Appraise Health Information Research Articles

Health literacy profiles in kidney transplanted patients: A cluster analysis.

Health literacy is important in chronic conditions, such as kidney transplantation. Understanding patients' health literacy profiles can assist tailoring follow-up and educational programmes to the health literacy needs of vulnerable kidney transplant recipients. This approach enabled us to cluster patients according to their profiles of challenges and strengths in different health literacy domains. This study aimed to identify different health literacy profiles within kidney transplant recipients and what characterized the different profiles. Cross-sectional study. One hundred ninety-five kidney transplanted recipients were included. We used the self-reported Health Literacy Questionnaire and analyzed using Ward's method (hierarchical cluster approach). We also collected background characteristics and clinical variables, including psychological distress (Hopkins Symptoms Checklist) and perceived health status (visual analogue scale, EuroQol-5D). The analysis revealed four clusters with substantial differences in health literacy profiles. One cluster's patients had the most challenges in all health literacy domains constituting 24% of the sample. Compared to the other three clusters, this cluster was associated with shorter duration of kidney disease, higher number of patients in dialysis before transplantation, higher percentage of male patients, lower number of kidneys from living donors, higher number of patients not working and higher representation of psychological distress. All four clusters reported the most challenges in the same domain: the ability to critically appraise health information. In kidney transplant recipients, profiling clusters with the Health Literacy Questionnaire and Ward's method aids in identifying health literacy needs in vulnerable groups, enabling transplant professionals to offer tailored health literacy support.

Health literacy in adult cardiac surgery patients; a multi-site Australian study

Abstract Background Almost 60% of Australians report low levels of health literacy (HL). International evidence indicates limited comprehension of the risks and benefits of cardiac surgery, in addition to understanding the basic elements of informed consent. Purpose The aim of this study was to explore HL in adult cardiac surgical candidates. Methods We recruited consecutive English speaking adult patients from a major public (Site 1), major private (Site 2) and regional hospital (Site 3) in Victoria, Australia. Prior to discharge, a Registered Nurse conducted a semi-structured interview using the Health Literacy Questionnaire (HLQ). The HLQ is a multidimensional validated instrument comprised of 9 independent scales. Data were analysed using descriptive statistics, t-tests and ANOVA. Results We recruited 164 (29.5%) eligible participants from; Site 1 (63, 32.1%), Site 2 (49, 19.3%) and Site 3 (52, 49.5%) respectively. Average age was 64.6 (SD 11.8), most participants were male (n = 134, 81.7%), few lived alone (n = 28, 17.1%), 122 (74.4%) identified as being Australian 5 (4.1%) of whom were indigenous and 9 (5.5%) spoke a language other than English at home. The majority of participants highest level of education was aligned with a trade certificate (n = 48, 29.3%) or not completing high school (44, 26.8%) and most were retired (n = 68, 41.5%), working full time (n = 51, 31.1%) or part time (n = 24, 14.6%). Less than half had private insurance (n = 72, 43.9%), more than half had presented to emergency (n = 87, 53.0%) in the previous 12 months and a history of cardiac complaints (n = 137, 83.5%) was as expected. In this study participants felt understood and supported by healthcare providers (Scale 1 M 3.32, SD 0.26), had sufficient information to manage their health (Scale 2 M 3.13, SD 0.35), proactively managed their health (Scale 3 M 2.98, SD 0.39), had strong social supports (Scale 4 M 3.31, SD 0.36), could appraise health information (Scale 5 M 2.88, SD 0.49) and were proactively engaged (Scale 6 M 4.00, SD 0.50). More challenging was their ability to advocate on their own behalf (Scale 7 M 3.80, SD 0.60), to explore information (Scale 8 M 3.70, SD 0.60) and to understand all written information (Scale 9 M 3.90, SD 0.60). Site 2 participants were highly educated, less likely to live alone, more likely to have private insurance, had fewer emergency presentations and higher scores on scales 6 to 9 (p < 0.05) that measure health care interactions, than those from Site 1 or 3. Conclusions There was a high level of HL in this cohort and findings indicate patient strengths in relation to HL differed according to site. In measuring individual skills and experience of participants interacting with services, systems and the health care environment this study provides valuable insight into HL levels in cardiac surgery candidates.

