Health Literacy In Adults Research Articles

Health Literacy Considerations for a New Cancer Prevention Initiative.

Cancer prevention efforts are newly focused on the older adult population. Adult literacy and health literacy findings and suggestions can help shape more efficacious health communication strategies and thereby increase the “accessibility” of important health information and the potential for healthful action. National and international surveys of adult literacy skills have consistently offered problematic findings that older adults have more limited proficiencies than do younger working adults and face difficulties using commonly available materials to accomplish everyday tasks. Clinical as well as population-based studies of health literacy similarly find limited health literacy among a majority of U.S. adults and even poorer health literacy among older adults. This is of concern because health literacy studies have established clear links between limited literacy and poor health outcomes as well as diminished participation in activities related to disease prevention. Literacy experts note difficulties associated with abstract concepts and with sophisticated numeracy tasks, both associated with disease prevention. Health literacy findings and insights are important considerations in the development of health messages and materials to promote cancer prevention among older adults.

PCV86 THE RELATIONSHIP BETWEEN SIGNATURE TIME AND FUNCTIONAL HEALTH LITERACY IN AN UNDERSERVED URBAN POPULATION

Low health literacy (HL) is consistently associated with worse health outcomes. Clinical screening for HL with available instruments is impractical due to added time and effort. Signature time may be a reliable, alternative option. Our aim is to explore the association between time to sign and HL in an underserved urban population. English-speaking patients receiving long-term warfarin therapy at UI Health were recruited. HL was assessed using the Short Test of Functional Health Literacy in Adults (STOFHLA). Time to sign was the average of two signature times recorded by stopwatch. Partial proportional odds logistic models, using odds ratios (OR) and 95% confidence intervals (CI), were fitted to evaluate the association between signature time and 3-level HL. Of 139 recruited patients, mean (SD) age was 59.7 (13.7) years, 98 (70.5%) were African-American, and 68 (48.9%) reported <$25,000 income. As for education level, 56 (40.3%) reported some college or above, 62 (44.6%) reported high school diploma or equivalent, and 20 (14.4%) reported less than high school diploma. HL was adequate in 101 patients (72.7%), marginal in 11 (7.9%) and inadequate in 27 (19.4%). For the total population, median (IQR) time to sign was 6.1 s (4.7-8.7). Time to sign was longest with inadequate HL, median (IQR) of 9.5 s (7.1-14.0), compared to marginal HL 7.4 s (5.4-9.6) and adequate HL 5.7 s (4.5-7.1) (p<0.001). Longer time to sign was significantly associated with lower HL in crude model (OR 0.76, 95% CI: 0.67-0.86, p<0.001), and model adjusted for age and education (aOR 0.79, 95% CI: 0.69-0.90, p<0.001). Longer time to sign was associated with lower HL levels in this underserved population. Evaluation of the relationship between signature time as a proxy for HL and anticoagulation clinical outcomes is warranted in the future.

Social Support, Health Literacy, and Health Care Utilization Among Older Adults.

The purpose of this study was to explore the relationship between social support, health literacy, and health care utilization in older Chinese adults. A cross-sectional survey design was employed. Data were collected from 32 nursing homes from Urumqi in Xinjiang of China. A total of 1486 respondents completed a pack of questionnaires. The average health literacy level of older adults in nursing homes was relatively low, only 73.68 ± 29.42 points; the average social support level was also relatively low, only 31.42 ± 7.12 points (lower than domestic norm of Chinese residents, P < .001). Both values were below the midpoint for the overall population, indicating a sample with below-average levels of healthy literacy and social support. Low social support levels are associated with poor health literacy and greater likelihood of hospital admission (P < .05). Social support was significantly associated with health literacy. Improving the quantity and quality of social support may be an effective means to obtain better health literacy and lower hospital admissions.

