Health Information Literacy Research Articles

The Effect of Online Health Information Seeking on Physician-Patient Relationships: Systematic Review.

BackgroundThe internet has now become part of human life and is constantly changing people's way of life. With the increasing popularity of online health information (OHI), it has been found that OHI can affect the physician-patient relationship by influencing patient behaviors.ObjectiveThis study aims to systematically investigate the impact of OHI-seeking behavior on the physician-patient relationship.MethodsLiterature retrieval was conducted on 4 databases (Web of Science, PubMed, China National Knowledge Infrastructure, SinoMed), and the time limit for literature publication was before August 1, 2021.ResultsWe selected 53 target papers (42 [79%] English papers and 11 [21%] Chinese papers) that met the inclusion criteria. Of these, 31 (58%) papers believe that patients’ OHI behavior can enable them to participate in their own medical care, improve patient compliance, and improve the physician-patient relationship. In addition, 14 (26%) papers maintain a neutral attitude, some believing that OHI behavior has no significant effect on doctors and patients and others believing that due to changes in the factors affecting OHI behavior, they will have a negative or a positive impact. Furthermore, 8 (15%) papers believe that OHI search behavior has a negative impact on doctors and patients, while 6 (11%) papers show that OHI reduces Chinese patients’ trust in doctors.ConclusionsOur main findings showed that (1) OHI-seeking behavior has an impact on patients' psychology, behavior, and evaluation of doctors; (2) whether patients choose to discuss OHI with doctors has different effects on the physician-patient relationship; and (3) the negative impact of OHI on China’s internet users is worthy of attention. Due to the low quality of OHI, poor health information literacy, short physician-patient communication time, and various types of negative news, patients' trust in doctors has declined, thus affecting the physician-patient relationship. Improvement of people's health information literacy and the quality of OHI are important factors that promote the positive impact of OHI on the physician-patient relationship.

The prevalence and determinants of COVID-19 vaccine hesitancy in the age of infodemic

ABSTRACT Background Addressing COVID-19 vaccine hesitancy is key to ending the COVID-19 pandemic. Communication and media environments are potential drivers of vaccine hesitancy. It is worthwhile to examine the relationship between social media use and COVID-19 vaccine hesitancy. Objective This study aims to understand the prevalence and determinants of COVID-19 vaccine hesitancy. Methods Questionnaires were administered to 463 participants in mainland China. Factor analysis, correlation analysis, and linear regression models were utilized to examine the prevalence and influencing factors of COVID-19 vaccine hesitancy in China, as well as the relationship between social media use, media trust, health information literacy, and COVID-19 vaccine hesitancy. Results Lack of confidence and risk were identified as factors of COVID-19 vaccine hesitancy. Age, occupation status and income levels were significantly associated with COVID-19 vaccine hesitancy. In addition, we observed that frequency of social media use, diversity of social media use, media trust and health information literacy were significantly correlated with COVID-19 vaccine hesitancy. Conclusion Increased frequency and diversity of social media use, media trust and health information literacy can mitigate COVID-19 vaccine hesitancy and promote COVID-19 vaccination.

The Gap Between Self-Rated Health Information Literacy and Internet Health Information-Seeking Ability for Patients With Chronic Diseases in Rural Communities: Cross-sectional Study.

BackgroundThe internet has become one of the most important channels for residents to seek health information, particularly in remote rural areas in China.ObjectiveIn this study, we aimed to explore the gap between self-rated health information literacy and internet health information seeking ability for patients with chronic diseases in rural communities and to preliminarily evaluate their barriers when seeking health information via the internet.MethodsResidents from rural communities near Bengbu City and with chronic diseases were included in this study. A self-rated questionnaire was used to evaluate their health information literacy, 3 behavioral competency tasks were designed to preliminarily evaluate their ability to seek health information on the internet and semistructured interviews were used to investigate their barriers to obtaining health information via the internet. A small audiorecorder was used to record the interview content, and screen-recording software was used to record the participants’ behavior during the web-based operational tasks.ResultsA total of 70 respondents completed the self-rated health information literacy questionnaire and the behavioral competence test, and 56 respondents participated in the semistructured interviews. Self-rated health information literacy (score out of 70: mean 46.21, SD 4.90) of the 70 respondents were moderate. Although 91% (64/70) of the respondents could find health websites, and 93% (65/70) of the respondents could find information on treatment that they thought was the best, 35% (23/65) of respondents did not know how to save the results they had found. The operational tasks indicated that most articles selected by the respondents came from websites with encyclopedic knowledge or answers from people based on their own experiences rather than authoritative health information websites. After combining the results of the semistructured interviews with the DISCERN scale test results, we found that most interviewees had difficulty obtaining high-quality health information via the internet.ConclusionsAlthough the health information literacy level of patients with rural chronic disease was moderate, they lack the ability to access high-quality health information via the internet. The vast majority of respondents recognized the importance of accessing health information but were not very proactive in accessing such information.