The Impact of Health Literacy on Diabetes Control

Abstract Introdution People with diabetes have a significant impact on treatment outcomes through their daily decisions. Therefore, health literacy (HL) is crucial for effectively managing the disease and maintaining overall health. This study aimed to explore the relationships between different dimensions of health literacy, self-care behaviors, and Diabetes Control (HbA1c). Methods HLwas assessed using the Health Literacy Questionnaire. 706 individuals with diabetes participated in the study, the majority of whom were male (60.2%), had more than 9 years of schooling (84.7%), and over half were employed (52.4%). To examine the relationship between dimensions of HLand HbA1c, multiple linear regression analysis was conducted. Results The study revealed a significant association between higher levels of HLand lower HbA1c levels. There is a statistically significant positive linear correlation between adherence to general nutrition and HLdimensions. In terms of physical activity, a positive correlation was also found with HLdimensions, and blood glucose monitoring showed a positive correlation with health literacy. Greater adherence to nutrition was linked to a decrease in HbA1c levels, while higher adherence to self-monitoring and medication was associated with an increase in HbA1c levels Conclusions This study emphasizes the importance of HLin managing diabetes. It underscores the impact of HLin diabetes compensation. The results reveal that higher levels of feeling understood and supported by healthcare professionals, having sufficient information to manage health, actively managing health, and appraising health information among people with diabetes lead to better adherence to blood glucose self-monitoring. Based on these findings, a crucial aspect of effectively managing diabetes will involve empowering individuals with the necessary skills for self-management of their condition, overall health, and treatment regimen. Key messages • The present research reinforces the importance of health literacy for diabetes compensation and self care activies. • One critical success factor in dealing with diabetes will be investing of health literacy of people with diabetes and health care providers responsiveness.

Measuring communicative health literacy – a revision of the HLS19-COM-P scale

Abstract Background Communicative health literacy (COM-HL) is important for patients being able to actively participate in communication with health care professionals, such as physicians. The HLS19-COM-P scale was developed for measuring COM-HL in the M-POHL HLS19 survey. However, two items under-discriminated according to the Rasch model and the item set did not sufficiently capture the aspect of appraising health information. Consolidating both a long and short version into a single scale was deemed appropriate. Hence, this study aimed to develop a revised version of the COM-HL scale. Methods The revision and development of new items followed a Delphi process. Items that worked well psychometrically in the six-item version of the HLS19-COM-P were kept, and new items concerning appraising information were developed. The revised version of the scale has so far been translated into nine languages (BG, CZ, DE, FR, HU, IT, NO, SK, UA). Challenging translation terms underwent multiple discussions to ensure language consistency. The interpretability of items has been explored in cognitive interviews in six countries (AT, CZ, HU, IT, SK, and UA) so far. Items that were difficult to understand were revised and tested in new interviews. The evaluation of the scale’s psychometric properties is scheduled for May and June 2024. Results The revised scale consists of eight items - two items for each of the cognitive domains of accessing, understanding, appraising, and applying health information. One item in each of these domains focuses on the interactive aspect of communication. An instruction for translation of terms that were challenging to translate has been developed. Overall, the revised HLS19-COM-P was well accepted in the cognitive interviews. Results from the quantitative testing will be presented. Conclusions The adapted HLS24-COM-P scale developed for the M-POHL Health Literacy Survey 2024-2026, is a short and conceptually sound instrument for measuring COM-HL.

