Social Determinants of Health (CSDH). Data were analyzed by using IBM SPSS version 22. Results: Average age of the participants was 30.88 ±7.38 years and 75.4% of the them were female. The total score of HL was 64.58 ±16.71 (range: 23.82-98.98). Overall, 31.7% (n=76) of the participants had adequate HL level, 32.5% (n=78) had borderline HL level and 35.8% (n=86) had inadequate HL level. Additionally, participants with higher educational levels had higher HL scores than those with lower educational levels (P&lt;0.001). HL score was significantly higher in males than in females (P=0.017). Conclusion: HL level seems to be inadequate among Iranian adults in the west of Iran. Moreover, enhancing social determinants such as educational level seems to increase HL. The results highlighted the necessity for change and improvement in adults’ HL.

Assessing the Future Assessors: A Health Literacy Assessment Using the Newest Vital Sign

Background & Aim: Health literacy (HL) has been defined as the ability to obtain, process, and understand basic information and services needed to make appropriate health decisions. This study aimed to determine the HL of undergraduate medical students using the Newest Vital Sign (NVS), a nutrition label-based HL tool. Method: This was a cross-sectional study conducted among newly admitted first year medical students using the Newest Vital Sign. Following informed consent, under supervision, the participants were handed over the nutrition label with six questions. Questions were asked in sequence, and continued even if the participant did not get the first or the second question right. If a participant got the first four questions right, it was considered a sign of adequate literacy. Results: The study involved 110 participants out of which 72 were females. Overall, 87% of the participants had adequate health literacy, 11% had a possibility of limited health literacy, and less than 2% had a likelihood of limited health literacy. The mean of the total time taken to answer the questionnaire was 9.89 ± 2.25 minutes. More than 50% of the participants answered the questionnaire in the time range of nine to eleven minutes. Only <25% participants took longer than ten minutes to solve the questionnaire. Conclusion: It was observed that more than 85% of the participants had an adequate level of health literacy. NVS, which is based on a nutrition label, is a very simple tool, and the test can be easily administered in ten minutes.

Low health literacy, poor knowledge, and practice among Turkish women patients undergoing cervical cancer screening.

The objective of this study is to evaluate health literacy level, cervical cancer knowledge, and practice among women patients undergoing screening. A cross-sectional study was conducted among 455 women family health center patients. Health literacy level was evaluated by Rapid Estimate of Adult Literacy in Medicine. Patients characteristics, health behaviors, cervical cancer knowledge, and practice were assessed by a questionnaire form. Chi-square test and logistic regression analyses were applied. This study has found that 19.3% women were in adequate health literacy level and 80.7% of were in low (inadequate or marginal) level. Health literacy levels were showed significant differences by age, education status, employment, self-perception of health, health condition and having health profession, smoking status, physical activity, body mass index, taking health care, skills and concern on materials. Inadequate health literacy was significantly higher among women patients with poor cervical cancer knowledge and practice. Based on binary regression analyses, adequate health literacy was significantly associated with younger ages. Adequate health literacy was poor among women patients. Health literacy levels were affected by patient characteristics, health behaviors, and cervical cancer knowledge and practice.