Health Literacy Ability Research Articles

Enhancing Health Literacy and Self-Care Abilities among Individuals with Chronic Diseases

Health literacy is an essential element in the effective management of chronic diseases. It provides a foundation for individuals to understand, evaluate, and utilize health information, thus enabling them to make well-informed decisions regarding their care. For individuals living with chronic conditions such as diabetes, heart disease, and hypertension, health literacy is not just about understanding their health needs; it is about empowering them to manage their conditions effectively, make informed healthcare decisions, and maintain a higher quality of life. This writing explores the multidimensional relationship between health literacy and self-care abilities among people with chronic diseases, examining the factors affecting health literacy, its impact on self-care, strategies for improvement, and the pivotal role of health professionals in this context.

Assessment of electronic health literacy and its association with self-management among gout patients: A cross-sectional study

Objectives: This study aimed to assess electronic health (eHealth) literacy and self-management ability among gout patients in China and analyze their correlation. Patients and methods: A cross-sectional study was conducted on 168 male gout patients (mean age: 44.5±13.8 years, range, 22 to 76 years) using a gout patient self-management assessment scale and the Chinese version of eHealth Literacy Scale between August 2020 and February 2021. The correlation between eHealth literacy and gout self-management was examined. Multivariate regression analysis was conducted to identify the predictors of gout patients’ self-management ability. Results: The scores of eHealth literacy and self-management were 28.56±1.72 and 3.59±0.78, respectively, which were both in the medium level, with the lowest score in the lifestyle management dimension. Pearson’s correlation analysis showed that eHealth literacy was significantly and positively associated with the total score of gout self-management and its four dimensions. Literacy in eHealth (β=0.399, p<0.001, 95% confidence interval [CI]: 0.023-0.069), living with family members (β=0.336, p=0.001, 95% CI: 0.313-1.234), living in an urban area (β=0.312, p=0.005, 95% CI: 0.191- 1.022), and having college or a higher level of education (β=0.268, p=0.016, 95% CI: 0.032-0.302) were the significant predictors of gout patients’ self-management ability, explained 30.6% of the total variance. Conclusion: Literacy in eHealth was the most significant predictor of gout self-management ability. Gout patients had the lowest score in the perceived ability of searching and applying online health-related information, indicating that both the quantity and quality of gout-specific information needs to be enlarged in electronic resources. Healthcare providers could design and implement eHealth literacy interventions to strengthen patients’ gout self-management ability

Development and validation of gestational diabetes mellitus health literacy scale

ObjectiveWhile there are various health literacy scales that exist, none of health literacy scale suitable for pregnant women with gestational diabetes mellitus (GDM). To address this gap, this study aimed to develop GDM health literacy scale and evaluate its psychometric properties. MethodsBased on the Delphi expert consultation, we developed the initial GDM health literacy scale. Item analysis was taken using a sample (n = 299) recruited in China to form formal scale. Additional participants (n = 395) completed survey to assess the internal consistency reliability, test-retest reliability, content validity, construct validity and criterion correlation validity of scale. ResultsThe scale performed well in terms of internal consistency reliability, content validity, construct validity and criterion correlation validity. Test-retest reliability indicated that the instrument was effective at measuring health literacy of GDM over time. ConclusionThe scale is a reliable and valid measure of six domains of health literacy for GDM. Practice implicationsThe scale can be used to effectively evaluate the level of health literacy of pregnant women with GDM. The information can provide targeted health support for pregnant women with GDM to improve their health literacy and self-management ability.

Occupational health literacy and work ability: a moderation analysis including interpersonal and organizational factors in healthy organizations.