Health Literacy of Pre-Service Teachers from Farhangian University: A Cross-Sectional Survey

Background: Teachers play a critical role as health promoters. However, relatively little knowledge is available to date about health literacy of pre-service teachers in Iran. Objectives The aim of this study was to determine the health literacy level of pre-service teachers from Farhangian University in Tehran, Iran. Methods: A cross-sectional study was conducted on a representative random sample of pre-service teachers stratified by major and gender from May to June 2015. Health literacy was measured using the health literacy for adults (HELIA) questionnaire, with 33 items on the domains of access to health information, reading, understanding, appraisal, and behavioral intention. SPSS version 20 was employed to analyze data using statistics including mean, standard deviation, and frequency, t-test and ANOVA. Results: In total, 704 pre-service teachers participated in the study. The mean age of the participants was 20.88 ± 1.43 and 65.8% were female. The health literacy score was 66.30 ± 12.66. Inadequate health literacy was found in 7.3% of the participants, problematic health literacy in 43.3%, sufficient health literacy in 38.5%, and excellent health literacy in 10.9%. Health literacy was significantly associated with age, gender, and marital status. Conclusions: As the high prevalence of limited health literacy in teachers is a barrier to enhancing the health literacy of students at schools, there is a need to design, implement, and evaluate different educational interventions to address health literacy among pre-service teachers.

Context-Sensitive Ecological Momentary Assessment: Application of User-Centered Design for Improving User Satisfaction and Engagement During Self-Report.

BackgroundEcological momentary assessment (EMA) can be a useful tool for collecting real-time behavioral data in studies of health and health behavior. However, EMA administered through mobile technology can be burdensome, and it tends to suffer from suboptimal user engagement, particularly in low health-literacy populations.ObjectiveThis study aimed to report a case study involving the design and evaluation of a mobile EMA tool that supports context-sensitive EMA-reporting of location and social situations accompanying eating and sedentary behavior.MethodsAn iterative, user-centered design process with obese, middle-aged women seeking care in a safety-net health system was used to identify the preferred format of self-report measures and the look, feel, and interaction of the mobile EMA tool. A single-arm feasibility field trial with 21 participants receiving 12 prompts each day for momentary self-reports over a 4-week period (336 total prompts per participant) was used to determine user satisfaction with interface quality and user engagement, operationalized as response rate. A second trial among 38 different participants randomized to receive or not to receive a feature designed to improve engagement was conducted.ResultsThe feasibility trial results showed high interface satisfaction and engagement, with an average response rate of 50% over 4 weeks. Qualitative feedback pointed to the need for auditory alerts. We settled on 3 alerts at 10-min intervals to accompany each EMA-reporting prompt. The second trial testing this feature showed a statistically significant increase in the response rate between participants randomized to receive repeat auditory alerts versus those who were not (60% vs 40%).ConclusionsThis paper reviews the design research and a set of design constraints that may be considered in the creation of mobile EMA interfaces personalized to users’ preferences. Novel aspects of the study include the involvement of low health-literacy adults in design research, the capture of data on time, place, and social context of eating and sedentary behavior, and reporting prompts tailored to an individual’s location and schedule.Trial RegistrationClinicalTrials.gov NCT03083964; https://clinicaltrials.gov/ct2/show/NCT03083964

Health Literacy: Current Status and Challenges in the Work of Family Doctors in Bosnia and Herzegovina.

Health literacy (HL) has become an important area of research. The aim of this study was to evaluate the HL of primary healthcare patients in the Republic of Srpska (RS), Bosnia and Herzegovina (B&H) and to identify socioeconomic and health factors associated with HL. This cross-sectional study among 768 patients was conducted in two healthcare centres between March and May 2017, using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Analysis was done using descriptive and inferential statistics (a chi-squared test and logistic regression). Inadequate and marginal HL was found in 34,6% of respondents. Socioeconomic and self-reported health factors were significantly related to HL. An age of 55 years and over (OR 1.02), living in a rural environment (OR 2.25), being divorced (OR 3.32), being insufficiently physically active (OR 1.29), having poor income (OR 1.96), having more than three chronic diseases (OR 1.94), and poor health (OR 1.59) were significantly corelated with inadequate and marginal HL. The results of our study indicate that a low level of HL is related to the elderly, having a divorce, having a rural residence, poor income, having more than three chronic diseases, poor health, and insufficient physical activity. Further evaluation, monitoring, and activities to improve HL are of great importance for patients’ health outcomes.