Analysis on the Key Influence of Adolescent Health Information Literacy Using Big Data Analysis Technology under Social Network Environment.

Purpose/Significance. This paper aims to explore the influence mechanism of adolescent health information literacy on health behavior. Method/Process. 13–19 year olds are taken as the survey objects to investigate their health information literacy through a questionnaire. Health information literacy mainly includes health information needs, acquisition, evaluation, use, and behaviors. A total of 252 adolescents' data were collected in this study, and model testing was performed with the help of regression analysis and structural equation modeling. Conclusion/Results. The results of the study show that adolescents' health information needs, acquisition, evaluation, and application abilities have a positive impact on health behaviors in the social network environment. Emotional responses and individual cognition as intermediate variables play important roles between health information literacy and health behaviors. Health information needs and health information assessments have the highest impact on mental health and social health, respectively. The society should pay special attention to the influence of adolescents' health cognition and anxiety on health behavior in the context of social network.

Opportunities to Integrate Primary Health Care Digital Innovations in Maternal and Child Health Care Services in Kenya

Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.

HEALTH INFORMATION BEHAVIOR DURING COVID-19 EFFECT OUTBREAK AMONG NAVSARI AGRICULTURE UNIVERSITY STUDENTS OF NAVSARI CITY

Health information shared on the web has the potential to enhance people’s quality of life. However, health information literacy and informational skills decide the individuals’ ability to get credible health information useful for them. This study investigates Navsari Agriculture university students of Navsari City health information behavior during the COVID-19 pandemic. The study has adopted a quantitative approach using a questionnaire to Navsari Agriculture university students of Navsari City health information behavior. A sample of a questionnaire was distributed randomly among 230 students and 185 students answered a questionnaire. The data were analyzed using SPSS software. The study results show that official health websites, social media, and family and friends are the first sources for health information for the participants. The findings also revealed that the sample has adequate health information skills, though many of the participants still got to raise their information literacy skills. Information credibility and private beliefs were found to affect the participants’ decision to share health information on the web . One of the limitations of the study is that the sample selected in this study was Agriculture students who are trained to find reliable information as part of their education. Findings could also be different for the “average” student. Furthermore, the questionnaire was distributed in one university, which means that the results cannot be generalized in Agriculture University using different courses. This study explores the health information behavior of Agriculture students during the COVID-19 pandemic. The current study results may help develop the course plan in other Agriculture universities in Gujarat, which would help improve the students’ health information literacy

Student Health Information Literacy Against Pandemi Covid-19 (Study for Students FISIP, University of Bengkulu


 Background: Health is becoming important today, especially during a pandemi situation. Everyone needs to take care of their health to avoid Covid-19. There are many information that students can use in maintaining their health from the internet. This is the basis for researchers to see student health information literacy.
 
 
 Research objectives: to determine the health information literacy of students from Faculty of Social and Political Sciences, University of Bengkulu and see the relationship between gender and study program with the dimensions of health information literacy.
 
 
 Research Methods: This study uses quantitative research using sample of 95 students of the Faculty of Social and Political Sciences, University of Bengkulu. The determination of the sample is based on the stratified sampling.
 
 
 Finding: Respondents already have health information literacy, especially information on Covid-19. The majority of respondents have an interest in finding information about Covid-19. Respondents already have health information literacy skills in the aspects of identifying, searching for, finding, and using the Covid-19 information they find. Female respondents have more health information literacy than men. In this type of education, Journalism study program students have information literacy compared to other study programs, especially in finding, evaluating and using Covid-19’s information.
 
