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Developing organizational health literacy in primary health care: a learning network of 18 Belgian projects

Objectives:
 
 Introduce the Organisational Health Literacy approach to
 
 primary care practitioners
 
 Discuss the challenges posed by introducing OHL in primary
 
 care
 
 Share potential solutions for best practice in OHL in primary care
 Reflect on appropriate process and outcome measures for OHL in primary care
 
 Rationale: The move towards active patient participation and informed decision making in health care has raised the interest in health literacy. Informed decision making requires sufficient knowledge about the possibilities, consequences, benefits and risks of interventions to make decisions that align with one’s personal values and preferences. As such, health literacy, defined as a person’s knowledge, motivation and skills to obtain, understand, evaluate, and apply health information, plays a key role in making informed health decisions.
 While the importance of health literacy is generally recognized by primary care practitioners, to date most efforts to address it have focused on enhancing the skills of patients to understand and apply the information given by professionals, and of professionals to adjust their communication to patients with low health literacy. Yet, as the health care systems is often complex and demanding, health care organizations can also try to reduce the demands they place on patients and families by implementing policies, practices, and systems that make it easier for people to navigate, understand, and use information and services to take care of their health. This strategy is known as Organizational Health Literacy (OHL). Critical components of OHL include (1) improving access to and navigation of health care facilities and systems; (2) encouraging patient engagement in the health care process; (3) enhancing communication with patients and families; (4) establishing a workforce with OHL-related knowledge and skills; (5) creating an organizational culture and infrastructure supportive of OHL; and (6) meeting patient needs, such as provision of interpreter services and self-management support.
 Efforts to introduce OHL are increasingly implemented with success in the hospital setting and, to a lesser extent, in other health organizations such as health insurance companies, but have thus far rarely been applied in the primary care setting.
 The workshop will address the challenges posed by introducing OHL in primary care, drawing on the first-hand experience with 18 OHL projects launched in 2022 in Belgium with support of the Dr. Daniël De Coninck Fund (managed by the King Baudouin Foundation) and functioning as a learning network.
 Audience: Primary care practitioners and managers of primary care networks.
 Workshop content:
 1.A short introduction to the concept and criteria of OHL
 and the 18 Belgian projects (10min)
 2.Three short presentations of projects focusing on OHL in
 primary care (20min)
 3.Discussion in breakout groups on challenges to introducing OHL in primary care (30min):
 (1)Embedding health literacy in the organizational mission,
 structure and functioning 
 (2)Building relationships between health care professionals
 and service users around HL
 (3)Developing HL through language, action and experience
 (4)Co-creating with service users throughout the care
 journey
 (5)Learning and evaluating across organizational
 boundaries
 4.A plenary debate (20min)
 5.Conclusion and summary of the learnings (10min)
 

Sosialisasi Kesehatan Reproduksi Pada Remaja SMP Muhammadiyah 61 Tanjung Selamet

Adolescence is an important period that requires proper knowledge about reproductive health to avoid risks such as unwanted pregnancy, risky sexual behavior, and the spread of HIV/AIDS. This study aims to increase understanding and awareness of adolescent reproductive health at SMP Muhammadiyah 61 Tanjung Selamat through community service activities. Through counseling approaches and interactive discussions, students are provided with information about physical changes, reproductive health, and the impact of unhealthy behaviors. The results of this activity show the high enthusiasm of students in discussions and questions related to reproductive health, indicating the success of the program. This counseling provides a positive first step in equipping students with essential knowledge to make smart decisions related to reproductive health. For the continuation of the program, it is recommended to conduct periodic evaluations, form a team of trained adolescent counselors, and conduct monitoring by accompanying teachers to ensure the application of reproductive health information in students' daily lives. With support from educators and medical personnel, it is hoped that students can develop a better understanding of reproductive health and build a positive attitude towards self-care.

An Active Model of Research Translation for the General Public: Content Analysis of a YouTube-Based Health Podcast.