Healthy organizations approach to occupational safety and health should holistically include individual, interpersonal, and organizational levels. There is an empirical research gap in considering different levels in organizations for health promotion in the context of maximizing work ability. This study aims to investigate the association of (1) occupational health literacy (on an individual level), (2) health-oriented leadership (interpersonal level), (3) participation possibilities in health, and (4) values of health in companies (both organizational levels) on work ability. Additionally, we examined the potentially moderating role of health-oriented leadership, participation possibilities in health, and values of health between occupational health literacy and work ability. Cross-sectional data were obtained from 828 employers and employees in small and medium-sized enterprises. Self-report measures included occupational health literacy, health-oriented leadership, work ability, participation possibilities in health at work, and values of health in the company. Occupational health literacy comprises two factors: a knowledge-/skill-based approach to occupational health and a willingness/responsibility for occupational health. Participation possibilities in health are measured regarding participatory opportunities and co-creation of health at work. Values of health in the company capture the importance of health in the workplace and the scope for improving employees' health. Data were analyzed using latent regression and latent moderation analyses controlling for age, gender, and educational level. Occupational health literacy (knowledge-/skill-based), health-oriented leadership, participation possibilities in health, and values of health in companies showed positive associations with work ability. Health-oriented leadership on an interpersonal level was found to moderate the positive relationship between (knowledge-/skill-based) occupational health literacy and work ability. Participation possibilities in health on an organizational level acted as a moderator on the relationship between both occupational health literacy factors and work ability. Individual, interpersonal, and organizational factors play important roles in maintaining work ability in healthy organizations. This study highlights the importance of promoting occupational health literacy among employees and leaders, creating a healthy workplace through health-oriented leadership, and providing participatory opportunities for co-creation in health promotion at work. Future research should further explore these factors' roles in different industries and contexts and how they may be addressed effectively in tailored workplace interventions.

Are We Missing the Mark? Understanding Health Literacy in A Rural-Border Hospital.

Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population. In addition, personal factors (i.e., demographics) were analyzed to determine their influence on the nurse's predictions and patients' HLL. Data were collected from 84 participant patient-nurse couplets admitted to a medical-surgical unit in a rural setting located on the United States-Mexico border. In addition to demographic information collected via survey, RNs were asked to predict their patient's health literacy abilities while the Newest Vital Sign, a health literacy assessment tool, was deployed to determine the actual HLL of patients participating in the study. Data were analyzed using descriptive statistics, t-tests, and chi-square tests while a Spearman correlational model was used to examine the relationship between predicted HLL and actual HLL. Finally, a logistic regression model was used to analyze the relationship between personal factors and HL data for RNs and patients. Analysis of the data revealed that RNs consistently overestimated patients' abilities, as evidenced by the disparity between patients' actual HLL (mean 1.71) and predicted HLL (mean 4.26) by RNs, with a moderately strong positive relationship (rs = .418). Notably, higher academic preparation and years of experience did not enhance the RNs' ability to identify LHL while the highest level of education completed was the only statistically significant predictor of adequate health literacy in the patient population sampled. These findings emphasize the need to prioritize effective health literacy education in RN academic preparation and clinical practice to support the detection of LHL when a standardized health literacy assessment tool is not utilized in the clinical setting. By recognizing the presence of LHL, healthcare professionals can better support patients' needs and bridge the knowledge gap, ultimately improving patient outcomes.

Coping With Women's Menstruation-Related Health Issues in Male-Dominated Companies: A Cross-Sectional Study in Japan.

