Insufficient Health Literacy Research Articles

Community-based Disease Prevention and Health Promotion: Promoting Digital Health Literacy among People in Precarious Living Conditions

The rapidly advancing digital transformation is opening up innovative opportunities for disease prevention and health promotion, particularly through sociotechnical innovations. Digitally-enabled interventions serve as augmentative tools for disseminating health-related information and promoting individual empowerment and self-efficacy. Despite their potential, digital media in community-based disease prevention and health promotion face challenges, such as the need for low-threshold design and consideration of technological acceptance factors. People in precarious life situations, who often face limited access and lower literacy towards digital technologies, could benefit from targeted measures geared to their specific needs. At the same time, it is important to highlight the risks of insufficient digital health literacy, which can have a negative impact on health. Promoting digital health literacy therefore appears to be an essential tool for improving the health situation of people in precarious living circumstances. This article argues for evidence-based and targeted further development of digital interventions for health promotion that are tailored to the needs of people in precarious living conditions and emphasizes the central role of digital health literacy in this process. In this contribution, the area of early childhood intervention is considered for exemplification.

Horizontal inequity in the use of mental healthcare in Australia.

For people experiencing mental health problems, timely access to high-quality healthcare is imperative for improving outcomes. However, limited availability of services, high out-of-pocket costs, insufficient health literacy and stigmatizing attitudes may mean people do not receive the necessary treatment. We analyze Australian longitudinal data to document the extent and predictors of horizontal inequity in mental healthcare use among people with a newly developed mild or moderate mental disorder. Importantly, we compare people with similar health, residing in the same area, thus controlling for differences in healthcare needs and availability of services. Results suggest that mental healthcare use is not significantly associated with household income or financial hardship. In contrast, we find significant inequities by educational attainment, with university graduates around 50% more likely to receive mental healthcare than high-school dropouts. These findings are robust across subsamples and alternative modeling approaches, including panel data models with individual fixed-effects. Additional explorations of the education gradient suggest a potential pathway through mental health-specific knowledge and attitudes.

The Effect of Parents Health Literacy Level on Attitudes Towards Childhood Vaccinations

Abstract While the importance of vaccination services increases day by day, WHO declared vaccine hesitancy as one of the 10 threats to global health in 2019 due to the decrease in vaccination numbers in recent years. Raising parents awareness about childhood vaccines with adequate and accurate information is likely to positively affect vaccination decisions.Although the level of knowledge on this subject depends on parents being able to obtain information using the right sources, this situation can also be associated with a sufficient level of health literacy.This study aimed to evaluate how parents health literacy level affects their attitudes towards vaccines. This cross-sectional study was conducted through a facetoface survey with 400 parents of children under the age of 18 who applied to the Istanbul Faculty of Medicine, ChildHealthDiseasesPolyclinic. Asdata collection tools, a survey form including general approaches to preventive health services and knowledge level about vaccines, as well as the TSOY-32 and PACV were used. As a result of our study, the average of the correct answers given by the participants to the questions regarding their vaccination knowledge levels was determined as 12.1±4.3. The average health literacy general index score was found to be 33.6±4.5. It was determined that 2.5% of the parents had insufficient health literacy levels, and 67.8% had problematic or limited health literacy levels. Parents received a total score of 30.2±23.7 (13 (1-83)) from the PACV scale. It was determined that 13.5% of parents were hesitant about childhood vaccines. It was determined that individuals with vaccine hesitancy had lower general health literacy and vaccine knowledge levels, and they used the media and neighbors as sources of information at a higher rate. Additionally, it was determined that low level of knowledge about the vaccine(OR 1.4 95%CI 1.3-1.6). and using the media(OR 2.3 95%CI 1.0- 4.9) as a source of information poses a risk for vaccine hesitancy. Key messages • Providing community-based training to increase the health literacy level of parents will also create positive changes in vaccine hesitancy. • Community-based studies should be carried out regarding misconceptions about vaccines, especially those acquired from the media, and individuals should be made aware.