 
 Conclusion: The results of this study indicate that students of the Faculty of Social and Political Sciences, University of Bengkulu have health information literacy skills in seeking information on Covid-19 during the pandemi season.
 
 
 

An assessment of health information literacy among women in rural Lake Zone, Tanzania

This article presents the results from a descriptive cross-sectional survey that was conducted to assess the health information literacy skills of women of childbearing age in rural Lake Zone, Tanzania. A total of 349 women were involved in the study. The study found that most rural women in the study area have low levels of health information literacy. The aggregate scores of health information literacy indicate a mean of 42.86% with a normal distribution curve, and estimated close-to-zero skewness (0.172) and kurtosis (−0.297) measures. The causal relationships between health information literacy and women’s socio-demographic factors indicate a positive and statistically significant effect ( p < .01) of women’s level of education, income, ownership of means of communication and access to health facilities on their level of health information literacy. The women’s inadequate ability to access, read, understand, appraise and use health information is a barrier to their acquisition of relevant health information. Enhancing the health information literacy skills of these women is most likely to improve their health outcomes.

Assessment of Health Literacy among Patients with Diabetes: Development of a Model for the Improvement of Health Literacy

Background: Health literacy refers to the skills and abilities people acquire, analyze, and understand regarding basic health information and services they need so that they can contribute to their health issues and make the right decision. Moreover, given the importance of diabetes in the world and in Iran, as well as the impact of health information literacy on the quality of life and control of diabetes, this study aimed to evaluate health information literacy of type 2 diabetic patients and design an information service model for promoting their health information literacy. Method: In this study, semi-structured interviews were used to collect the qualitative data needed to present the model. In the qualitative method, semi-structured interviews were conducted with 14 health literacy experts selected through purposive sampling. The Grounded Theory method was then used for analyzing interviews and explaining related dimensions and components. Results: In total, five categories (nutritional factors, media development, physical activity, inclusive education, as well as racial and age consciousness) and a core category of "type 2 diabetes recognition" were identified in this study. Conclusion: It was found that diabetes type 2 was heavily influenced by lifestyle and education factors. Finally, according to the interviews, a model was developed to improve the health literacy of diabetic patients.

Recognizing fake information through a developed feature scheme: A user study of health misinformation on social media in China

This study aims at helping people recognize health misinformation on social media in China. A scheme was first developed to identify the features of health misinformation on social media based on content analysis of 482 pieces of health information from WeChat, a social media platform widely used in China. This scheme was able to identify salient features of health misinformation, including exaggeration/absolutes, induced text, claims of being unique and secret, intemperate tone or language, and statements of excessive significance and likewise. The scheme was then evaluated in a user-centred experiment to test if it is useful in identifying features of health misinformation. Forty-four participants for the experimental group and 38 participants for the control group participated and finished the experiment, which compared the effectiveness of these participants in using the scheme to identify health misinformation. The results indicate that the scheme is effective in terms of improving users’ capability in health misinformation identification. The results also indicate that the participants’ capability of recognizing misinformation in the experimental group has been significantly improved compared to those of the control group. The study provides insights into health misinformation and has implications in enhancing people's online health information literacy. It informs the development of a system that can automatically limit the spread of health misinformation. Moreover, it potentially improves users’ online health information literacy, in particular, under the circumstances of the COVID-19 pandemic.

A Qualitative Exploratory Study in Health Information and Health Communication Leadership in the Age of the COVID-19 Pandemic

Low health literacy is a public health scourge. Health information and health literacy around COVID-19 is a miscalculated public health conundrum. Zarocostas referred to the COVID-19 not as a pandemic, but an info-demic because of the need for patients to be more health literate when they are being bombarded by inaccurate or misleading information from social media, public officials, and family. During a global pandemic, the need to understand and explore the nuances of health literacy has never been more pressing. This qualitative exploratory study uses the expertise of subject matter experts on health literacy to classify the barriers to health information literacy, the best practices for improving health information literacy, and the additional measures taken by medical providers during the COVID-19 outbreak ensure that patients have the most accurate and useful health information.