Japanese women face many female-specific health problems in the workplace, especially menstruation-related issues, which can adversely affect their quality of life and productivity. This study aims to examine how female employees in a male-dominated company in Hiroshima, Japan, cope with menstruation-related health issues in the workplace and the factors that influence their coping strategies. This study used a cross-sectional survey research method. The survey investigated age, health, and menstrual-related issues, as well as women's active participation support and health literacy (HL) levels. The sample population included employees of a manufacturer in Hiroshima prefecture. The data were collected from February 20 to March 10, 2023. The analysis subjects were 171 women who had experienced menstruation-related, women-specific health issues in the workplace. Their attitudes toward menstruation-related issues could influence their experiences. They were categorized into positive and negative groups based on their attitudes toward coping with women's health issues. Chi-square tests and logistic regression analysis were used to compare the two groups. The study found that 50.3% (N = 296) of female employees had experienced women's menstruation-related health issues at work. As many as 62.6% (N = 171) of female employees showed a positive attitude, and the study also found that female employees with a positive attitude toward menstruation-related health issues had higher HL (odds ratio (OR) = 1.216, 95% CI: 1.007-0.1.468) and were more likely to be able to predict menstruations (OR = 4.528, 95% CI: 1.618-12.670). Conclusions: In male-dominated companies, many female employees are affected by menstruation-related problems in the workplace. A positive attitude toward women's health issues was positively associated with HL and predictive ability. Male-dominated companies should pay attention to women's menstruation-related health issues in the workplace, implement interventions to improve their health literacy and predictive ability, strengthen communication with them, and encourage them to actively participate in women's health initiatives.

Health Literacy Level of Posyandu Cadres in Preventing Stunting Prevalence in Tambak Kalisogo Village

This study aims to analyze health literacy in village posyandu cadres in preventing stunting prevalence in Kalisogo Tambak Village. This research uses descriptive statistical methods with quantitative and qualitative approaches obtained and then used as analysis material. Data collection techniques are carried out by conducting observations, interviews, and questionnaires. The data analysis technique used is Likert scale measurement with the help of SPSS program version 26. The results of this study explain the analysis of 4 (four) aspects of health literacy which is elaborated with the prevention of stunting prevalence of village posyandu cadres which can be used as a reference to improve the ability of posyandu cadres in handling public health. Aspects according to Sorensen et.al. These include: 1) Access, 2) Understand, 3) Appraise and 4) Apply. Of the four indicators, the results of the health literacy index research on posyandu cadres in preventing stunting prevalence are the highest indicator in the dimension of accessing various health-related information obtained from several reliable sources with a value of 68%. Then, the lowest score is on the indicator assessing various health-related information with a value of 55%. These results show that the health literacy ability of posyandu cadres in preventing stunting prevalence in Kalisogo Tambak Village is quite good, but in the aspect of assessing various health-related information, especially in stunting prevention, it needs to be improved again considering that stunting greatly affects the quality of human resources.

Telepharmacy Model of Care

PurposeThis study assessed the feasibility of the Telepharmacy Model of Care, a medication review and deprescribing model for use in older adults, with innovations in cognitive and functional evaluation, in telemedicine delivery, and in the use of a pharmacy technician. MethodsThis retrospective medical record review/abstraction analyzed (from March 1, 2022, to December 31, 2022) data from US veteran participants in a pilot implementation (April 13, 2021, to May 20, 2022) of the Telepharmacy Model of Care at the Veterans Affairs Ann Arbor Healthcare System (Ann Arbor, Michigan). The project team assessed and made recommendations about multiple factors in medication management: medication list accuracy; safety of medications and their combinations; older adults' cognition, health literacy, and physical abilities and impairments in self-managing medications; and caregivers' ability to compensate for those impairments. FindingsThe pilot included 60 US veterans (mean age, 75 years [range, 59–93 years]; 97% were men). Overall, participants were successful in using telemedicine (98%). Encounters required 30 to 45 minutes for the visit and 20 minutes for follow-up and documentation (P = 0.14 pharmacist vs pharmacy technician). The median number of medications per patient was 18. A total of 57% of patients had four or more medication-related discrepancies; fewer patients experienced medication-adherence problems, drug–drug interactions, problematic medication combinations, and untreated/undertreated conditions. Using the Safe Medication Algorithm for Older Adults tool, 35% were identified as taking a Red Flag medication (contraindicated in older adults), and 74%, a High Risk medication (eg, an anticoagulant). A total of 37% had cognitive and health literacy impairments, and 45%, physical impairments, interfering with the ability to self-manage medications. Recommendations on deprescribing were made in 98% of patients. ImplicationThe telemedicine-based and pharmacist/pharmacy technician–delivered model was a feasible method for addressing comprehensive medication review and deprescribing in these cognitively and functionally impaired US veterans.