Online health information seeking is changing the way people engage with health care and the health system. Recent changes in practices related to seeking, accessing, and disseminating scientific research, and in particular health information, have enabled a high level of user engagement. This study aims to examine an innovative model of research translation, The Huberman Lab Podcast (HLP), developed by Andrew Huberman, Professor of Neurobiology and Ophthalmology at the Stanford School of Medicine. The HLP leverages social media to deliver health information translated into specific, actionable practices and health strategies directly to the general public. This research characterizes the HLP as an Active Model of Research Translation and assesses its potential as a framework for replicability and wider adoption. We applied conventional content analysis of the YouTube transcript data and directed content analysis of viewers' YouTube comments to 23 HLP episodes released from January to October 2021, reflecting the time of data analysis. We selected 7 episodes and a welcome video, to describe and identify key characteristics of the HLP model. We analyzed viewer comments for 18 episodes to determine whether viewers found the HLP content valuable, accessible, and easy to implement. The key HLP features are direct-to-the-consumer, zero-cost, bilingual, and actionable content. We identified 3 main organizing categories and 10 subcategories as the key elements of the HLP: (1) Why: Educate and Empower and Bring Zero Cost to Consumer Information to the General Public; (2) What: Tools and Protocols; Underlying Mechanisms; and Grounded in Science; (3) How: Linear and Iterative Knowledge Building Process; Lecture-Style Sessions; Interactive and Consumer Informed; Easily Accessible; and Building the Community. Analysis of viewers' comments found strong consumer support for the key HLP model elements. This Active Model of Research Translation offers a way to synthesize scientific evidence and deliver it directly to end users in the form of actionable tools and education. Timely evidence translation using effective consumer engagement and education techniques appears to improve access and confidence related to health information use and reduces challenges to understanding and applying health information received from health providers. Framing complex content in an approachable manner, engaging the target audience, encouraging participation, and ensuring open access to the content meet current recommendations on innovative practices for leveraging social media or other digital platforms for disseminating science and research findings to the general public, and are likely key contributors to HLP impact and potential for success. The model offers a replicable framework for translating and disseminating scientific evidence. Similar active models of research translation can have implications for accessing health information and implementing health strategies for improved outcomes. Areas for further investigation are specific and measurable impacts on health, usability, and relevance of the model for reaching marginalized and high-risk populations.

A CROSS-SECTIONAL STUDY EVALUATING THE ASSOCIATION OF PATIENT LITERACY WITH THE STAGE OF PENILE CARCINOMA

Background: Penile carcinoma is a rare and often late-diagnosed malignancy associated with advanced-stage presentation and poor prognosis. Health literacy, the ability to understand and apply health information, is crucial in healthcare-seeking behavior and early diagnosis. Methods: This cross-sectional study, conducted over 12 months at a tertiary care center, included 150 patients diagnosed with penile carcinoma. Patient literacy was categorized into four levels based on educational background. Data on demographic and clinical variables, such as age, smoking status, circumcision status, HPV infection, and the time to medical consultation, were collected. The TNM classification system was used to determine the disease stage. Results: Lower patient literacy levels were significantly associated with an increased likelihood of advanced-stage penile carcinoma presentation (p < 0.001). Patients with limited literacy, particularly those with "No Education," exhibited longer delays in seeking medical attention, contributing to the advanced stage at diagnosis. Additional factors, such as circumcision status and the time to medical attention, were also linked to disease stage. Discussion: This study underscores the critical role of health literacy, categorized into distinct educational levels, in penile carcinoma presentation. Patients with lower literacy levels face barriers to recognizing symptoms and seeking timely medical attention, ultimately resulting in advanced-stage diagnosis. The findings highlight the need for tailored health education and awareness campaigns, especially in communities with varying educational backgrounds. Conclusion: Patient literacy is associated with advanced-stage penile carcinoma presentation. Addressing disparities in health literacy and promoting awareness of penile carcinoma symptoms may enhance early diagnosis and treatment outcomes. The study emphasizes the multifaceted nature of cancer risk factors, underlining the importance of considering cultural and healthcare-related elements in future research and public health efforts.

The impact of compliance with health literacy principles in Facebook posts on user engagement