EHealth literacy and digital health interventions: Key ingredients for supporting the mental health of displaced youth living in the urban slums of kampala, Uganda

During and after displacement, many displaced youth face increased vulnerability to poor mental health and can encounter inaccurate or confusing health information. Digital tools create new opportunities to reach more of these youth with mental health interventions. Yet maximizing these tools' effectiveness among displaced youth requires understanding their eHealth literacy (eHEALS; i.e., the ability to find, understand, and appraise health information from electronic sources and apply this knowledge to a health problem). Thus, we conducted a community-based cross-sectional survey of 445 displaced youth (16–24 years) living in the slums of Kampala, Uganda to measure their eHEALS and its association with psychosocial wellbeing. Exploratory and confirmatory factor analysis identified a unidimensional measure of eHEALS. Structural equation modeling results indicated that eHEALS was not directly associated with depressive symptoms (β = .08, p = 0.15), but was significantly positively associated with resilience (β = .32, p < 0.001). Resilience was, in turn, significantly negatively associated with depressive symptoms (β = −.21, p < 0.001). The Sobel test for indirect effects confirmed that eHEALS indirectly negatively affected depressive symptoms through resilience (i.e., βindirect effect = −.07, p = 0.004). Our findings highlight the need for interventionists to develop contextualized eHealth interventions that facilitate displaced youth's ability to access, understand, and use health information to the best of their ability and optimally benefit from services.

Effectiveness of e-learning material on essential components of evidence-based medicine among laypersons: a randomized controlled trial.

Evidence-based medicine (EBM) is helpful for laypersons' decision-making. This study aimed to evaluate the effectiveness of e-learning materials on the essential components of EBM for laypersons. We conducted a web-based, open-label, randomized controlled trial with laypersons in Japan aged ≥20 years who used the internet. Participants were randomly assigned to the intervention group with the e-learning material and the control group with only the 'Introduction' section of the same material. The primary and secondary outcomes were the self-created acquirement test scores (responding correctly with confidence) immediately after using the material and after 4 weeks. A multiple linear regression analysis was conducted. Of the 122 participants, 62 were randomly assigned to the intervention group and 59 to the control group; finally, 59 and 58, respectively, were included in the full analysis set. The mean (standard deviation) of the acquirement test score immediately after learning was 14.11 and (3.11) and 11.07 (3.88) in the intervention and control groups, respectively, indicating statistical significance (multivariable P < 0.001). The secondary long-term outcome was also statistically significant. The results showed that the e-learning material was effective for laypersons in acquiring the essential components of EBM. The material may increase laypersons' confidence in appraising health information, which can be used in decision-making.

Understanding health literacy in men: a cross-sectional survey

BackgroundMales have a shorter life expectancy than females. Men are less likely to seek the advice of a health professional or utilise preventive health services and programs. This study seeks to explore health literacy and the characteristics affecting this among Australian men.MethodsFour hundred and thirty-one adult males engaged with the New South Wales Rural Fire Service, completed an online cross-sectional survey, undertaken from September – November 2022. The survey tool captured demographic data, health status and lifestyle risk characteristics. Health literacy was measured using the 44-item Health Literacy Questionnaire (HLQ). Descriptive statistics, frequencies, percentages, means and standard deviations, were used to describe the sample. Interferential statistics, including the Mann-Whitney U Test and the Kruskal-Wallis Test, were used to explore differences between demographics and HLQ scales.ResultsFor the first 5 scales (4-point Likert scale), the lowest score was seen for ‘Appraisal of health information’ (Mean 2.81; SD 0.52) and the highest score was seen for ‘Feeling understood and supported by healthcare providers ’ (Mean 3.08; SD 0.64). For the other 4 scales (5-point Likert scale), the lowest score was seen for ‘Navigating the healthcare system’ (Mean 3.74; SD 0.69). The highest score was seen for ‘Understand health information well enough to know what to do’ (Mean 4.10; SD 0.53). Age, income level and living in an urban/rural location were significantly related to health literacy scales.ConclusionsThis study provides new insight into men’s health literacy and the factors impacting it. This knowledge can inform future strategies to promote men’s engagement with health services and preventive care.

