Adequate Health Literacy Research Articles

Health literacy and diabetic retinopathy.

Health literacy (HL) is defined as a cognitive and social skill that determines the motivation and ability of individuals to understand and use information to promote and maintain proper health. Inadequate HL has been associated with worse outcomes in diabetes control, poor self-care, and higher hospitalization rates for some chronic diseases. We hypothesized that HL influences the prevalence of diabetic retinopathy (DR) among individuals with type 2 diabetes mellitus (T2DM) and that inadequate glycemic control would mediate this association. This was a cross-sectional study carried out with 288 participants of the "Brazilian Diabetes Study" cohort. Inclusion criteria were people diagnosed with T2DM aged between 40 and 70 years and ability to read and write. In the adequate HL group, DR was found in 16.5% of participants and in the inadequate HL group, it was found in 32.8% (P=0.0081). Individuals with inadequate HL had a higher risk of having DR, and this association was still statistically significant after adjusting for HbA1c, low-density lipoprotein cholesterol, systolic blood pressure, and diastolic blood pressure. In conclusion, HL is related to DR without the mediation of classical clinical variables.

Health literacy and patient rights awareness in ethnic Hungarian mothers in Eastern Europe.

The paper proposes to identify the determinants of patients' rights awareness in mothers and to examine the relationship of health literacy with awareness of those rights. Our results are based on data from a convenience sample of 894 non-health professional ethnic Hungarian mothers from Hungary, Romania and Slovakia. Health literacy is measured with the HLS-EU-16 questionnaire. Analysis of variance reveals a significant association of health literacy with patient rights awareness. Our results show that health literacy is the highest among patients who filed a complaint through formal channels and/or took legal measures to restore their rights upon violation. A logistic regression model is built to identify the likelihood of having high patient rights awareness, that is, acting formally for the restoration of rights upon infringement. The model controls for covariates. When controlled for covariates, the likelihood of having high patient rights awareness increases with age, and is higher for mothers with highest education, for inhabitants of larger towns, as well as for those with adequate health literacy. The findings of our study have implications for health policy, as they reveal significant inequalities in patient rights culture.

RELIGIOSITY, DEATH EXPOSURE, AND HEALTH LITERACY AS PREDICTORS FOR ATTITUDES TOWARD MEDICAL AID IN DYING (MAID)

Abstract Only legal in ten states (Death with Dignity, 2023), Medical aid in dying (MAID) is the current term for requesting lethal medication through a physician to end one’s life. Research has explored individuals’ characteristics who request MAID and whether they complete the prescribed medication process (Ganzini et al., 2009). However, little research explores relations between health literacy, religiosity, and individuals’ attitudes toward MAID. We hypothesized that participants with high health literacy and greater death exposure would hold greater support for MAID, while greater religiosity would be associated with lower support. Having implemented attention checks, participants (N = 265) completed measures via MTurk, assessing for health literacy, religiosity, death exposure, and attitudes toward MAID. Ages ranged from 19 to 83 (M = 37.81, SD = 12.55), with 17.7% of the sample over the age of 50. The majority were self-reported female (62.6%), non-Hispanic white (79.6%), and indicated adequate functional health literacy (82.6%). Significant correlations were observed between religiosity, attitudes toward MAID, and MAID support. Although there was no direct effect on MAID support, health literacy and death exposure remained in the path model to ensure adequate model fit. The results of this study help us understand the effect of individuals’ experiences and their attitudes toward MAID, indicating the importance of tailoring health literacy towards supporting autonomous choices in end-of-life care.

Assessing the health literacy of caregivers in the pediatric intensive care unit: a mixed-methods study.