Abstract Background Addressing health literacy in designing health messages can improve understanding and application of health information by the audience. However, the impact of health literacy-compliant social media posts on user engagement remains unclear. The aim of this study was to investigate the relationship between compliance with health literacy principles in Facebook posts and user engagement by governmental and non-governmental health organizations in Taiwan. Methods A total of 3,305 Facebook posts were collected from two governmental and four non-governmental health organizations. Using a proportional sampling method, 600 posts were selected for analysis. A quantitative content analysis was conducted. Compliance with health literacy principles was assessed using a Chinese tool adapted from the US CDC Clear Communication Index, which provided health literacy scores for the text and visual components of each post. User engagement was measured by the number of likes, shares, and comments. Non-parametric statistical methods were used for analysis. Results The use of pictures had a positive impact on the number of likes (z = 4.77, p < .001) and shares (z = 2.45, p = .014) received. Posts with higher health literacy scores in their text and visual components received more likes (Spearman's r = .21, p < .001 for text; r = .25, p < .001 for visual), shares (r = .24, p < .001; r = .24, p < .001), and comments (r = .12, p = .002; r = .13, p = .002). Posts with text components that fully corresponded to health literacy indicators received more likes (z = 3.78, p < .001), shares (z = 4.05, p < .001) and comments (z = 2.21, p = .027) than those that only partially corresponded to. The same trend was found in visual components (z = 4.95, p < .001 for likes; z = 4.92, p < .001 for shares; z = 2.73, p = .006 for comments). Conclusions Compliance with health literacy principles and/or using pictures in Facebook posts positively affects user engagement for health organizations. Key messages • Health organizations should consider health literacy principles when creating social media posts to improve user engagement. • Applying visual aids on Facebook posts enhances user engagement for health organizations.

Adaptation of the Digital Health Literacy Instrument and testing with German school-aged children

Abstract Background Children and adolescents in particular navigate in the digital space intensively and use the Internet, social media, and apps to seek health related information. From a public health perspective, the increasing amount of online-based information requires them to possess the abilities to find, understand, evaluate, and apply health information, making digital health literacy more and more important. The Digital Health Literacy Instruments (DHLI) is a psychometrically tested instrument for assessing digital health literacy in adults, which has been adapted for children and adolescents in the United States, using cognitive interviews. However, this version has not yet been adapted for Germany. Hence, the aim of this study is to adapt and test a German version of DHLI for secondary schoolchildren. Methods The pretest tool was translated into German by three native speakers. To test the translated version of the DHLI adapted for secondary schoolchildren, cognitive pretests were conducted with N = 12 children and adolescents aged 10-17 years. The thinking aloud method and probing questions were used during the pretests. The aim of the evaluation was to maximize usability and comprehensibility of the adapted version for schoolchildren in Germany. Results In order to adapt the instrument for a German target group, preferred synonyms were identified during the pretests, as well as a preferred word collocation for health information, namely ‘information about health,’ which was used consistently for all items. Furthermore, two explanations were added in one instruction and one item. Conclusions Based on the results of the pretest analysis, a German version of the DHLI for children and adolescents is now available. Psychometric properties and the methodological quality of the schoolchildren's version of the DHLI have been analyzed in a representative quantitative study, shown in the subsequent presentation.

2.L. Workshop: Digital health literacy in childhood and adolescence: concepts, assessment tools, and study results

Abstract The on-going digital transformation of societies and our health system has to be taken into account when it comes to child and adolescent public health. Digitalization is also rapidly changing European (public) health systems, impacting the design of healthcare, the delivery of health education, and the necessary training of health professionals working with children and adolescents. Digital health literacy is rooted in health literacy and comprises the competencies to find, understand, appraise, and apply health information and services. Digital health literacy is becoming increasingly relevant to navigate the health system, to be informed and interact on health topics, and to manage one's own health. Digital health literacy not only has a positive impact on health it is also considered a key element to a successful transition to digital health and digital public health. Children and adolescents are born into a digital world and already at young age they start to engage with digital technologies and applications. This familiarity does not, however, imply a high digital health literacy, the competencies relevant to digital health literacy must still be trained and learned. The earlier children and adolescents develop these competencies, the earlier they can take responsibility for their health behaviours and health. Schools and educational institutions are therefore crucial concerning the promotion of digital health literacy. For its promotion it needs knowledge regarding the concept, how it can be measured and effectively promoted. The objectives of this workshop are to: • Provide an introduction into the concept of digital health literacy and its relevance for child and adolescent public health • Provide an overview and current challenges of measuring digital health literacy. • Provide insights into first time representative data on school children's digital health literacy and a collaborative project in schools between public health and paediatrics. • To clarify questions and exchange with the audience on experiences and possible interventions promoting digital health literacy in this age group • To provide data on school teachers' digital health literacy and the implementation of digitial health literacy in schools In this workshop, we wish to share knowledge and evidence on digital health literacy in children and adolescents and enter into an expert discussion on the public health relevance of digital health literacy, evidence and limitations of current digital health instruments, as well as options for the promotion of digital health literacy in children and adolescents. Three presentations will set the foundation for this exchange (3 x 10 minutes, brief Q&A) after which 20 minutes are dedicated to the discussion. Key messages • Digital health literacy is an increasingly important health determinant of child and adolescent health and should be measured and promoted. • Digital health literacy can be promoted in the context of school health promotion, prevention and education.