Mediating effect of social support on the associations between health literacy, productive aging, and self-rated health among elderly Chinese adults in a newly urbanized community.

With the growing urbanization of China, which has changed older adults’ living conditions, lifestyle, and the source of support, coupled with rapid population aging, the health status of the elderly should be paid attention to. In addition to objective indicators such as the decline of function, specific factors, such as social support, health literacy, and productive aging, also have an impact on the health outcomes of the elderly. However, the interrelationships among these factors and their potential mechanisms in the context of urbanization remain unclear. Thus, this study was the first to explore the interrelationships among social support, health literacy, productive aging, and self-rated health in older adults living in a newly urbanized community in China.We aimed to investigate the mediating effect of social support on the associations between health literacy, productive aging, and self-rated health among elderly Chinese adults in a newly urbanized community to provide reference data for future health interventions for the elderly.This cross-sectional study was conducted between June and August 2013. Questionnaires on social support, health literacy, productive aging, and self-rated health were administered to 992 elderly residents. Structural equation models were used to examine the relationships among these 4 variables. Statistical analyses were performed using IBM SPSS Statistics 21.0 and Mplus 7.0.The mean scores for social support, health literacy, productive aging, and self-rated health were 34.5 ± 5.8, 13.6 ± 4.4, 11.3 ± 3.0, and 3.4 ± 0.7, respectively. Social support was directly related to self-rated health (β=0.119, 95% confidence interval [CI]: 0.041–0.198), while productive aging and health literacy had indirect associations with self-rated health via social support (β=0.071, 95% CI: 0.054–0.216; β=0.049, 95% CI: 0.066–0.183). Both productive aging (β=0.214, 95% CI: 0.047–0.381) and health literacy had direct associations with social support (β=0.327, 95% CI: 0.175–0.479), while health literacy had a direct association with productive aging (β=0.676, 95% CI: 0.604–0.748). Productive aging mediated the relationship between health literacy and social support.Overall, improving health outcomes among older adults requires enhancement of social support, along with consideration of productive aging and health literacy.

Associations of Acculturation with English- and Spanish-Language Health Literacy Among Bilingual Latino Adults

Background:Low health literacy (HL) is associated with poor health status and outcomes. Racial/ethnic minorities in the United States disproportionately experience low HL and HL-related health disparities. Among Latinos, acculturation is associated with health outcomes, but little is known about the relationship between acculturation and HL.Objective:We examined associations of sociodemographic and acculturation variables with English- and Spanish-language HL among 142 bilingual Latino adults with adequate HL.Methods:HL was assessed in English using the Rapid Estimate of Adult Literacy in Medicine (REALM) and in Spanish with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). Acculturation was assessed using the four subscales of the Multidimensional Acculturation Scale-II. Associations of sociodemographic data and acculturation with HL were examined using linear regression.Key Results:Higher education, higher income, higher English proficiency, and lower Latino cultural identification predicted REALM scores (ps <.05) in univariate models. When these variables were entered into a single model, only education and Latino cultural identification were associated with REALM scores. In univariate analyses, the following characteristics were associated with SAHLSA scores: female gender, being partnered, higher education, higher income, being non-US born, lower English proficiency, and higher Spanish proficiency (ps < .05). Education, being non-US born, English proficiency, and Spanish proficiency were each significant in the multivariate model.Conclusions:Results revealed a significant association between acculturation and English- and Spanish-language HL among bilingual Latino adults with adequate HL, suggesting that HL should be assessed in the language in which individuals are most proficient. HL assessed in a nonprimary language may be confounded with language proficiency. [HLRP: Health Literacy Research and Practice. 2019;3(2):e81–e89.]Plain Language Summary:The results of this investigation revealed a significant association between acculturation and English- and Spanish-language health literacy among bilingual Latino adults. This suggests that health literacy should be assessed in the language in which individuals are most proficient. Health literacy assessed in a nonprimary language may be influenced by language proficiency.