Limited health literacy is associated with increased hospitalizations, emergency visits, health care costs, and mortality. The health literacy levels of caregivers of critically ill children are unknown. This mixed-methods study aims to quantitatively assess the health literacy of caregivers of children admitted to the pediatric intensive care unit (PICU) and qualitatively describe facilitators and barriers to implementing health literacy screening from the provider perspective. Caregivers of patients admitted to our large, academic PICU (between August 12, 2022 and March 31, 2023) were approached to complete a survey with the Newest Vital Sign (NVS), which is a validated health literacy screener offered in English and Spanish. We additionally conducted focus groups of interdisciplinary PICU providers to identify factors which may influence implementation of health literacy screening using the Consolidated Framework for Implementation Research (CFIR) framework. Among 48 surveyed caregivers, 79% demonstrated adequate health literacy using the Newest Vital Sign screener. The majority of caregivers spoke English (96%), were mothers (85%), and identified as White (75%). 83% of caregivers were able to attend rounds at least once and 98% believed attending rounds was helpful. Within the PICU provider focus groups, there were 11 participants (3 attendings, 3 fellows, 2 nurse practitioners, 1 hospitalist, 2 research assistants). Focus group participants described facilitators and barriers to implementation, which were mapped to CFIR domains. Timing of screening and person administering screening were identified as modifiable factors to improve future implementation. We found the health literacy levels of PICU caregivers in our setting is similar to prior assessments of parental health literacy. Participation in morning rounds was helpful for developing understanding of their child's illness, regardless of health literacy status. Qualitative feedback from providers identified barriers across all CFIR domains, with timing of screening and person administering screening as modifiable factors to improve future implementation.

Scientific production on health literacy in the palliative care context

This is an integrative review aiming to identify the scientific production on health literacy (HL) in the palliative care context. LILACS, BDENF and MEDLINE were accessed via the BVS/BIREME, and PUBMED database was also used to search. Portuguese, English and Spanish language full-text papers were included based on the research question. 10 papers were included proved different aspects related to health literacy in the context of palliative care, in which the relevance of health literacy in the self-care of patients in palliative care is highlighted, emphasizing the importance of effective communication between professionals, patients and caregivers. Underscore health guidelines is crucial and depends on adequate health literacy to be effective.

Teachers' Negative Attitudes and Limited Health Literacy Levels as Risks for Low Awareness of Epilepsy in Turkey.

For students with epilepsy, schools are a critical environment for managing the disease properly. This study examined awareness of epilepsy, attitudes toward epilepsy, and health literacy among school teachers in Turkey. This study was conducted in a city in Turkey with 1408 public school teachers from June 2021 to September 2021. The median scores of the scales were 5, 29, and 32 for epilepsy awareness, epilepsy attitudes, and health literacy, respectively. Epilepsy awareness was higher in women, and epilepsy attitudes were more positive in women than men (p<0.05). While epilepsy awareness was higher in primary school teachers, epilepsy attitudes were more positive in secondary school teachers (p<0.05). Epilepsy awareness was lower in secondary school teachers (odds ratio [OR], 1.27; p<0.05), those who did not have an individual with epilepsy in their family/social environment (OR, 1.57; p<0.001), those who did not have a student with epilepsy in their class (OR, 1.45; p<0.05), and in those who had not witnessed an epilepsy seizure (OR,1.19; p<0.05). Compared to those with positive attitudes regarding epilepsy, epilepsy awareness was 1.36 times lower in those with negative attitudes (p<0.001). Epilepsy awareness was 1.92 times lower in those with limited health literacy than those with adequate health literacy (p<0.001). In this study, low epilepsy awareness, negative epilepsy attitudes, and limited health literacy were common among teachers. The findings from this study suggest that panels, workshops, and health training on epilepsy should be organized for school teachers and included at regular intervals in certified first-aid practices.

Acquisition, application, and distribution of health literacy from culturally sensitive type 2 diabetes education among Arabic-Speaking migrants in Denmark: A longitudinal qualitative analysis.

Effective self-management of type 2 diabetes requires adequate health literacy (HL) and a supportive network. Diabetes self-management education and support programmes play a crucial role in improving these factors. However, limited research exists on how such programmes can support health literacy among migrants and facilitate the dissemination of knowledge within their social networks. This study aimed to investigate the perspectives of Arabic-speaking informants with a migrant background in relation to how their type 2 diabetes-related health literacy was acquired, applied and distributed within social networks through participation in a culturally sensitive diabetes self-management education and support (DSMES) programme. Semi-structured interviews were conducted with 12 informants during the programme and three to 7 months later, from September 2019 to May 2020. Abductive analysis was applied using HL and distributed health literacy (DHL) theory as frameworks. The analysis generated three themes: (1) sources of health information and the development of health literacy; (2) changes towards active self-management; and (3) distributed health literacy. Prior to programme participation, informants faced challenges in navigating conflicting information from family, friends and social media. After participating in the programme, they reported improvements in HL, particularly in knowledge acquisition. Many became more actively engaged in decision-making and exhibited improved health behaviours, such as dietary choices. Nonetheless, some informants continued to struggle with choosing appropriate prevention and treatment strategies. Notably, certain informants acted as HL mediators, sharing their newly acquired knowledge within their social networks in Denmark and abroad. Culturally sensitive diabetes self-management education programmes have the potential to enhance HL among migrants, leading to the distribution of relevant diabetes knowledge within their social networks. Future studies should explore how members of migrants' social networks perceive their supportive role in type 2 diabetes management. Programmes can benefit from emphasising critical HL and exploring how participant-informants effectively communicate diabetes-related knowledge within their networks to address misinformation and conflicting information.