Is the education of the parents differently associated with their children health literacy?

Abstract Background Parents with higher levels of education tend to have better abilities in searching and integrating health information, which can ultimately benefit their childreńs health literacy. We aim to analyse the associations between childreńs health literacy and parents’ education in families with school-age children. Methods A total of 735 children (51.7% boys) with a mean of age (SD) of 7.7 (1.2) years old, participated in this study. Childreńs health literacy was measured with the HLS-Child-Q15, which contained 15 items assessing the child's perceived ease or difficulty in finding, understanding, appraising, and applying health information (α = 0.7). A mean of all items was conducted along with a median split (limited and sufficient health literacy). Parents self-reported their education (e.g., primary school, secondary schools and higher education) and family income. Binary regression models were used, adjusting for age and income. Results Boys whose mothers had a higher education degree had lower odds of achieving sufficient health literacy (adjusted odds ratio (aOR)= 0.4, 95% confidence interval (CI)=0.1; 0.9). In contrast, boys whose fathers had a secondary or higher education degree had a significantly higher odds of achieving sufficient health literacy (aOR=2.3 (1.1; 4.7) and 2.9 (1.2; 6.9, respectively), irrespective of their age and income. Conclusions The indirect association between mothers’ education levels and their sons’ health literacy, and the direct association of fathers’ education levels on their sons’ health literacy, could be explained by previous research that has linked a motheŕs education level to the quality of everyday childcare and a fatheŕs education level to the access of higher social positions and resources, that ultimately can be invested in the child's health literacy. Future intervention studies should take into account the important role of fathers in improving childreńs health literacy, mainly in boys. Key messages • Parents with higher levels of education tend to have children with better health literacy. • There are significant associations between parentśeducation and childreńs health literacy, mainly in boys.

Skills4 Health Literacy– Nordic project promoting capacity building on health literacy and dementia

Abstract Background An increasing proportion of the population is living with dementia and need health- and social care. People with limited health literacy have difficulties with accessing, understanding, appraising, and applying health information to promote and maintain health. Knowledge about how to promote health literacy is limited among health- and social care providers although such knowledge is important to be able to work person-centered and to reduce the risk of unequitable health and health care. As a response to this, the Erasmus+ project Skills 4 Health Literacy is conducted in the period 2022-2025. The project's overall aim is to meet the needs of higher education institutions in training future and current health and social care professionals, through digital education technologies, to promote health literacy capacity-building when supporting persons at risk of dementia to deliver relevant and personalized interventions. Methods A review of research, policies, and curriculums, and four focus group discussions and 14 individual interviews with experts from with a wide range of social and health care sites in Denmark, Finland, Norway, and Sweden. Results We developed a competence profile for health- and social care workers highlighting which knowledge, skills, and abilities they need to promote and take health literacy into account when working with people at risk of dementia and relatives to those. Thereafter, we developed, and pilot tested health literacy courses (1 classroom-based, 1 traditional online and 1 MOOC) based on this competence profile, in three of the Nordic countries. Conclusions There is a need for health literacy training among health- and social care workers in the Nordic countries. This project suggests a consensus-build competency profile to further develop the capacity building within health and social care and dementia with regards to health literacy training. Key messages • Health- and social care workers in the Nordics who meet elderly need training in health literacy. • A competence profile and health literacy courses have been developed to meet those needs.

Assessing perceived and functional health literacy among parents in Cyprus: A cross-sectional study.