Correlation analysis between oral health literacy and disease severity in patients with periodontitis

Objective To analyze the correlation between oral health literacy and disease severity in patients with periodontitis and to understand the influencing factors for oral health literacy. Methods Totally 191 patients with periodontitis attending the outpatient or inpatient service of the Department of Stomatology, Peking University Third Hospital from January 2016 to January 2018 were selected. Their general information was collected, and the Oral Health Literacy Adults Questionnaire (OHL-AQ) was used to investigate their oral health literacy. The severity of their periodontitis was evaluated according to the indicators as recommended by the Center for Disease Control of the American Academy Periodontology (CDC-AAP) . The difference in oral health literacy between patients with different general information. SPSS 22.0 software was used for statistical analysis. Correlation analysis was used to analyze the correlation between oral health literacy and periodontitis severity. Multiple linear regression analysis was used to explore the influencing factors of oral health literacy. Results Totally 74 sustained mild periodontitis, 60 moderate periodontitis, and 57 severe periodontitis among the 191 patients with periodontitis. The OHL-AQ scores were (14.55±2.59) , (11.26±2.41) and (10.25±2.30) , respectively (F=31.705, P<0.01) . Correlation analysis showed that the severity of periodontitis was negatively correlated with oral health literacy (r=-0.692, P<0.01) . There were statistically significant differences in oral health literacy between patients with different age, educational background, monthly household income, occupation and marital status (F/t=6.054, 51.812, 49.936, 2.594, 2.107; P<0.05) . Multiple linear regression analysis showed that age, educational background and monthly household income were the influencing factors for oral health literacy (P<0.01) . Conclusions The severity of periodontitis can be ameliorated by improving the patients' oral health literacy. Age, educational background and monthly household income were the influencing factors for oral health literacy. Key words: Oral disease; Periodontitis; Health literacy; Severity; Correlation; Influencing factors

QuikLitE, a Framework for Quick Literacy Evaluation in Medicine: Development and Validation.

BackgroundA plethora of health literacy instruments was developed over the decades. They usually start with experts curating passages of text or word lists, followed by psychometric validation and revision based on test results obtained from a sample population. This process is costly and it is difficult to customize for new usage scenarios.ObjectiveThis study aimed to develop and evaluate a framework for dynamically creating test instruments that can provide a focused assessment of patients’ health literacy.MethodsA health literacy framework and scoring method were extended from the vocabulary knowledge test to accommodate a wide range of item difficulties and various degrees of uncertainty in the participant’s answer. Web-based tests from Amazon Mechanical Turk users were used to assess reliability and validity.ResultsParallel forms of our tests showed high reliability (correlation=.78; 95% CI 0.69-0.85). Validity measured as correlation with an electronic health record comprehension instrument was higher (.47-.61 among 3 groups) than 2 existing tools (Short Assessment of Health Literacy-English, .38-.43; Short Test of Functional Health Literacy in Adults, .34-.46). Our framework is able to distinguish higher literacy levels that are often not measured by other instruments. It is also flexible, allowing customizations to the test the designer’s focus on a particular interest in a subject matter or domain. The framework is among the fastest health literacy instrument to administer.ConclusionsWe proposed a valid and highly reliable framework to dynamically create health literacy instruments, alleviating the need to repeat a time-consuming process when a new use scenario arises. This framework can be customized to a specific need on demand and can measure skills beyond the basic level.

Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study.