Understanding health information literacy of mHealth app users from digital wellbeing perspective: Evidence from regression analysis and fsQCA

While past research suggests mHealth apps help cultivate users’ health information literacy (HIL), factors contributing to their HIL development have not been systematically studied. Applying digital wellbeing framework, an empirical investigation using a large-scale survey dataset was conducted. From regression analysis and fuzzy-set qualitative comparative analysis (fsQCA), two findings were yielded. First, six influential factors, including person-specific factors (i.e., gender, annual family income, Internet experience), device-specific factors (i.e., screen sizes of mobile phones), and context-specific factors (i.e., use frequency and perceived quality of mHealth apps), were identified. Second, gender, annual family income, internet experience, screen size of mobile phones, use frequency and perceived quality of mHealth apps had synergistic effects on HIL. By introducing fsQCA to library and information science community, the study not only extends literature by teasing out the combinations of different categories of factors contributing to HIL but informs health professionals and mHealth app developers.

Keterampilan literasi informasi sebagai upaya pencegahan hoaks mengenai informasi kesehatan di media sosial

People must know how identify and search for credible health information. This study aimed to determine how information literacy activities prevented the spread of health information hoaxes on social media. This study used a qualitative approach and case study research methods. The collect research data through observation, interviews with 15 interviewees, and literature study techniques. The study results found that people obtained health information literacy by utilizing social media that is used daily. First, people recognized when they needed information, meaning they already understood when to search for information and knew what information to seek. Second, people can find information was performed in various ways, such as choosing a mass media portal that was easy to use, searching for specific information by including keywords or hashtags. Third, people evaluate the information found by knowing who made the information. Who disseminates the information? Are social media accounts trustworthy? Does the skill match the required information? Fourth, people use the obtained information effectively. People only chose the information that was suitable for what they felt and needed. Conclusion this research is people that who use social media must have information literacy expertise in finding health information so that avoid hoax information widely circulating today.

Subjective Commentary of Health Literacy through Social Networks for Civil Servants’ Pension Fund Beneficiaries: A Qualitative Study

Background and Objectives: Elderly people need to pay more attention to promoting health promotion and improving quality of life in comparison with other people. On the other hand, the interest and desire to work with the Internet and social networks of internet plays an indelible role in improving the health literacy of the community. This study was carried out with the aim of evaluation the subjective explanation of health literacy through social networks for retired of fund beneficiaries. Material and Methods: The present study is a phenomenological study with emphasis on Van Mennen's perspective to discover the experiences of retirees from the phenomenon of health literacy through social networks. The data were collected through a deep interview. Semi-structured interviews were conducted with 15 retirees of the State Pension Fund in Tehran in 2020 using purposive sampling. All interviews were recorded and implemented and the theme analysis method was used to analyze the interviews. Results: Data analysis resulted in the extraction of 71 primary codes and 33 sub-themes, which was classified in four main themes of experience in the field of "access to health information", experience in the field of "understanding health information" "Experience in the field of" health information evaluation ", experience in the field of" application of health information ". Conclusion: Retirees, who make a large part of the country's elderly population, are embedded in social networks, and all organizations that play a role in the health and education of retirees can create rich educational content and using Simple, understandable multimedia content by social networks as well as the introduction of networks with reliable information for retirees, to improve the level of health literacy and increase useful health information for them, which is an effective factor in maintaining health and increasing the quality of life.

Relating health information literacy self-efficacy to information technology use and health status: A large-scale study among Chinese undergraduates

The purpose of this paper is to relate individuals’ health information literacy (HIL) self-efficacy to their information technology (IT) use and health status. Using a large-scale field survey with 6,160 valid respondents from undergraduates in a Chinese university, we found that individuals’ HIL self-efficacy was significantly related to some socio-demographics and lifestyle features, IT use, and health status. Meanwhile, some socio-demographics and lifestyle features and health status help identify low HIL self-efficacy individuals, while moderate daily IT use may improve HIL self-efficacy. Theoretical and practical implications, as well as limitations and future work, are also discussed.