Health literacy, including related vaccination, of the working Russian population: data from a survey on the Atria platform

Health literacy (HL), including related vaccination, is an important health determinant. For the working population, it helps to maintain and improve their ability to work. Despite the clear benefits of vaccination, vaccine confidence has recently declined worldwide, which may lead to decreased vaccination coverage and a renewal of infectious diseases. Based on this, increasing the level of public health, including vaccination issues, is one of the preventive medicine tasks. Staff groups seem to be an effective place for implementing measures to improve the health and vaccination prevention of the working population.Aim. To assess the level of public health, including vaccination issues, among the working Russian population using digital technologies.Material and methods. The study was conducted online and included employees filling out a questionnaire on their own. The results were posted on the Atria digital platform, which is a tool for assessing and implementing corporate programs to improve employee health. HL was assessed using the updated 2019 Health Literacy Survey Questionnaire (HLS19-Q) adapted into Russian and validated. The study lasted 18 months (from December 2022 to May 2024).Results. A total of 58357 employees took part in the study on the Atria digital platform to assess the public health level, of which 47044 (80,6%) were women. In general, workers had a predominantly excellent HL (n=39637, 67,9%), while in women it was 69,4% (n=32644). The insufficient HL varied slightly among workers of different age groups. The fewest workers with an excellent HL were recorded in the age group of 40-49 years (65,4%, n=11857), and the most among workers >60 years old (74,2%, n=3573). The study found that 43,3% of men and 56,2% of women are vaccinated against influenza annually. Among those workers who are vaccinated against influenza annually, the highest HL rate was recorded among workers >60 years of age (63,4%, n=4188), and the lowest among workers <30 years of age (48,2%, n=4992). Workers with an excellent HL are predominantly vaccinated against influenza annually (77,8%, n=21306).Conclusion. For the first time in the Russian Federation, a study was conducted to assess the HL level, including vaccination issues, among workers using digital technologies. The results obtained indicate that further measures are needed to increase the HL level of workers, including in terms of vaccination. Based on research data, methodological documents and corporate programs aimed at improving the current situation should be developed and implemented.

Trends in Electroconvulsive Therapy Utilization in South Korea: Health Insurance Review Data From 2008 to 2018.

The study aimed to analyze and clinically correlate 10-year trends in the demographic characteristics of patients receiving electroconvulsive therapy (ECT) to provide an overview of ECT utilization in South Korea. Using health insurance claims data from 2008 to 2018 retrieved from Health Insurance Review and Assessment Service database in South Korea, we identified individuals undergoing ECT based on procedural codes. Descriptive analysis evaluated baseline clinical characteristics, and trend analysis used a linear regression model. The prevalence of ECT increased by 240.49% (0.405/105 inhabitants in 2008 to 0.974/105 inhabitants in 2018). The increasing trend was more pronounced in younger and older patients. The proportion of women consistently exceeded that of men. A rise in the proportion of patients with affective disorders, and a decrease in the proportion of psychotic disorders was observed. More antidepressants and atypical antipsychotics were prescribed to patients undergoing ECT. The proportion of ECT sessions conducted in large hospital inpatient settings also decreased during the observation period. Despite increasing global trends, ECT prevalence in South Korea remains significantly lower than worldwide rates. This study demonstrated an increasing trend of ECT across a wide range of population demographics and in more accessible settings. The comparatively low prevalence of ECT in Korea compared to other countries might be attributed to insufficient mental health literacy and the stigma associated with ECT. Given the elevated suicide rates in Korea, more extensive adoption of ECT appears imperative.

Development and validation of a health literacy scale for family caregivers of older people with chronic illness

BackgroundFamily caregivers (FCs) encounter a variety of health problems in older people with chronic illness, necessitating a certain level of health literacy to access, understand, appraise and apply health information and services. This study aimed to develop and validate a scale for measuring health literacy among FCs of older people with chronic illness.MethodsConcept mapping was first employed to develop a conceptual model of health literacy of FCs. Scale domains were derived from the conceptual model, and item generation was performed using deductive and inductive methods. Quantitative methods, including merging scale dimensions and items, expert reviews, cognitive interviews, and item reduction analysis, were used to refine the scale. Confirmatory factor analysis was employed to validate the scale’s structure. Concurrent validity, internal consistency, and test-retest reliability were also examined.ResultsA 20-dimension conceptual model was developed, and 60 items were generated for the scale. Expert review (content validity index > 0.85) and cognitive interview with FCs confirmed the relevance and clarity of the majority of the generated scale items. Confirmatory factor analysis with 451 FCs of older people with chronic illness supported a 5-factor structure (symptom management, daily personal care and household tasks, care coordination, communication and relationship with the care recipient, and self-care of caregivers) with 42 finalized scale items, including four levels of health literacy skills (accessing, understanding, appraising and applying health information). Concurrent validity with the European Health Literacy Questionnaire (HLS-EU-Q47) was satisfactory (r = 0.67, p < 0.01). The Cronbach’s α coefficient of the scale was 0.96, with subscales ranging from 0.84 to 0.91. The two-week test-retest reliability was 0.77 (p < 0.01).ConclusionThis study developed a conceptual model explaining the concept and factors of health literacy among FCs of older people with chronic illness that could provide the groundwork for future studies in developing relevant evidence-based interventions. A new Health Literacy Scale-Family Caregiver (HLS-FC) with satisfactory psychometric properties was developed in this study, which can be utilized to identify caregivers with insufficient health literacy and facilitate timely interventions by healthcare professionals.