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.

Physiotherapists' views and experiences of health literacy in clinical practice.

Using a qualitative design, this study aimed to explore the experience of physiotherapists' supporting patient health literacy in clinical practice, gain an understanding of their conceptualisation of health literacy, and make recommendations for improving health literacy support in clinical practice. Convenience sampling via social media was used to recruit eight participants who were all physiotherapists practicing in the United Kingdom. Semi-structured interviews took place on Zoom during the second Covid-19 lockdown. Interviews were audio-recorded, transcribed, coded, and thematically analysed to uncover physiotherapists' views on health literacy, experiences of supporting patients with health literacy and opinions and recommendations for practice. Of the eight participants, five were female and the mean years of clinical experience as a qualified physiotherapist was 5.8. Four main themes were identified: physiotherapists' conceptualisation of health literacy, identification of health literacy and skills required to support patients, training and barriers to providing health literacy-sensitive care and recommendations for improvement. The findings highlighted that physiotherapists identified a patient's health literacy abilities by picking up tacit clues throughout their consultations and they pre-dominantly viewed health literacy as the ability to read, write and communicate effectively. They reported having a limited exposure to health literacy training and recommended raising awareness and education as key to improve practice.

Analysis of Factors to Hinder Self-directed Learning about Medication Education to Patients with Hearing Loss

To improve medication education for patients with hearing loss, pharmacists must better understand hearing loss and provide and collect medication information based on patients' health literacy and communication abilities. However, no systematic educational e-learning systems for hearing loss are currently available. Therefore, an e-learning system based on instructional design, microlearning principles, and multimedia teaching materials was developed. The e-learning system used Moodle, an open-source e-learning system, and included two courses: one for self-directed learning by watching videos and answering quizzes, and another for evaluating medication education after learning. A study was conducted on 84 pharmacists and 36 pharmacy students who took the learning course to investigate the factors that hinder their understanding and progress of self-directed learning. Although they fully understood the content by watching videos, students with no experience in medication education required an explanation to understand how to communicate with patients. As the learning course was self-directed and related to communication lectures, all students completed it; however, the completion rate for pharmacists was approximately 50%. The following factors could have slowed pharmacists' e-learning progress: difficulty accessing the learning course through system login and long-duration content, such as answers to free descriptions. This survey found that this e-learning method can be used for self-directed learning about medication education for patients with hearing loss. Further improvement of the e-learning system is necessary so that recognizing the need to understand hearing loss and take appropriate actions for patients with hearing loss in medication education can lead to self-directed learning among pharmacists.

The Use of Multidimensional Nomial Logistic Model and Structural Equation Model in the Validation of the 14-Item Health-Literacy Scale in Chinese Patients Living with Type 2 Diabetes.

To evaluate the psychometric properties of the 14-item health literacy scale (HL-14) in patients living with type 2 diabetes mellitus (T2DM) in clinical setting. Cross-sectional study using item response theory and structural equation modeling (SEM) for testing the item difficulty and three dimensional-HL configurations was adopted in this study. Chinese patients living with T2DM admitted to endocrinology department of Huadong hospital were evaluated by the HL-14 including communication, functional and critical health literacy from August to December 2021. The multidimensional random coefficients multinomial logistic model indicated the difficulty settings of the scale are appropriate for the study populations, and differential item functioning was not observed for sex in the study. SEM demonstrated that the three-dimensional configuration of the scale is good in the study population (x2/df=2.698, Comparative Fit Index = 0.965, Root Mean Square Error of Approximation = 0.076, standard residual mean root = 0.042). The HL-14 scale is a reliable and valid measurement, which can perform equitably across sex in evaluating the health literacy in Chinese patients living with T2DM. Moreover, the scale may help fill the gaps of multidimensional health literacy assessment and rapid screening of health literacy ability for clinical practice.