Accuracy, readability, and quality of websites about metastatic renal cell carcinoma treatment

ObjectivesPatients with metastatic renal cell carcinoma (mRCC) face complex treatment decisions and frequently turn to the Internet for treatment information. The content of patient educational websites about mRCC treatment has not been evaluated. This study evaluated the accuracy, readability, and quality of websites about the treatment of mRCC. MethodsA total of 2,700 Internet queries were performed. Across 3 Internet search engines, 25 links of 36 permutations of mRCC keywords and their synonyms were screened for eligibility. Eligible websites were English-language websites containing information about mRCC treatments. Sponsored, social media, provider-facing, and news websites were excluded. Accuracy of eligible websites was evaluated in 2 domains: (1) Completeness by calculating the percentage of mRCC facts included in websites using an investigator-created checklist based on the NCI's RCC Treatment (PDQ®)–patient version, and (2) Correctness by identifying incorrect statements that were inconsistent with guidelines. Websites containing ≥60% of checklist items had a “passing” completeness score. Incorrect statements were tallied and qualitatively categorized. Readability was evaluated using the Fry and SMOG formulae, which calculate reading grade levels. Quality was evaluated using validated instruments that appraise health information quality: QUEST (scored 0–28), which focuses on online information, and DISCERN (scored 16–80), which focuses on treatment choices. ResultsThirty-nine websites were analyzed. Mean completeness score was 30% (range 0%–69%); only 2 (5%) websites had a passing score. Twelve (31%) websites had ≥1 incorrect statement, such as listing homeopathy or hormone therapy as mRCC treatment options, or including outdated statements. Mean readability levels were 11th and 12th grades for the Fry and SMOG methods, respectively. No website had a reading level lower than 9th grade. Mean QUEST score was 19 (range 9–28); authorship, complementarity, and currency items had the lowest scores. Mean DISCERN score was 56 (range 42–76), with 7 (18%) websites rated “excellent”, 22 (56%) rated “good”, and 10 (26%) rated fair. ConclusionsMany websites about mRCC treatment have incomplete, inaccurate, and unreadable information. Quality is highly variable. Efforts to improve accuracy, readability, and quality are needed to ensure that patients with mRCC can make well-informed treatment decisions and avoid harm from misinformation.

Enhancing Patient Communication Through Health Professionals’ Digital Literacy

Digital health literacy has been defined as the ‘ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to address or solve a health problem’ (Norman and Skinner, 2006). Health literacy and digital health literacy are essential in order to reach universal health coverage and to reform the processes of the healthcare systems (WHO, 2018). Healthcare professionals need to treat patients in a continuous evolving structure (WHO, 2013). The research question that guided the paper is ‘How can Romanian health professionals’ digital health literacy be used to improve communication with their patients?’. The aim of the study is to explore Romanian health professionals’ level of digital literacy, to identify how it can improve the communication with the patients. 20 interviews with resident and senior medical doctors, medical students and nurses were conducted. The interviews were audio recorded, transcribed and then stored as Word documents in a password-secured environment. From the data gathered in the interviews four major themes emerged: (a) digital health literacy; (b) communication with the patients; (c) improvements for the National Health Strategy 2014-2020; (d) time as a barrier in communication. Data was analyzed using thematic analysis through the MAXQDA2018 software.

Effectiveness of a health communication intervention on health literacy in the first year following kidney transplantation – A randomized controlled study

ObjectiveThis study aimed to evaluate the effect of a new health communication intervention focusing on knowledge management skills on health literacy and medication adherence during the first year following kidney transplantation. MethodsWe randomized 195 patients during 2020–2021, to either intervention- or control group. Questionnaires were completed at baseline and at 12 months post-transplantation with a 12-month response rate of 84%. Health literacy was measured by the multidimensional Health Literacy Questionnaire (HLQ) instrument. Medication adherence was measured by the self-reported questionnaire (BAASIS©). ResultsResults showed that the intervention group had a significant increase in 2 HLQ domains compared to the control group capturing the “ability to appraise health information” Domain 5, (p-value = 0.002) and the “ability to navigate the healthcare system” Domain 7, (p-value <0.04). The effect sizes of SRM were 0.49 (Domain 5) and 0.33 (Domain 7). Medication adherence was comparable in the groups at any measure points. ConclusionsThis study contributes to important knowledge about how a health communication intervention focusing on knowledge translation using motivational interviewing techniques positively strengthens health literacy in kidney transplant recipients. Practical implicationsCurrent patient education practice may benefit from focusing on knowledge translation in combination with motivational interview technique.