Low rates of adherence to self-management behaviors are common among patients with COPD. Health literacy and cognitive abilities may influence engagement in self-management behaviors. We sought to assess the association between health literacy and cognitive abilities with self-management behaviors in patients with COPD. We conducted an observational cohort study among American adults with COPD in New York, New York, and Chicago, Illinois. Outcomes included adherence to COPD medication, metered dose inhaler (MDI) and dry powder inhaler (DPI) technique, receipt of vaccination, and routine healthcare appointments. Health literacy was measured with the Short Test of Functional Health Literacy in Adults. Cognitive function was assessed in terms of global, fluid (working memory, processing speed, executive function) and crystallized (verbal) ability. Adequate health literacy was associated with adequate adherence to COPD medications (OR 1.46; 95% CI, 1.02-2.08), correct MDI (OR 1.66; 95% CI, 1.13-2.44) and DPI (OR 2.17; 95% CI, 1.30-3.64) technique. Fluid abilities were also associated with medication behaviors and visiting a regular healthcare provider, while crystalized abilities were not. Global cognitive abilities were associated with correct inhaler technique. No other associations were found with non-medication self-management behaviors. COPD patients with limited health literacy and deficits in fluid cognitive abilities have lower rates of adherence and poorer inhaler technique than individuals with adequate health literacy and greater fluid cognitive abilities. These findings highlight the importance of considering the health literacy level and cognitive ability when caring for and educating patients with COPD.

A Preliminary Study on the Oral Health Literacy and Related Factors of Community Mid-Aged and Older Adults

Oral health literacy is one of the factors known to affect oral health. The results of prior studies indicate that Taiwanese lack accurate oral health knowledge and skills. Assessing the understanding of Taiwanese of the various aspects of oral health literacy is necessary to explore their ability to access, process, and understand basic oral health information and to make informed health decisions. To understand the oral health literacy of mid-aged and older adults living in the community and to identify the related factors that significantly affect their oral health literacy. This cross-sectional study was conducted on a convenience sample of 263 mid-aged and older adults living in the community. Each participant completed a demographics datasheet and the Oral Health Literacy-Adult Questionnaire. The survey data were analyzed using descriptive statistics, independent t test, one-way analysis of variance test, and Pearson's correlation. The reading comprehension domain earned the lowest average score, indicating that reading comprehension of oral-health-related information should be strengthened in the mid-age/older population. Age was negatively associated with oral health literacy, while educational level and financial status was positively associated with oral health literacy. Furthermore, the participants who scored higher in oral health literacy were better able to accurately choose the oral hygiene tools that best suited their needs. The results of this study suggest that strategies aiming to promote oral health literacy among community-dwelling mid-aged and older adults should focus particularly on strengthening reading comprehension abilities and on those of older age, lower education level, and lower financial status.

Adult Functional Health Literacy and its Related Factors: A Cross-Sectional Study

Background and aims: Health literacy (HL) can affect individual health, health communication and error in taking medicine. The aim of this study was to determine the level of HL and associated factors among Iranian adults. Methods: In this cross-sectional study, 240 participants over 18 years of age referring to health centers in Hamadan, west of Iran in 2015 were selected by multistage random sampling. HL was assessed by the Test of Functional Health Literacy in Adults (TOFHLA). The questionnaire was completed by a trained interviewer. The independent variables were structural and intermediate social factors based on the Commission on Social Determinants of Health (CSDH). Data were analyzed by using IBM SPSS version 22. Results: Average age of the participants was 30.88 ±7.38 years and 75.4% of the them were female. The total score of HL was 64.58 ±16.71 (range: 23.82-98.98). Overall, 31.7% (n=76) of the participants had adequate HL level, 32.5% (n=78) had borderline HL level and 35.8% (n=86) had inadequate HL level. Additionally, participants with higher educational levels had higher HL scores than those with lower educational levels (P&lt;0.001). HL score was significantly higher in males than in females (P=0.017). Conclusion: HL level seems to be inadequate among Iranian adults in the west of Iran. Moreover, enhancing social determinants such as educational level seems to increase HL. The results highlighted the necessity for change and improvement in adults’ HL.

Measurement of health literacy in patients with cardiovascular diseases: A systematic review.