Health literacy, knowledge, household disposal, and misuse practices of antibiotics among UAE residents: a nationwide cross-sectional study

ABSTRACT Background The study aimed to evaluate health literacy, knowledge, household disposal, and misuse practices of antibiotics among the United Arab Emirates (UAE) residents. Research design and methods An observational cross-sectional study was conducted between May 1st and August 31st, 2022. The study encompassed a sample of 1074 participants. Results Participants involved in a medical field (OR: 1.98, 95% CI: 1.45–2.69, p < 0.001) were more likely to have adequate health literacy. Most participants rarely (n = 315; 29.33%) or sometimes (n = 292; 27.19%) sought help from a doctor or pharmacist with reading the instructions and leaflets of antibiotics. A bachelor`s degree was associated with a reduced odds ratio of self-medication with antibiotics (OR: 0.46, 95% CI: 0.29–0.75, p = 0.002). Only 10.61% of unneeded antibiotics were returned to the pharmacy, 79.42% were disposed of at home and 10% were disposed of using other disposal practices. Conclusions Higher levels of adequate health literacy were observed in those involved in the medical field and those with higher educational levels. The prevalence of self-medication with antibiotics among the UAE population was low. These findings highlight the importance of improving health literacy, promoting responsible antibiotic use, and encouraging proper disposal practices among the population.

Readability of Online Information on the Latarjet Procedure.

Introduction A common complication of first-time or recurrent shoulder dislocations is bone loss at the humeral head and glenoid. Recurrent shoulder instability is often a result of bony defects in the glenoid following shoulder dislocations. In the setting of glenoid bone loss, surgical interventions are generally required to restore stability. The Latarjet procedure is a challenging operation and, due to its complexity, may be associated with operative complications. It can be difficult to explain the procedure to patients in a manner that is easily comprehensible, which may lead to confusion or being overwhelmed with information. Hence, it is important that the information available to patients is easily accessible and perceivable to allow for adequate health literacy. Health literacy is defined as the ability to make health decisions in the context of everyday life. Methods The search engines Google and Bing were accessed on a single day in the month of July 2023, searching the terms "Latarjet surgery" and "Latarjet procedure." For each term on both search engines, the first three pages were evaluated, resulting in a total of 114 websites for review. Out of these, 25 websites met the inclusion criteria and underwent further in-depth analysis through the online readability software, WEB FX. This software generated a Flesch Reading Ease Score (FRES) and a Reading Grade Level (RGL) for each website. Results In our study, the mean FRES was 50.3 (SD ±12.5), categorizing the data as 'fairly difficult to read.' The mean RGL score was 8.12 (SD ±2.35), which exceeds the recommended target. Conclusion In conclusion, the results of this study have demonstrated that the material available on the Internet about the Latarjet procedure is above the recommended readability levels for the majority of the population. Our findings align with similar studies assessing the readability of online patient information. Based on these findings, physicians should provide patients with vetted information to facilitate a better understanding of the procedure, thereby enabling patients to make more informed decisions regarding their health.

Influence of patient trust in provider and health literacy on receipt of guideline-concordant chronic opioid therapy in HIV care settings.