Depression mediates the association between health literacy and health-related quality of life after myocardial infarction.

So far, health literacy (HL) and its related factors in patients with acute myocardial infarction received little attention. Thus, the objective of this study was to investigate the associations between the different dimensions of HL and disease-specific health-related quality of life (HRQOL), and factors that may affect these relations in patients after acute myocardial infarction (AMI). All survivors of AMI between June 2020 and September 2021, from the Myocardial Infarction Registry Augsburg (n=882) received a postal questionnaire on HL [Health Literacy Questionnaire (HLQ)], HRQOL (MacNew Heart Disease HRQOL questionnaire) and depression (Patient Health Questionnaire). From the 592 respondents, 546 could be included in the analysis. Multivariable linear regression models were performed to investigate the associations between the nine subscales of the HLQ and the total score and three subscales of the MacNew questionnaire. A mediation analysis was performed to estimate direct and indirect effects of HL on HRQOL taking into account the mediating effect of depression. In the sample of 546 patients (72.5% male, mean age 68.5 ± 12.2 years), patients with poor education showed significantly lower HLQ scores. Significant associations between the subscales of the HLQ and the MacNew were found, which remained significant after adjustment for sociodemographic variables with few exceptions. More than 50% of the association between HL and HRQOL was mediated by depression in seven HLQ subscales and a complete mediating effect was found for the HLQ subscales 'Actively managing my health' and 'Appraisal of health information'. Depression mediates the associations between HL and disease-specific HRQOL in patients with myocardial infarction.

An Investigation into Health Literacy and Extracurricular Reading Habits: The Case of Students at Abadan University of Medical Sciences in Iran

Background: The process of developing health literacy (HL) begins in childhood and embraces several skills and experiences. Individuals need these skills to properly manage their health and interact with healthcare systems. Although studies considering HL and its related variables are extensive in volume and informative in results, it seems necessary to add more to the field by addressing the issue among students of medicine. Objectives: The present study aimed to check the level of HL and extracurricular reading habits among students of medicine, how they obtain health information, the relationship between their HL and their extracurricular reading habits, and the relationship between extracurricular reading habits and each of the five aspects of HL. Methods: The participants (N = 220) were studying at Abadan University of Medical Sciences, Abadan, Iran. The data were collected using the Health Literacy for Iranian Adults (HELIA) questionnaire (Montazeri et al., 2015) and a questionnaire developed by the researchers. Results: The findings suggest that extracurricular studying positively correlated with reading health information, reaching health information, and using health information for the respondents of the present study. There was also a significant difference between the extracurricular reading habits and the HL of respondents. However, extracurricular studying and their appraisal of health information did not positively correlate. Furthermore, the Internet was the first source of information for the respondents. Conclusions: The aforementioned results might direct health policymakers’ attention to the HL concerns that medical students need and the ways that they immediately hang on to reach information (i.e., the Internet).

Sociodemographic differences in digital health literacy of schoolchildren: a representative study

Abstract Background The increasing amount, availability, and use of digital health information through the Internet, social media, and apps highlights the relevance of digital health literacy in schoolchildren. Children and youth need digital health literacy in order to find, understand, and appraise health information and to make health decisions in everyday live. However, there is only limited to none evidence available on child and youth digital health literacy. This study aims at investigating digital health literacy of schoolchildren in Germany and explore associations with sociodemographic differences. Methods Data were collected from a representative sample of N = 1,448 secondary schoolchildren employing a face-to-face survey (CAPI) (Oct-Nov 2022). In addition to sociodemographic information (age, gender, migration, family affluence, education level), digital health literacy was measured using an adapted and translated self-report tool for secondary schoolchildren in Germany. Descriptive statistics, chi-square tests, and internal consistency were calculated using SPSS. Results Cronbach's alpha indicated a good internal consistency (α=.82) for the overall scale and an acceptable-to-good reliability for the subscales (α=.735-.866). Digital health literacy was low in more than half of the participants (52.9%). While no differences were found for gender (X2 (1)=0.25, p=.618) and migration background (X2 (2)=2.34, p=.31), lower digital health literacy was more frequent among younger children aged 9-11 years (X2 (2)=34.69, p = &amp;lt;.001), children with low family affluence (X2 (4)=24.16, p = &amp;lt;.001), and lower parental education (X2 (2)=8.26, p=.016). Conclusions The results of the first study of its kind in Europe suggests an elevated need to promote digital health literacy in schoolchildren. Public health and education policies and interventions are needed that pay attention particularly to younger children's needs, to those from lower family affluence, and lower parental education.