Analysis of factors influencing health literacy of older adults by applying the Anderson model

ABSTRACT This study attempted to identify the level of health literacy among older adults by applying the Andersen model and analyzing the factors affecting this level. We used the nationwide secondary data from the 2021 Korea Community Health Survey. Data obtained from 74,492 older adults aged 65 years or more were analyzed using the t-test, Pearson’s correlation coefficient, and multiple regression analysis. As a result of applying the Anderson model to the health literacy ability of older adults, statistically significant variables were predisposing (age, sex, spouse), enabling (education level), and need (subjective health status) factors for health literacy. Based on the results of this study, we conclude that it is necessary to establish a public healthcare program to improve the health literacy and welfare of older adults.

A Review of Female Sterilization in the United States in the Wake of Roe v Wade [ID: 1377581

INTRODUCTION: With the anticipation of the overturning of Roe v Wade, U.S. physicians reported an increase in demand for female sterilization procedures. This literature review aims to analyze existing survey tools and how they assess sterilization motivations and postprocedure regret. METHODS: Keywords “female sterilization tool,” “female sterilization assessment,” “female sterilization questionnaire,” and “female sterilization survey” were entered into the National Center for Biotechnology Information PubMed search. A title screen for female human studies and an abstract screen selection for survey-based, English, and full-text studies were applied. Seventy percent intercoding agreement was reached between four researchers. RESULTS: Sixty-five texts were fully reviewed. The minority (15.4%) were U.S. based and 18 (27.7%) of the publications utilized pretested questionnaires. One hundred seventy-four questions across six surveys were analyzed. Comprehension of complex vocabulary and medical terms cannot be assumed to be within the health literacy abilities of most nonmedical professionals. Cultural sensitivity was deficient in questions around contraception choices and family planning, which assumed that these practices are ubiquitous among sexually active women without acknowledging cultures that do not readily use contraception in family planning. Exclusive language regarding gender and sexuality assumed heterosexual preference and cisgender identity for both participants and their partners, which alienates participants who identify LGBTQ+, transgender, or nonbinary and obscures the nuance of sterilization practices among these identities. CONCLUSION: Data on sterilization regret and motivations could be hindered by literacy and biased questioning. A novel, pretested survey tool oriented toward inclusive and comprehensive language is needed to capture female sterilization trends.

Gebelerin Sağlık Okuryazarlığı ile Öz Bakım Gücü Arasındaki İlişkinin Değerlendirilmesi

Amaç: Araştırma, gebelerin sağlık okuryazarlığı ile öz bakım gücü arasındaki ilişkinin değerlendirilmesi amacıyla yapılmıştır.
 Gereç ve Yöntem: Araştırma, tanımlayıcı ve ilişki arayıcı nitelikte yapılmıştır. Veriler, bir devlet üniversitesinin eğitim ve araştırma hastanesi kadın doğum polikliniklerinde Aralık 2019-Haziran 2020 tarihleri arasında 500 gebeden toplanmıştır. Veriler kişisel bilgi formu, sağlık okuryazarlığı ölçeği ve öz bakım gücü ölçeği kullanılarak toplanmıştır. Verilerin değerlendirilmesinde; yüzdelik dağılımlar, ki kare, ortalama, t testi ve Pearson korelasyon analizi kullanılmıştır. 
 Bulgular: Gebelerin öz bakım gücü toplam puan ortalamaları karşılaştırıldığında, primipar gebelerin toplam puan ortalaması 109.79±10.60, multipar gebelerin toplam puan ortalaması 110.28±9.65 olarak bulunmuştur. Gruplar arasında anlamlı istatistiksel anlamlı bir fark olmadığı bulunmuştur (p>0.05). Gebelerin sağlık okuryazarlığı toplam puan ortalamaları karşılaştırıldığında, primipar gebelerin toplam puan ortalamasının 111.23±9.70 olduğu, multipar gebelerin ise toplam puan ortalamasının 108.02±14.35 olduğu ve gruplar arasında istatistiksel olarak anlamlı bir fark olduğu saptanmıştır (p