While many instruments have been developed, validated, and used to assess health literacy skills, their use and appropriateness among patients with cardiovascular diseases (CVDs) are not widely studied. To identify, appraise, and synthesize available health literacy assessment instruments used in patients with CVDs. Electronic databases were searched for studies that used validated measures to assess health literacy in patients with CVDs. Included studies were assessed for risk of bias and the identified instruments were evaluated based on their psychometric properties. Data were synthesized using a narrative approach. Forty-three studies were included in the review, of which 20 were cross-sectional studies and 12 were randomized controlled trials. Eleven health literacy assessment instruments were identified, of which only one was disease-specific. The Abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) (n = 19) and the Rapid Estimate of Adult Literacy in Medicine (REALM) (n = 13) were found to be the most commonly used instruments to assess health literacy in CVDs. The S-TOFHLA and the REALM are the most widely used instruments to evaluate health literacy in CVD population. More CVD-specific health literacy screening instruments are warranted. Assessment of health literacy should be a standard of care in patients with CVDs and effective interventions should be developed to improve the impact of limited health literacy on health outcomes in this population.

Health literacy, sociodemographic factors, and cognitive training in the active study of older adults.

Health literacy is critical for understanding information from health-care providers and correct use of medications and includes the capacity to filter other information in navigating health care systems. Older adults with low health literacy exhibit more chronic health conditions, worse physical functioning, and poorer mental health. This study examined the relationship between sociodemographic variables and health literacy, and the impact of cognitive training on change in health literacy over 10years in older adults. Participants (N=2,802) aged 65years and older completed assessments, including reading and numeracy health literacy items, as part of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. We evaluated baseline sociodemographic variables and change in health literacy over a 10-year period in individuals exposed to cognitive training in reasoning, processing speed, memory, or a no-contact control condition. Age, sex, race, education level, and general cognitive functioning at baseline were all associated with baseline health literacy in older adults. Predictors of change in health literacy over the 10-year follow-up were age, race, education level, general cognitive functioning, and neighborhood income; disparities in health literacy because of race attenuated over time, while the effect of age increased over time. Health literacy was generally stable across the ACTIVE intervention groups over 10years. The present study showed important disparities in health literacy level and change over 10years. Cognitive training did not significantly impact health literacy, suggesting that alternative approaches are needed to reduce the disparities.

The Health Literacy of Adults in Alborz Province in Iran

Introduction: Health literacy is defined as the ability of an individual to acquire, interpret, and understand the basic information about health services and to use them. Health literacy is a strong predictor of health. Its low level is germane to health problems of people and society as well as economic costs. This study was designed to determine the level of health literacy considering socio-demographic factors in residents of Alborz province in 2015. Methods: This is a cross-sectional study in which 465 people aged between 18 and 60 years old living in Alborz province were evaluated using two-stage random sampling technique (stratified and cluster sampling). In this study, Iranian Health Literacy Questionnaire (IHLQ) and socio-demographic Information Questionnaire were used to collect the required data. The data were analyzed using descriptive statistics as well as T-test, Mann-Whitney test, and Spearman correlation test using SPSS software. Results: The mean age of participants was 36.57(±11.08) years old and 68.2% of them were female. 22.4% of people had adequate, 44.3% had a moderate, and 33.3% had a poor level of health literacy. Health literacy in all dimensions of IHLQ except individual empowerment and social empowerment was moderate. People's access to health information also was moderate. The T-test indicated that the health literacy score was significantly higher in the individuals with the educational level of diploma and higher (p= 0.000), in Persian people (p= 0.008), and in unemployed people (p= 0.006). Conclusion: The high level of inadequate (moderate and poor) health literacy of 77.6% of the Alborz province population should be taken into consideration in health system policies to apply an effective strategy for promoting health literacy that results in better health status, regarding effective socio–demographic factors for each dimension of health literacy. Keywords: Health Literacy, Adults, Iranian Health Literacy Questionnaire (IHLQ)

Assessment of health literacy in the adult population registered to family medicine physicians in the Republic of Srpska, Bosnia and Herzegovina