Creating culture-centered health and health insurance literacy resources: lessons learned from Haitian Creole, Mandarin, Native American, and Vietnamese communities

ABSTRACT Background To improve health insurance literacy, the Centers for Medicaid and Medicare Services launched From Coverage to Care (C2C) to help individuals translate health insurance into appropriate healthcare utilization. One aim of C2C is to extend its health communication tools to vulnerable populations, including providing materials in several languages in addition to English and Spanish. Understanding the experiences of organizations and populations that utilize these materials is critical for ensuring meaningful and effective conveyance of health literacy information. Methods The authors evaluated C2C, which included a qualitative case study approach of four communities using C2C products. The authors draw on findings from interviews with organizations that used C2C materials and focus groups with Haitian Creole, Mandarin, Native American, and Vietnamese consumers. Results Five key lessons learned are described that are relevant to public health education and campaigns. Lessons include: the importance of culture-centered materials in building empathy and trust; emphasizing appropriate and salient translations of materials; choosing targeted venues for dissemination that are responsive to the constraints and preferences of minority populations; drawing on educational tools in conjunction with individually tailored approaches; and, working with other local organizations to amplify dissemination. Conclusions Increasing health insurance literacy among vulnerable populations is critical. National efforts, such as C2C, are an important step, but moving beyond simply providing educational materials in additional languages and adopting a culture-centered perspective throughout an initiative is important for creating positive change.

Online health information-seeking behaviors and skills of Chinese college students

BackgroundSeeking online health information (OHI) has become a common practice globally. The information seekers could face health risks if they are not proficient in OHI literacy. The OHI-seeking behaviors and skills of Chinese college students, the largest proportion of college students in the world, are understudied. This study was aimed to describe OHI-seeking behaviors and skills of college students in Guangdong, China.MethodsCollege students in the Guangdong province with OHI-seeking experience were invited via WeChat, QQ, and Sina Weibo using QR code posters and flyers for participation in this online anonymized questionnaire-based study. Data on demographics, OHI literacy, information resources, search approaches, and behaviors were collected. The relationship between perceived OHI literacy and high-risk behaviors was investigated by bivariate logistic regression analysis.ResultsRespondents were 1203 college students with a mean age of 20.6 years, females (60.2%), and undergraduates (97.2%). They sought health information via websites (20.3%), WeChat (2.6%), or both (77.1%). Baidu was the main search engine, and baike.baidu.com (80.3%), Zhihu.com (48.4%), and Zhidao.baidu.com (35.8%) were top three among 20 searched websites for information about self-care (80.7%), general health (79.5%), disease prevention (77.7%), self-medication (61.2%), family treatment (40.9%), drugs (37.7%), western medications (26.6%), hospitals (22.7%), physicians (21.4%), and Traditional Chinese Medicine (15.6%). Despite most respondents (78%) lacked confidence in the evidence quality and satisfaction with the results, only 32.4% further consulted doctors. Many (> 50%) would recommend the retrieved information to others. About 20% experienced hacking/Internet fraud. Cronbach’s alpha for the internal consistency of OHI literacy was 0.786. Bivariate logistic regression analysis showed that students who believed they can judge the evidence level of OHI were more likely to self-diagnose (OR = 2.2, 95%CI, 1.6–3.1) and look for drug usage (OR = 3.1, 95%CI, 1.9–5.0).ConclusionsThis study reveals Chinese college students’ heavy reliance on OHI to manage their own and others’ health without sufficient knowledge/skills to identify misinformation and disinformation. The apparent risky information-seeking behaviors of Chinese college students warrant the provision of regulated, accurate, and actionable health information; assurance of cybersecurity; and health information literacy promotion in colleges by concerned authorities.

The Role of Sources and Types of Health Information in Shaping Health Literacy in Cervical Cancer Screening Among African Immigrant Women: A Mixed-Methods Study.