Persons with HIV (PWH) frequently receive opioids for pain. Health literacy and trust in provider may impact patient-provider communication, and thus receipt of guideline-concordant opioid monitoring. We analyzed baseline data of HIV-positive patients on chronic opioid therapy (COT) in a trial to improve guideline-concordant COT in HIV clinics. Retrospective cohort study. Two hospital-based safetynet HIV clinics in Boston and Atlanta. A cohort of patients who were ≥18 years, HIV-positive, had received ≥ 3 opioid prescriptions from a study site ≥21 days apart within a 6-month period during the prior year and had ≥1 visit at the HIV clinic in the prior 18 months. Adjusted logistic regression models examined whether health literacy and trust in provider (scale scored 11-55, higher indicates more trust) were associated with: (1) ≥ 2 urine drug tests (UDTs) and (2) presence of an opioid treatment agreement. Among 166 PWH, mean trust in provider was 47.4 (SD 6.6); 117 (70 percent) had adequate health literacy. Fifty patients (30 percent) had ≥ 2 UDTs and 20 (12 percent) had a treatment agreement. The adjusted odds ratio (aOR) for a one-point increase in trust in provider was 0.97 for having ≥ 2 UDTs (95 percent CI 0.92-1.02) and 1.03 for opioid treatment agreement (95 percent CI 0.95-1.12). The aOR for adequate health literacy was 0.89 for having ≥ 2 UDTs (95 percent CI 0.42-1.88) and 1.66 for an opioid treatment agreement (95 percent CI 0.52-5.31). Health literacy and trust in provider were not associated with chronic opioid therapy quality outcomes.

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.

Development of CO-MMUNE Supplements on Immune System Material to Improve Concept Understanding and Health Literacy of High School Students

This study aims to analyze the validity, feasibility and effectiveness of health case-based learning supplements to increase the level of concepts understanding and health literacy of high school students on immune system material. It is a type of R&amp;D research using the development method by Sugiyono. The development process is carried out by conducting links to various articles related to Covid-19 infection cases in national and international journals. The supplement testing phase consists of three stages, namely validity test, feasibility test and effectiveness test. Validity tests include material validity tests and media validity tests conducted by material and media validators. The feasibility test and effectiveness test were carried out at Senior High School1 Tayu. The population of this study was all grade XI mathematics and natural sciences students at Senior High School 1 Tayu with class XI MIPA 4 as a sample. Sample selection is carried out using the purposive sampling method. In collecting data on the effectiveness of supplements to improve students' understanding of concepts and health literacy, a one group pretest-posttest design was used. Observation and interview sheets, validation questionnaire sheets, student and teacher response sheets, comprehension test questions and health literacy questionnaire sheets based on HLS-EU-Q indicators were the instruments used in this study. Based on the results of the material validity test and media validity, it shows that the supplement is in the very valid category with a percentage of material validity of 91% and media validity of 94%. Based on the results of the feasibility test from the responses of teachers and students, supplements get a percentage of 83% and 93.5% which are included in the very feasible criteria. Based on the results of the supplementation effectiveness test, students' concept understanding showed that 77.14% of students had reached the minimum completeness category whereas, the health literacy index score showed that 94.2% of students had achieved an adequate health literacy index. These results show that the CO-MMUNE learning supplement prepared based on Covid-19 cases is valid and feasible for use in learning and is effective in increasing understanding of the concept of immune system material and literacy student health. The use of health problems as learning materials in the classroom will provide a good understanding of health so that it has the opportunity to become a means of increasing health literacy.

Patient perspectives of the quality of preoperative education in surgical cancer care.

207 Background: Preoperative education is an important component of surgical cancer care that has been shown to impact surgical outcomes. However, the quality of education varies, especially among patients with low health literacy (HL), which is prevalent among states in the Deep South. Low HL patients experience worse surgical outcomes, and variation in preoperative education further increases the disparity gap for this vulnerable patient population. We aimed to characterize patient perspectives of preoperative education by HL level among gastrointestinal cancer patients in the Deep South. Methods: Surveys were administered to colorectal, pancreatic, and esophageal cancer survivors in Alabama and Mississippi. Eligible participants had stage 1-3 cancer, were within 5 years of diagnosis, and had surgery as part of their cancer care. Participants were also administered the BRIEF survey, which is a validated four question survey measuring HL level. Patients with a score of 17 or higher were categorized as having adequate HL, while a score of 16 or less were categorized as having low HL. Fisher Exact or Chi Square tests were performed to examine significant differences between patients with low and adequate HL. Results: Of 272 survey respondents, the mean age was 63.17 (±11.57) and 151 (55.5%) were women. 92 (33.8%) had low HL and 174 (64.0%) had adequate HL. Compared to patients with adequate HL, patients with low HL reported lower rates of a health care provider in the surgeon’s clinic definitely giving them all the information needed about their surgery (80.9% versus 90.1%, p=0.07) and lower rates of their surgeon or other provider definitely talking to them about what to expect for surgery and recovery (76.4% versus 89.0%, p=0.03, respectively). Low and adequate HL patients reported similar rates of receiving instructions about getting ready for surgery (88.6% and 90.1%, p=0.66). However, 88.3% of low HL patients reported these instructions were easy to understand compared to 97.4% for adequate HL patients (p=0.001). Low and adequate HL patients reported similar rates of visual aids used during education (76.1% versus 78.2%, p=0.54, respectively), with low HL patients reporting slightly lower use of flyers/pamphlets with pictures (58.7% versus 60.3%, p=0.79) and drawings (40.2% versus 42.5%, p=0.72); similar use of models (9.8% versus 9.2%, p=0.86); and less frequent use of videos (7.6% versus 10.9%, p=0.39). Conclusions: Patient-reported disparities in preoperative education exist among surgical cancer patients with low health literacy. 1 in 5 patients with low HL did not think they received enough information prior to surgery and the information they received was difficult to understand. Overall, there was a low use of visual aids among this patient population. Future directions should aim to improve the quality of education for low HL, incorporating the use of visual aids.