Background: Health literacy is an important determinant of health. This concept is under-researched in the Republic of Srpska, Bosnia and Herzegovina.Objectives: To assess health literacy and its association with sociodemographic variables, self-perception of health and the presence of chronic conditions in primary healthcare setting.Methods: In May 2016, a cross-sectional study was executed in two primary healthcare centres. Out of approximately 1500 patients who visited both health centres during four consecutive days, about 800 were eligible. Of these, 110 patients agreed to complete the translated Short Test of Functional Health Literacy in Adults (S-TOFHLA). The influence of demographic, social, economic, and health characteristics (independent variables) on the S-TOFHLA score (dependent variable) was assessed by multiple logistic regression analysis.Results: One questionnaire was incomplete and therefore 109 questionnaires were analysed. Inadequate, marginal, and adequate health literacy were present in 19 (17.4%), 16 (14.7%) and 74 (67.9%) respondents. Adequate health literacy was found predominantly among respondents younger than 55 years and those with a high level of education. Regression analyses showed that low level of education (OR: 5.3), age 55 years and over (OR: 3.9), living in a rural area (OR: 3.7) and having three or more chronic diseases (OR: 2) were independently associated with inadequate or marginal health literacy.Conclusion: In this study performed in two primary healthcare centres in the Republic of Srpska, Bosnia and Herzegovina, low health literacy was associated with low level of education, older age, living in a rural area, and having more chronic diseases.

Test of health Literacy for Portuguese-speaking Adults.

Health literacy has been evaluated in several countries by tools developed for local language and culture. This study aimed to adapt and to validate the Health Literacy Test (TLS) for the Brazilian Portuguese language based on the Test of functional health literacy in adults (TOFHLA). The TLS, translated and adapted to the Brazilian scenario based on the Test of functional health literacy in adults, was administered to 302 users of a clinic of a University in Santa Catarina from September to October 2013. Cronbach's Alpha coefficient, Spearman's correlation and Analysis of Variance were used to assess the internal consistency, the correlation between the parts of the test and association between sociodemographic variables and the score of the Test, respectively. The average score of the test was 72,2, and 54.6% of participants had adequate health literacy, 19.2% had marginal health literacy and 26.2% had inadequate health literacy. The average score of the test was inversely related to the age of the participants and directly related to the level of education. There was no significant difference in the other sociodemographic characteristics. The internal consistency (Cronbach's alpha) was 0.953. The coefficients for the numerical and reading passages were 0.808 and 0.951, respectively. All the sections correlated positively and significantly with the Test, and also with each other. The validation of this test provides a new instrument to determine the literacy level in Brazilian adults.

Study of foreign experience in measuring health literacy in adults at the population level

Study of foreign experience in measuring health literacy in adults at the population level

Assessment of functional health literacy in Brazilian carers of older people.

ABSTRACT.Individuals with low health literacy have less knowledge of their own health condition. Carers play a key role in older people’s activities of daily living.Objective:to evaluate the performance of carers of older people using the S-TOFHLA (Short Test of Functional Health Literacy in Adults) and to identify caregiver characteristics associated with low functional health literacy.Methods:a cross-sectional study was conducted. The S-TOFHLA, a sociodemographic instrument, the Mini-Mental State Exam and the Patient Health Questionnaire-2 were applied to 80 carers of older patients routinely followed by doctors from the Primary Health Care Sector of the City of Botucatu, São Paulo. The multivariate analysis used an ordinal logistic regression model with test (S-TOFHLA) scores as the dependent variable. The level of statistical significance adopted was 0.05.Results:the individuals had a mean age of 54.6 (± 11.7); 27% of the carers evaluated had inadequate levels of health literacy (S-TOFHLA ≥54). A higher proportion of individuals with low education had inadequate or marginal health literacy (p<0.001).Conclusion:nearly 1/3 of the carers had marginal or inadequate levels of health literacy. These results highlight the difficulties of many carers in understanding health information.