Determination of the relationship between parents' health literacy and fever management of their children: Across-sectional study.

The research was conducted to determine the practices of parents regarding the fever management of their children and reveal the relationship between their health literacy (HL) and fever management of their children. Cross-sectional study was used. This study was carried out with 242 parents. The data were collected using the Parent Descriptive Information Form, Turkish HL Scale-32 and Parents' Fever Management Scale between September 2021 and September 2022. The data were evaluated with the SPSS program, using percentages, averages, Pearson's correlation and regression analysis. The mean age of the parents was 31.87 ± 6.59. The parents' mean Parents' Fever Management Scale score was 36.22. It means that parents had high fever management practice. Their mean Turkish HL Scale-32 total score was 34.43. 51.6% of the parents had a problematic or insufficient HL level. In the cases of fever, 61.2% of the parents stated that they took off the child's clothes, 69.0% measured temperature from the armpit, and 55.4% gave antipyretics according to the doctor's prescription. There is a statistically significant positive correlation between the Parents' Fever Management Scale and Turkish HL Scale-32. It is observed that 8.2% of the change in parents' fever management is explained by HL. The study found that with an increase in parents' HL, fever management of their children also increased. Emerging evidence showed that developing parents' HL knowledge and skills could be an option/approach in fever management. It should be a basic nursing skill that to provide HL support to parents. This study adhered to the relevant cross-sectional STROBE (the Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. No patient or public contribution.

Determinants of medication adherence among elderly with high blood pressure living in deprived areas.

The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

Concept analysis of "Insufficient health literacy" in older adults and refinement of a diagnosis proposal.

This study aims to conduct a thorough analysis of the concept of insufficient health literacy (IHL) in older adults and to refine a nursing diagnosis proposal while considering the specific characteristics of this demographic. A comprehensive concept analysis was undertaken using Walker & Avant's method as a framework. A systematic search across seventeen databases yielded 29 relevant studies for inclusion. Through analysis, we identified 15 antecedents, 3 attributes, and 7 consequents associated with IHL in older adults. The concept analysis brought clarity to the understanding of IHL within older adults, facilitating the refinement of a diagnosis proposal. This process was instrumental in establishing a diagnostic structure that accounts for the unique needs and challenges faced by older adults. The structured diagnosis derived from the concept analysis provides a solid theoretical foundation for nurses specializing in Gerontology. By tailoring care interventions to address the specific requirements of older adults, this framework enhances the quality of nursing practice and contributes to improved patient outcomes in geriatric care settings.

Relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer

IntroductionBladder cancer is one of the most important diseases that threatens oral and dental health due to its nature and side effects of chemotherapy. Therefore, the present study was conducted to investigate the relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer.MethodsThis cross-sectional study was conducted on patients with bladder cancer in Ahvaz, 2023. Subjects were selected randomly from the patients those were registered in Cancer Registry Center in Ahvaz Jundishapur University of Medical sciences and invited to Golestan Hospital for data collection through clinical evaluation, the Oral Health Literacy Adult Questionnaire (OHL-AQ), and the Oral Health Impact Profile-14 (OHIP-14PER) questionnaire. The data were analyzed using Pearson correlation coefficient, independent t-test, and analysis of variance.ResultsThe number of participants was 194. The mean oral health literacy in patients with bladder cancer was 9.74 ± 2.39, indicating insufficient oral health literacy. A significant association was observed between OHL-AQ and DMFT index, but no significant association was found between OHIP-14PER and DMFT index. Furthermore, a significant correlation was found between OHL-AQ and OHIP-14PER (r = −0.68) in patients with bladder cancer.ConclusionBased on the findings of the present study, all dimensions of oral health literacy have correlation with the oral health-related quality of life in patients with bladder cancer. Therefore, adopting oral health behaviors and increasing oral health literacy can be the best way to improve the oral health-related quality of life to among patients with bladder cancer.