Health literacy and post-vaccination COVID-19 prevention behavior in the community: a crosssectional study in Indonesia

Background: The government has made vaccination the primary strategy to control the COVID-19 pandemic. However, the public still needs to implement COVID-19 prevention behavior even though they have been vaccinated because COVID-19 infection with or without symptoms can still occur. Health literacy is the basis for behavior change. Purpose: This study aimed to determine the relationship between health literacy and post-vaccination COVID-19 prevention behavior of the community in the work area of ​​the Patrang Public Health Center, Jember Regency. Methods: A descriptive correlation study with a cross-sectional approach was performed in May 2022. The sample in this study was 435 selected by purposive sampling with the inclusion criteria of those aged >17 years old and receiving a full primary dose of vaccination. The data were collected using the Health Literacy Survey Coronavirus Disease Questionnaire 22 (HLS-COVID-Q22) and COVID-19 prevention behavior questionnaire. The data were analyzed by Spearman with a significance level of 0.05. Results: The results showed that the majority of health literacy was inadequate health literacy (43,2%), and the post-vaccination COVID-19 prevention behavior was in the moderate category (42.7%). There was a significant moderate positive correlation between health literacy and post-vaccination COVID-19 prevention behavior (p < 0.001; r = 0.513). Conclusion: The higher the health literacy, the better the post-vaccination COVID-19 prevention behavior. The nurse was importance to provide health education by paying attention to the health literacy ability. Focusing on improving health literacy is an important strategy to enhance COVID-19 prevention behavior and reduce transmission of the coronavirus.

What are the modifiable factors of treatment burden and capacity among people with Parkinson's disease and their caregivers: A qualitative study.

People with long-term conditions must complete many healthcare tasks such as take medications, attend appointments, and change their lifestyle. This treatment burden and ability to manage it (capacity) is not well-researched in Parkinson's disease. To explore and identify potentially modifiable factors contributing to treatment burden and capacity in people with Parkinson's disease and caregivers. Semi-structured interviews with nine people with Parkinson's disease and eight caregivers recruited from Parkinson's disease clinics in England (ages 59-84 years, duration of Parkinson's disease diagnosis 1-17 years, Hoehn and Yahr (severity of Parkinson's disease) stages 1-4) were conducted. Interviews were recorded and analyzed thematically. Four themes of treatment burden with modifiable factors were identified: 1) Challenges with appointments and healthcare access: organizing appointments, seeking help and advice, interactions with healthcare professionals, and caregiver role during appointments; 2) Issues obtaining satisfactory information: sourcing and understanding information, and satisfaction with information provision; 3) Managing medications: getting prescriptions right, organizing polypharmacy, and autonomy to adjust treatments; and 4) Lifestyle changes: exercise, dietary changes, and financial expenses. Aspects of capacity included access to car and technology, health literacy, financial capacity, physical and mental ability, personal attributes and life circumstances, and support from social networks. There are potentially modifiable factors of treatment burden including addressing the frequency of appointments, improving healthcare interactions and continuity of care, improving health literacy and information provision, and reducing polypharmacy. Some changes could be implemented at individual and system levels to reduce treatment burden for people with Parkinson's and their caregivers. Recognition of these by healthcare professionals and adopting a patient-centered approach may improve health outcomes in Parkinson's disease.

Addressing Barriers to Mental Health Wellness: Prescriptions for Marketing

The rising number of adults living with emotional and mental health challenges is a growing concern. This research examines specific barriers that may preclude individuals from achieving mental health wellness. A model (n = 382) is tested using individuals from the millennial generational cohort to outline key factors that contribute to negative behaviors and barriers that impede mental health engagement. Findings indicate that perceived stigma related to mental health conditions is negatively associated with mental health engagement and positively related to efforts to self-treat by using consumption to manage emotional distress. Trust in a mental health care provider is positively related to interest in seeking help for a mental health condition (motivation) and mental health literacy (ability). Furthermore, interest in seeking help, mental health literacy, and access to mental health services (opportunity) are also positively related to mental health engagement. The authors offer prescriptions for social marketing and public policy to help reduce obstacles to mental health wellness and to encourage the consumption of mental health services. These recommendations are put forth with the intention of heightening mental health engagement and increasing mental health care access such that consumer and societal well-being are enhanced.