Parents often must take decisions regarding their children's health, which requires certain skills and competences. Parental health literacy (HL) is important in establishing positive health-promoting behaviours and better health outcomes to their children. Limited parental HL has been associated with various negative children's health outcomes. The aim of the study was to explore perceived and functional HL among parents in Cyprus. A cross-sectional study was conducted with a convenience sample of 416 parents of children, aged 6 months to 15 years old, presenting in pediatric outpatient departments across three Cypriot cities. Participants completed the HLS-EU-Q47, a self-reported measure of HL, and the NVS (Newest Vital Sign), a performance-based measure of HL. Associations with socio-demographic characteristics and health behaviors were explored. Based on suggested ranges, among 416 parents, mostly mothers (83.2%), almost half of parents (42.6%) were classified as having inadequate or problematic perceived HL. Consistently, 62.8% showed high likelihood or significant possibility of limited functional HL, based on the NVS with a mean score of 2.73 out of 6 (SD = 2.02). Nevertheless, no correlation was observed between the two measures of HL. Limited parental perceived HL was statistically significantly associated with lower educational attainment, lower number of children in the family, increased self-assessed health status, and limited exercise habits. Limited parental functional HL was statistically significantly associated with female gender, younger age, lower educational attainment, receiving financial aid, lower family income, and lower alcohol consumption. Even though there was lack of agreement in the classification according to the HLS-EU-Q47 and the NVS, moderate-to-low levels of perceived HL appear consistent with a performance-based measure of HL. As a high number of parents may face challenges in assessing and applying health information to improve outcomes for their children, with evidence of social gradient, healthcare services should be oriented towards identifying problematic HL while Public Health interventions are needed to enhance parental HL.

Health literacy among fathers and fathers-to-be: a multi-country, cross-sectional survey.

During pregnancy and early fatherhood, men are at higher risk of poor health, exacerbated by low engagement by healthcare services. Yet the transition to fatherhood presents an opportunity for men to improve their health and health behaviours. Health literacy refers to individuals' competence in accessing and applying health information. Poor health literacy is associated with poor health and low help-seeking. The aim of this study was to identify health literacy strengths, needs and profiles among fathers. Men who were expecting a baby ('antenatal') or had become fathers in the past 18 months ('postnatal') were recruited through an international, online paid survey platform. The survey included the nine-scale Health Literacy Questionnaire (HLQ). Of 889 survey respondents (n = 416, 46.5% antenatal; n = 473, 53.5% postnatal), 274 (31.0%) were residing in the USA and 239 (27.0%) in the UK. Relatively higher scores were reported for HLQ scales relating to having sufficient information and finding and understanding this information, as well as social support for health. Relatively lower scores were obtained for scales relating to actively managing one's own health and navigating the health care system. Three scale scores were significantly lower among nulliparous than multiparous men. Seven health literacy profiles were identified. In conclusion, while fathers have some health literacy strengths, they also experience some barriers, particularly first-time fathers. Awareness of diverse health literacy profiles among fathers may assist in developing strategies to strengthen health services' capacity to meet fathers' needs and reduce risks to their health at this critical juncture in families' lives.

Health literacy in low- and middle-income countries

Health literacy (HL) is defined as a person’s ability to access, understand, appraise, and apply health information in order to make sound health decisions. It has emerged as a key determinant of health outcomes, more particularly in noncommunicable diseases (NCDs). Low HL has been associated with lower use of health-care services and poorer health outcomes, including increased morbidity and mortality. During the second meeting of the EMAC-AOC Group (Epidemiology of Chronic Diseases – Central and Western Africa), HL and NCDs in low- and middle-income countries (LMICs) were discussed to explore options for interventional studies in sub-Saharan Africa on NCDs’ prevention and control. We reviewed how HL is defined, how it is associated with health outcomes and health inequities, and what instruments are available to assess it. Several published studies, systematic reviews, especially in LMICs, as well as national and international recommendations were discussed to explore potential approaches to improve HL in a study evaluating interventions for the prevention and control of NCDs in Africa.

Translation, cross-cultural adaptation, and validation of the Chinese version of the COVID-19 health literacy scale in nursing students