Maternal health literacy and postpartum complication readiness among nursing mothers: Implications for adult literacy educators in Southern Cross River State, Nigeria

This study assessed maternal health literacy and postpartum complication readiness among nursing mothers and identify the implications for adult literacy educators in the Southern Cross River State, Nigeria. This cross-sectional study was conducted with 252 nursing mothers using a structured questionnaire. Data were analysed using descriptive statistics, one-way analysis of variance (ANOVA) and independent sample t-test. The results showed that with an average mean of 2.2, the participants’ level of maternal health literacy was moderate, while the average mean was 2.1 equally indicates that the level of postpartum complication readiness among respondents was equally moderate. The respondents’ education level, household income, and mode of delivery were not significantly associated with health literacy and postpartum complication readiness. Specifically, nursing mothers with higher levels of education and household income were not likely to have adequate health literacy and better postpartum complication readiness than others. The study’s results also indicate that adult literacy educators play a crucial role in improving maternal health literacy levels among nursing mothers. These educators can provide effective health education to nursing mothers to enhance their knowledge of maternal health and postpartum complications. This study highlights the need for adult literacy educators to incorporate maternal health literacy and postpartum complication readiness into their programs. This can be achieved by developing tailored health literacy materials and using interactive teaching methods that promote active participation and discussion among learners. Moreover, community-based interventions targeting vulnerable populations such as low-income mothers and those with limited education are needed to improve maternal health outcomes in Nigeria.

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.

The assessment of determinants of vaccine-related conspiracy beliefs in Polish society

Abstract Background The COVID-19 pandemic showed that health denialism and conspiracy beliefs may influence adherence to preventive measures. Many variables have been considered as determinants of conspiracist attitudes. This study aims to assess the determinants of conspiracy beliefs related to vaccination (Vaccine Conspiracy Beliefs Score, VCBS) in Polish society during the COVID-19 pandemic. Methods The analysis was based on data from the online survey conducted in November 2021 in a representative sample of adult Internet users. Uni- (ULR) and multivariable linear regression (MLR) models were developed for VCBS. The relationships of health literacy (HL), e-health literacy (eHL), future anxiety (FA), Internet (IU) and social media use (SMU), self-assessed health status (SAHS), and prevalence of chronic disease (CD) with VCBS were assessed after adjusting for sociodemographic variables and political sympathies. B coefficient (B) and 95% confidential intervals (95%CI) are reported here for MLR. Results The study sample of 2189 comprised 51.2% of women and 26.1% of persons with a University education. The mean age (standard deviation, SD) of respondents was 44.1 (15.25) years; VCBS - 3.77 (1.52), eHL score - 28.91 (10.63), and FA score 4.75 (1.27). MLR revealed that VCBS was significantly associated with HL but not eHL. VCBS was higher in persons with inadequate HL than those with sufficient HL (B; 95%CI: 0.66; 0.36 - 0.95). Greater FA was also associated with higher VCBS (0.08; 0.03 - 0.13). Interestingly, less duration of IU (the lowest vs. the highest use: 0.47; 0.08 - 0.85) but more intense SMU (frequent vs. infrequent use: 0.31; 0.11 - 0.51) predicted higher levels of VCBS. Finally, SAHS and CD were not significant predictors. Conclusions Health literacy remains a key modifiable determinant of the prevalence of conspiracy beliefs related to vaccination. Effective measures counteracting conspiracy beliefs should be considered in future public health challenges. Key messages • Developing adequate health literacy may be an efficient measure counteracting unfavorable impact of conspiracist thinking on the acceptance of vaccinations. • Health denialism manifesting with conspiracy beliefs should be treated as a target for public health interventions during pandemics.