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.

Dilemma, an innovative public health scientific animation for the youth, France, 2022

Abstract Background The spread of disinformation and institutions distrust increases individuals difficulty to adhere to public health recommendations. How citizens can critically appraise health information is a major public health matter and a need to favor health democracy. In this field, to both enhance curiosity and critical thinking, young people represent a population with specific needs for innovative approaches. Objectives To provide 15-24y people a space for experimentation and discussion on public health concepts, a multidisciplinary experts team created the “Dilemma” scientific animation that uses a playful approach. Trained young facilitators guide participants through four games (on proportions, risk/protective factors, scientific estimation, benefit/risk ratio). We assessed the program using mixed method (self-questionnaires; focus groups) to answer the following questions: can the approach generate curiosity and participation among young people? Is it effective in improving health literacy and confidence in control over one's own well-being? Results Dilemma was launched in a French region in Nov 2022 targeting high-school students; preliminary results are presented for 67 participants from a Bordeaux technical high school (extended results are awaiting). Of these, 76% were satisfied, 82% felt they improved their critical thinking skills and 79% their curiosity. Facilitators’ fun and friendly nature was an important aspect in participants’ satisfaction. However, they reported difficulties in remembering the messages behind the games and asked for more calm and shorter texts. No effect was found on health literacy or internal locus of control. Conclusions Dilemma shown promising results on how science animations on public health could interest young people. It should develop more games and closer collaboration with school teachers to improve its effectiveness. Fun aspects and peer support needs to be considered for future actions. Key messages • The scientific public health animation Dilemma shows promising results in increasing curiosity and critical thinking of the youth. • Using playful scenarios could contribute to favor health democracy.

The practice of information appraisal: An ethnographic study of a health information intervention.

As healthcare systems grow increasingly complex, greater demands are placed on patients' abilities to find, understand, appraise, and use health information - often termed their 'health literacy'. Most health literacy research does not focus on information appraisal. When it does, there is a tendency to equate it with patients' assessment of credibility. This reproduces a healthcare-centric understanding of information appraisal where patient agency is omitted. This study explores how participants in a health information intervention practiced information appraisal. The intervention aimed to increase information uptake for people with low back pain by delivering health information to them through animations. This study draws on ethnographic participant observation of the encounters between the intervention and its participants, including 49 rapid interviews and semi-structured telephone interviews with 23 participants carried out in the spring of 2021. Inspired by a social practice approach, the study thoroughly grounds the health literacy subcategory of 'appraisal' in practice. It illustrates that participants appraised the information provided in the intervention according to several factors. These include relating the information to their personal health needs, interpreting the intended audience of the health animations, and prioritising their attention situationally between the animations and other immediate concerns. We suggest that information appraisal is a fundamental component of health literacy and should be considered key in research, policy and practice. To accommodate current healthcare ideals of patient centeredness, empowerment and informed choice, the complex and dynamic ways in which people appraise health information need be considered legitimate practices of health literacy.