BackgroundEffective communication is an essential component of high-quality nursing care. Health literacy, the ability to access, describe, evaluate and apply health information to make informed decisions, is an important component of effective communication in nursing. Nurses, including student nurses, with good levels of health literacy (HL) are well positioned to communicate reliable public health-related information effectively, at times like the COVID-19 global pandemic. At this time, many nursing students have been at the frontline of patient education, as such, it would be expected that they have high levels of HL. However, it has been suggested that there is the need to improve HL levels in nursing students. AimsThe aim of this study was to analyse the structure of item response of a back translated Chinese version of the COVID-HLS-Q22 questionnaire and to assess the coronavirus-related HLof Chinese speaking nursing students in Hong Kong using the COVID-HLS-Q22-CN. MethodsA cross-sectional study of 97 undergraduate nursing students was conducted using two self-reported questionnaires. The HLS-EU-16 scale, with face validity already established, was used to assess scale equivalence Using a cross-over study approach, student participants were randomly assigned in sequential order. The validation process was performed in five phases: direct translation, translation synthesis, back translation, consolidation with experts, and testing with the students. The intended outcome of this study will be a formally tested model of the Chinese version of the COVID-HLS-Q22-CN, that can be replicated in Chinese population. ResultsFactorial equivalence was present across language versions in both questionnaires. Internal consistency was excellent for COVID-HLS-Q22-CN (coefficient alpha for Chinese version of questionnaire, 0.957 and English version, 0.953). This suggested that the four subscale are stable across the two questionnaires. ConclusionThe COVID-HLS-Q22-CN has proven to be a feasible and reliable tool in the assessment of Hong Kong based Chinese speaking nursing students. The emergence of issues around COVID-related HL further highlights the need to include the teaching of critical health literacy skills within nurse education, preparing the healthcare professionals of the future for public health emergencies.

Roles of the interaction with children and families in mediating the association between digital health literacy and well-being of early childhood teachers in Portugal: A cross-sectional study.

To analyze the associations between early childhood education (ECE) teachers´ digital health literacy (DHL) and well-being, and to determine whether the ECE teachers´ interaction with children and family mediated these associations. A total of 853 early childhood teachers, predominantly women (99.4%) participated in this cross-sectional study. The participants had a mean age of 39.9 years (standard deviation SD = 8.2). Data was collected through an online survey. DHL was assessed using five subscales adapted to the new coronavirus context, and the professionals´ well-being was measured using the WHO-5 well-being scale. Binary logistic regression and mediation analysis were used to analyze the data. ECE teachers' DHL in dimensions of "information searching" and "determining relevance" had both direct and indirect effect on their well-being. Specifically, higher DHL in these dimensions was associated with better well-being. The dimension "evaluating reliability" had an indirect positive effect on well-being by promoting interaction with children. These findings suggest that improving ECE teachers´ DHL could have a positive effect on their well-being and their interactions with children. Therefore, it is recommended to develop health promotion practices aimed at enhancing DHL among ECE teachers. Additionally, integrating DHL contents and competencies more prominently into the qualification, further education and training of ECE teachers may help equip them with the necessary skills to access and apply health information effectively. This, in turn, can enhance interactions with children and contribute to their overall well-being.

How do Australian mental health services use easy read to make information accessible for people with intellectual disability?

Access to health information is a right for all people. Easy read information is one strategy used to make information accessible for people with intellectual disability. This research explored how easy read is used and the ways accessible information can address access barriers, with a focus on Australian mental health services. Semi-structured interviews were conducted across four sites to explore how easy read was used. Participants (n = 49) were easy read users, health practitioners and staff from services providing mental health care in New South Wales, Australia. An integrated health literacy framework was used to analyse data. Most mental health staff did not use easy read or other accessible information, and did not consistently offer people with intellectual disability opportunities to understand, appraise and apply health information. This investigation confirmed the limited availability of accessible information resources, including easy read, and the importance of relationships of support when accessing health information. People with intellectual disability did not routinely have access to mental health information. Substantial change is required to address this disparity. Agency policy and processes require change to support staff practices that uphold the right to information. Inclusive practices that incorporate using easy read in health contexts, including mental health, are needed to facilitate change.

European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context

Health literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald’s omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population.

Examining Health Literacy in Taiwanese Smoking Cessation Populations: A Multidimensional Evaluation of Sociodemographic Factors and Domain-Specific Competencies.

Cigarette smoking is a serious global health issue. Limited studies previously analyzed health literacy components in patients undergoing smoking cessation interventions. This study focuses on individuals enrolled in smoking cessation services and investigates the distribution of health literacy in three domains (health care, disease prevention, and health promotion) and four abilities (access, understand, appraise, and apply health information). The study also explores the correlation between background factors (age, BMI, etc.) and health literacy, as well as the differences in health literacy levels among different background variables (gender, etc.). 228 individuals completed the health literacy questionnaire. Descriptive statistical analysis, Pearson Correlation, and a Chi-Squared Test were employed to investigate the various health literacy levels and background variables. 68% had excellent or sufficient health literacy. A total of 32% were considered problematic or to have inadequate health literacy. Of the three domains of health literacy, participants performed better in the healthcare domain. More than one-third were problematic in accessing and appraising information. this paper, being the pilot study in providing an analysis of health literacy components in individuals undergoing smoking cessation, could serve as a useful reference for devising interventions for different population groups in trying to maximize successful cessation rates.