Background:Health literacy is a strong determinant of health outcomes among immigrants. How sources and types of health information influence health literacy in the context of cervical cancer screening among African immigrant women remains unknown.Objective:This study was undertaken to explore how various sources and types of health information influence information sharing and health literacy in the context of cervical cancer screening among African immigrant women.Methods:Using a mixed-methods approach, a convenience sample of African immigrant women (N = 167) completed study surveys followed by semi-structured individual phone interviews with a purposive sub-sample (n = 20) of survey participants. The relationship between sources and types of health information and health literacy was assessed using multivariate logistic regression. Emergent themes were identified in the qualitative interviews using content analysis. Qualitative and quantitative data were merged to describe differences and similarities in African immigrant women's experiences and display of health literacy by different sources and types of health information.Key Results:Health care providers (78%), women friends (46%), and internet (45%) were the most common sources of health information used by African immigrant women, followed by women relatives (32%), television (22%), social media (17%), and church (16%). Content analysis revealed that the health care provider was rated as the most credible source; personal experiences of family and friends made health information more relatable; and church was the least endorsed source. Health information presented verbally (adjusted odds ratio of 5.51, p = .01) was associated with higher health literacy even after controlling for covariates. Most African immigrant women had health information presented in verbal form (80%), with pictures (43%) being the least popular type of health information.Conclusions:Study findings suggest that verbal communication is associated with health literacy in the context of cervical cancer screening among African immigrant women. Health interventions that use peer educators (women friends and family) and incorporate verbal communication may be a more effective strategy in promoting positive cervical cancer health behaviors among African immigrant women. [HLRP: Health Literacy Research and Practice. 2021;5(2):e96–e108.]Plain Language Summary:For this mixed-methods study, a convenience sample of African immigrant women (N = 167) completed study surveys followed by semi-structured individual phone interviews with a purposive sub-sample (n = 20) of the survey participants. Study findings show a strong association between verbal communication and health literacy in the context of cervical cancer screening among African immigrant women.

The Effect of Socio-Economic Status on Health Information Literacy among Urban Older Adults: Evidence from Western China.

The present study aimed to observe the effect of socio-economic status on health information literacy and to identify whether there is a social gradient for health information literacy among urban older adults in Western China. This study employed a cross-sectional research design, and 812 urban participants aged 60 and older were enrolled in Western China. In the current study, only 16.7% of urban older adults reported having adequate health information literacy. Binary logistic regression analysis showed that socio-economic status factors including educational attainment, ethnicity, and financial strain were significantly and tightly associated with health information literacy. Additionally, other factors including suffering from chronic diseases, information-seeking activity, reading magazines and books, and watching television were also significantly linked to health information literacy. Consistent with existing studies, the findings indicate the health information literacy deficit and demonstrate the crucial impact of socio-economic status on health information literacy, which implies a social gradient in health information literacy. The importance of other factors related to health information literacy are discussed as well. The results suggest that reducing the health information literacy deficit and social gradient in health information literacy must be considered as an important priority when developing public health and health education strategies, programs, and actions among urban older adults in Western China.

The Association Between Health Literacy and Self-rated Health Among Residents of China Aged 15–69 Years

Health literacy is a critical determinant of health. However, the association between health literacy and outcomes among Chinese residents has not been studied using nationally representative data. This study examines the association between health literacy and self-rated health among Chinese residents based on the 2017 China Health Literacy Survey. The 2017 China Health Literacy Survey was conducted among non-institutionalized residents aged 15-69 years from 31 provinces in China. Self-rated health was measured using a single question with a 1-5 scale. Health literacy was assessed using the Chinese Health Literacy Scale. Multilevel linear regression models examined the association between health literacy and self-rated health. Data were collected in 2017 and analyzed between 2018 and 2019. The final sample size was 85,384. The overall weighted mean of the self-rated health score was 4.02 (95% CI=4.00, 4.03). After adjusting for individual-, county-, and province-level covariates, Chinese residents with higher levels of health literacy were more likely to have better self-rated health (β=0.0007, SE=0.0002, p<0.001). Of 6 dimensions of health literacy, 4 (i.e., infectious diseases literacy, chronic diseases literacy, medical care literacy, and health information literacy) were associated with self-rated health. Additionally, self-rated health was associated with gender, age, education, occupation, annual household income, and chronic conditions. Using nationally representative data collected in 2017, this study found that self-rated health is associated with health literacy among Chinese residents aged 15-69 years. The promotion of health literacy should be an important component of health education, patient management, and health promotion.