The barriers and facilitators to health-promoting lifestyle behaviors among people with multiple sclerosis during the coronavirus disease 2019 pandemic: a content analysis study

Background and aimHealth-promoting lifestyle behaviors (HPLBs) have a significant impact on disease management among people with multiple sclerosis (MS). However, the coronavirus disease 2019 (COVID-19) pandemic has significantly affected lifestyle of all individuals, particularly patients with chronic diseases. The present study aimed to explore the barriers and facilitators to HPLBs among people with MS during the COVID-19 pandemic.MethodsThis qualitative study was conducted in Iran. Participants were sixteen people with MS purposively selected from the central MS clinic of a referral specialty neuroscience hospital in Tehran, Iran. Data were collected via in-depth semi-structured face-to-face interviews and concurrently analyzed through conventional content analysis.Findings: The mean of participants’ age was 37.93 years and most participants were female (81.25%). The major barriers to HPLBs were lack of knowledge, limited access to resources, and poor health status, while the major facilitators were attention to inner abilities and social support.ConclusionMany different factors such as lack of knowledge, limited access to resources, poor health status, awareness, and social support can influence engagement in HPLBs among people with MS. Healthcare authorities and policymakers need to use quality educational and supportive interventions to improve knowledge, health literacy, perceived support, self-efficacy, and self-care ability among people with MS during the COVID-19 pandemic.

The Relationship of Perceived Health Literacy and Vaccination Hesitancy in People with Dementia Associated Disorders

AbstractBackgroundDementia associated disorders (DAD) refers to clinical conditions that are typically characterized by progressive cognitive impairment (CI) that interferes with an individual’s ability to function independently. In routine care CI in DAD may be poorly recognized and can vary considerably in degree and combination across multiple cognitive domains. Therefore, clinical judgement may be insufficient alone to identify CI across these varied types/degrees, and how CI may directly affect both patient quality of life and decision‐making. Patient reported outcomes (PRO) are used to survey patient perception of their disease across varied real world impact. The BRIEF Health Literacy (HL) survey (BHL), Electronic health literacy (eHealth Literacy Scale, EHL) and the psychological antecedents of vaccinations (Vaccine 5C, V5C), vaccine hesitancy, have not been explored across these areas in people with DAD (PwDAD).MethodRetrospective cross‐sectional analysis of PwDAD who completed the following PRO’s V5C, EHL, and BHL in routine care.Results146 PwDAD, average age of 72+/‐15 years. Linear regression statistics were used to analyze trends between individual V5C questions with the BHL and EHL. Significant correlations were found as follows (p<0.01): V5C‐2 (the need for vaccination)vs BHL (r = .2), V5C‐3 (everyday stress interfering with vaccination) vs BHL (r = .2), V5C‐4 (I personally weight risks/benefits of vaccination) vs BHL (r = .3), V5C‐2 vs EHL (r = .2), V5C‐3 vs EHL (r = .1), V5C‐4 vs EHL (r = .2).ConclusionLower perception health literacy ability (BHL) and lower ability to use electronic sources to gain information regarding their health literacy (EHL)in PwDAD impact decision and feelings regarding vaccination (i.e. the necessity of vaccination, stress as a barrier to vaccination, and risk‐benefit analysis respectively). Further investigation beyond perceptions to quantitative measures of CI across multiple cognitive domains (degrees/combinations) between the V5C, BHL, and EHL would prove useful in exploring these relationships and defining a path to enhance education to reduce vaccine hesitancy.