The Turkish Validity and Reliability of the Coronavirus-Related Health Literacy Scale on Health Science Students

Objective: Health literacy is one’s ability to access, comprehend, appraise, and apply health-related information. Health literacy has become an important topic since the COVID-19 pandemic. This methodological study aimed to adapt the Coronavirus-Related Health Literacy Scale (HLS-COVID-Q22) to Turkish. &#x0D; Methods: The sample consisted of 539 students of the faculty of health sciences of a university in Turkey. The study was conducted between December 2020 and May 2021. The content validity ratio was calculated for content validity. The construct and concurrent validity, internal consistency reliability, test-retest reliability, and ceiling and floor effects were also determined. A confirmatory factor analysis was performed for construct validity. &#x0D; Results: The fit indices indicated an adequate fit (2/df: 4.970.70) and Cronbach’s alpha values (&gt;0.90) were above acceptable limits. Most students had “adequate health literacy” (71.8%). A quarter of the students had “problematic health literacy” (24.5%). The remaining students had “inadequate health literacy” (3.7%). Students with lower levels of health literacy were more likely to have confusion about coronavirus-related information (p

Pharmaceutical indication pictograms for low literacy viewers: Health literacy and comprehension.

Poor comprehension of pharmaceutical pictograms used on medicine labels or leaflets can compromise understanding of medicine-taking information, potentially causing negative health outcomes. The aim was to assess association of health literacy (HL) with comprehension of pictograms displaying indication and side effect information in a lower literacy, limited English proficiency (LEP) population. Community centre, Makhanda, South Africa. This was a quantitative cross-sectional study using simple random probability sampling. Ninety isiXhosa-speaking adults with a maximum of 12 years schooling, attending primary healthcare clinics were interviewed using structured interviews. Health literacy was assessed using the Health Literacy Test for Limited Literacy populations. Comprehension of 10 locally developed pictograms was evaluated. The mean pictogram comprehension score was 7.9/10, with 8/10 pictograms complying with the International Organization for Standardization criterion of 66.7% correct comprehension. Only 15.6% of participants had adequate HL. A significant association of HL with pictogram comprehension was established (p = 0.002). Pictogram misinterpretation was higher in those with lower HL; adequate HL was associated with superior comprehension. Pictogram comprehension was negatively associated with age (p < 0.006), and positively associated with education (p < 0.001) and English proficiency (p < 0.001). Higher HL was associated with better pictogram comprehension. Low HL, LEP and low education levels are regarded as potential indicators for possible pictogram misinterpretation. This study observed the potential for misinterpretation of medication pictograms. Health professionals should be aware that low HL, limited schooling and limited English proficiency could signal difficulty in fully comprehending pictogram content.

The impact of health literacy on adolescent and young adult pediatric liver transplant recipients.

Pediatric liver transplant recipients have increased rates of morbidity and mortality following transfer to adult health care providers. The role of health literacy (HL) has not been adequately assessed in this population and may be an unrecognized barrier to successful health care transition. We sought to determine the impact of HL for patients and their caregivers on measures of transition readiness (TR), adherence, health-related quality of life, and medical outcomes following pediatric liver transplant. This is a single-center study of pediatric liver transplant recipients transplanted between the ages of 12 and 26 from October 2016 through August 2020. Patients and caregivers completed 4 surveys to evaluate TR, health-related quality of life, and HL. Clinical outcomes were stratified based on the presence or absence of adequate HL. Limited HL was identified in 57.0% of recipients and 47.4% of caregivers. Patients with limited HL were more likely to be younger in age ( p = 0.004), Hispanic ( p = 0.003), and less likely to have obtained a high school diploma or equivalent ( p < 0.001). Patients with adequate HL demonstrated significantly higher levels of TR ( p < 0.001). Patient HL did not impact health-related quality of life, adherence, or medical outcomes. Caregiver HL did not impact patient outcomes or adherence, though higher levels of caregiver education were associated with adequate patient HL ( p = 0.049). This study demonstrates that limited HL is associated with decreased measures of TR. Inadequate HL may be an unrecognized barrier to a successful health care transition. Regular assessment of HL may provide an opportunity for intervention prior to transfer of care. Future studies should investigate the impact of these interventions on long-term medical outcomes.