Exploring the relationships between health literacy, social support, self-efficacy and self-management in adults with multiple chronic diseases

BackgroundSelf-management in chronic diseases is essential to slowing disease progression and preventing complications. However, empirical research on the associations of critical factors, such as health literacy, social support, and self-efficacy with self-management in the context of multiple chronic diseases is scarce. This study aimed to investigate these associations and provides insights for healthcare providers to develop effective educational strategies for people with multiple chronic diseases.MethodsUsing a cross-sectional survey design, adults (n = 600) diagnosed with at least two chronic diseases were conveniently recruited. To measure health literacy, social support, self-efficacy, and chronic disease self-management behaviours, the Health Literacy Questionnaire (HLQ), Medical Outcome Study - Social Support Survey, Self-efficacy in Managing Chronic Disease, and Self-management in Chronic Diseases instruments were utilized respectively. Comorbidity status was assessed using Age-adjusted Charlson Comorbidity Index (ACCI). A generalised linear regression model was used with a backward technique to identify variables associated with self-management.ResultsParticipants’ mean age was 61 years (SD = 15.3), 46% were female, and most had up to 12 years of education (82.3%). Mean scores for HLQ domains 1–5 varied from 2.61 to 3.24 (possible score 1–4); domains 6–9 from 3.29 to 3.65 (possible score 1–5). The mean scores were 52.7 (SD = 10.4, possible score 0–95), 5.46 (SD = 1.9, possible score 0–10) and 82.1 (SD = 12.4, possible score 30–120) for social support, self-efficacy, and self-management, respectively. Mean ACCI was 6.7 (SD = 2.1). Eight factors (age > 65 years, being female, 4 health literacy domains, greater social support, and higher self-efficacy levels) were significantly associated with greater self-management behaviours while comorbidity status was not. The factors that showed the strongest associations with self-management were critical health literacy domains: appraisal of health information, social support for health, and healthcare provider support.ConclusionsDeveloping critical health literacy abilities is a more effective way to enhance self-management behaviours than relying solely on self-confidence or social support, especially for people with multiple chronic diseases. By facilitating communication and patient education, healthcare providers can help patients improve their critical health literacy, which in turn can enhance their self-management behaviours.

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.

Health literacy profiles of medical students in an Australian Doctor of Medicine programme: A cross-sectional study using the Health Literacy Questionnaire.

With the emerging focus on designing health-literate organisations and health care systems, it is essential to understand the health literacy profiles of the medical workforce including medical students, as medical professionals play a key role in within these systems. Medical professionals contribute to good patient health outcomes through enabling access to appropriate health care, provision of quality health information and collaborative shared decision-making, which are fundamental health literacy competencies. The aim of this study is to identify health literacy strengths and weaknesses of medical students enrolled in an Australian Doctor of Medicine programme. Students from all 4 years of an Australian Doctor of Medicine programme were invited to complete an anonymous, online survey in January 2021. Health literacy profiles were identified using the 9-domain, 44-item multi-dimensional Health Literacy Questionnaire, a validated tool which comprehensively evaluates health literacy strengths and weaknesses from diverse perspectives. Demographic characteristics and social attributes were also recorded. The results were compared with Australian Bureau of Statistics data. Eighty-six participants completed the survey. Most participants were female students (57%) who spoke English at home (88%) with tertiary-educated fathers (60%) and resided in locations associated with high socioeconomic status during adolescence (61%). Males scored significantly higher in three domains which explored health information access and appraisal, and ability to actively engage with health care providers. Students' scores were significantly lower than the Australian general population in Domain 6 (Ability to actively engage with health care providers) and Domain 7 (Navigating the health care system). Medical students' health literacy profiles indicate areas of weakness in their ability to engage with health care providers and to navigate the health system. Medical educators will need to create opportunities to address these weaknesses within medical curricula. Gender differences identified in self-rated ability to access and appraise health information requires further exploration. SO WHAT?: Further understanding of health literacy profiles of medical students may influence design of medical school curricula.

The eliminate hepatitis C (EC) experience study: baseline characteristics of a cohort of people who inject drugs in Melbourne, Australia

ObjectivesDirect-acting antivirals provide an opportunity to eliminate hepatitis C virus (HCV) as a public health threat in Australia, yet barriers to care remain. In this study, we use baseline data...