How socioeconomically disadvantaged people access, understand, appraise, and apply health information: A qualitative study exploring health literacy skills.

Health literacy, or a person's competence to access, understand, appraise and apply health information, can be considered a mediating factor between socioeconomic characteristics and health disparities. Socioeconomically disadvantaged people in particular present with less health literacy skills. To develop targeted interventions tailored to their real needs, it is important to understand how they function and what difficulties they encounter when dealing with health information. The purpose of this study was to explore their experiences when accessing, understanding, appraising, and applying health information in their everyday lives. Semi-structured face-to-face interviews were conducted with 12 socioeconomically disadvantaged adults living in the community in Switzerland (age range: 44-60 years old). Thematic analysis of the interviews yielded four themes, describing the health literacy processes of participants, related barriers, and compensatory strategies used: Financial insecurity triggers the need for health information; Pathway 1: Physicians as ideal (but expensive) interlocutors; Pathway 2: The internet as a suboptimal alternative; and Pathway 3: Relatives as a default resource. The progression of socioeconomically disadvantaged people in the health literacy process is like an 'obstacle course', with numerous steps taken backwards before they can develop compensatory strategies to overcome the barriers to obtaining health information. Financial deprivation seems to be the most important factor contributing to health literacy barriers. Appraising health information is the health literacy skill with which socioeconomically disadvantaged people struggle the most. Physician-based, individual skills-based, organizational, and policy-based interventions are needed to help them overcome their health literacy challenges.

The Facilitators and Barriers to Digital Health for Managing Nutrition in People With Parkinson's Disease and Their Caregivers: A Formative, Qualitative Study

ObjectiveIdentify techniques to assist in designing digital health platforms for nutrition services for people with Parkinson's disease and caregivers to improve their quality of life. DesignSemistructured, dyadic interviews with 20 dyads (20 people with Parkinson's disease and 20 caregivers). SettingHome visits were conducted in the northeast US. ParticipantsPeople with Parkinson's disease and their caregivers were recruited via email, flyers, news articles and announcements at support groups. Phenomenon of InterestIdentification of facilitators and barriers to using digital health platforms to inform future digital nutrition services. AnalysisInterviews were recorded, transcribed and double-coded using a framework analysis method. ResultsReported digital health platforms utilization facilitators were: knowledge acquisition, convenience, intention to use, socializing, enjoyment, and forced adoption. Barriers included: negative feelings toward technology, lack of access or knowledge, disinterest, product design, frustration and functional reliability, and applying health information. Conclusions and ImplicationsAlthough dyads often lack knowledge on both how to use technology and nutrition, they are willing to use digital health platforms to increase their nutrition knowledge if platforms are convenient. Based on the identified facilitators and barriers, the added benefits of access and training nutrition digital health platforms must be clearly communicated to end-users to improve their quality of life.

Improving menstrual health literacy in sport.

Menstrual health represents a state of complete physical, mental, and social well-being in relation to a woman's menstrual cycle. From a health literacy perspective, knowledge acquisition and expertise are dependent upon the degree to which an individual can find, access, understand, critically analyse, and apply health information. Therefore, menstrual health literacy can be used to describe the state of knowledge acquisition and application specific to menstrual health-related issues. Menstrual health literacy is low among female athletes, their coaches, and practitioners, and few evidence-informed education or implementation strategies exist to improve menstrual health literacy in sport. Moreover, athletes seldom discuss their menstrual cycles or hormonal contraceptive use with their coaches, despite experiencing menstrual symptoms and/or disturbances and perceiving their menstrual cycles/hormonal contraceptive use to affect performance. Barriers to communication about menstrual cycle- and hormonal contraceptive-related topics include a perceived lack of knowledge among athletes, coaches, and practitioners, concerns about how conversations on these issues will affect interpersonal relationships, and a lack of formal and informal discussion forums. Whilst evidence relating to the effects of the menstrual cycle phase and hormonal contraceptive use on training and performance is currently limited, with existing studies often lacking methodological rigour, impactful steps can still be made to support female athletes. This cornerstone review highlights the current state of menstrual health literacy among athletes, coaches, and practitioners, and provides recommendations for improving menstrual health literacy in sport.