Relationships between COVID-related health literacy, mental health and workload of school leaders

Objective: Studies have shown that school leaders’ health literacy is key to supporting health development in school. During the COVID-19 pandemic, the importance of school leaders’ health literacy became evident, as school leadership was characterised with uncertainty and demanded high levels of alertness to the need to implement rapidly changing health-related measures at short notice. This study sought to explore school leaders’ health literacy, mental health and work-related characteristics in Danish public primary and lower secondary schools during the pandemic. Methods: Selecting schools from the national Danish register of institutions a sample of 220 complete responses was achieved in a cross-sectional survey. School leaders or a member of the school management team completed a self-administered version of the COVID-HL: School Principals Survey, which assessed health literacy, three domains of mental health, sense of coherence and workload. Data were analysed using chi-square tests and logistic regression. Results: The majority of school leaders (71.4%) demonstrated a sufficient level of health literacy. However, there was a significant difference in workload increase between those with sufficient (66.0%) and insufficient (81.6%) health literacy. A high general workload was associated with lower well-being, while an increase in workload during the COVID-19 pandemic was linked to psychosomatic complaints. Sense of coherence explained variations in well-being, emotional exhaustion and psychosomatic complaints. Conclusion: This study highlights the importance of enhancing the health literacy of Danish school leaders, enabling them to deal effectively with complex health-related information and make informed decisions during health crises. Strengthening health literacy is crucial to promoting overall health and well-being in schools under normal circumstances, as well as navigating health crises.

The Relationship between Health Literacy and Cyberchondria Based on the Mediating Role of Health Anxiety

Introduction: The Internet is a neutral tool which was initially used to facilitate research in scientific and military institutions, but now it has affected mental health of society. The present study was conducted with the aim of investigating the relationship between health literacy and cyberchondria in women with the mediating role of health anxiety.&#x0D; Methods: The current research method was descriptive-correlational and based on structural equations. Using convenience sampling method, 300 women from Shiraz city were selected as a statistical sample, taking into account the criteria for entering and exiting the research. Data collection was done using McElree and Shelvin's cyberchondria questionnaires, Salkoskis and Warwick's health anxiety questionnaires , and Montazeri et al.'s health literacy questionnaires . Descriptive data analysis and hypothesis testing were done by structural equation method with path analysis approach and using SPSS and Amos software.&#x0D; Results: The results showed that there was a significant and direct relationship between health literacy and cyberchondria (p=0/05 and β =0/15) and between health anxiety and cyberchondria (p=0/0005 and β =0/60) at 0/001. By entering health anxiety as a mediating variable into the model, an indirect relationship between health literacy and cybercrime was obtained (p=0/0005 and β=0/30).&#x0D; Conclusion: Considering that more than half of the people have insufficient health literacy, it is necessary to design and implement effective interventions to empower them regarding health literacy. Moreover, it is necessary to provide people with newer methods such as online education in order to obtain more health information.

Assessment of health literacy in patients with polycystic ovary syndrome and its relationship with health behaviours: a cross-sectional study

ObjectiveHealthy behaviours are important for people with polycystic ovary syndrome (PCOS). However, adopting and maintaining lifestyle changes involves a complex set of behavioural changes, which most patients fail to adhere...

Social determinants of health and glycemic control in persons with type 2 diabetes mellitus attending a tertiary hospital in Nepal: A cross-sectional study.

Diabetes mellitus (DM) is an emerging global public health challenge worldwide, including Nepal. Social determinants of health (SDOH) play a major role in glycemic control among persons with type 2 DM (T2DM). However, little is known about the association between SDOH and glycemic control among individuals with T2DM in Nepal. This study aimed to identify the level of glycemic control and SDOH associated with glycemic control among Nepalese with T2DM. This cross-sectional study was conducted at a tertiary hospital in Kathmandu, Nepal, among 135 Nepalese diagnosed with T2DM who attended follow-up appointments. Convenience sampling and inclusion criteria were utilized for participant selection. Data were collected from April to June 2021 using validated scales. Descriptive statistics, Chi-square test, and binary logistic regression were employed to analyze the data. The mean age of the participants in this study was 53.84 (SD = 11.78) years, and the average monthly household income was 567.64 (SD = 362.30) USD. The majority of the participants (77.8%) were literate and had no health insurance coverage (73.3%). Approximately 64.4% of the participants showed suboptimal glycemic control indicated by glycated hemoglobin (HbA1c) ≥7%. The significant determinants of good glycemic control included monthly household income of >850 USD (odds ratio [OR] = 12.20, 95% confident interval [CI] = 1.76-84.61, p = 0.011) and 341-600 USD (OR = 7.64, 95% CI 1.35-42.98, p = 0.021), being literate (OR = 6.37, 95% CI = 1.65-24.49, p = 0.007), having health insurance (OR = 5.82, 95% CI = 1.49-22.65, p = 0.011), sufficient health literacy (OR = 3.46, 95% CI = 1.10-10.83, p = 0.03), and high (OR = 16.17, 95% CI = 2.36-110.67, p = 0.005) and moderate (OR = 7.02, 95% CI = 1.26-39.07, p = 0.026) food availability, respectively. The study revealed suboptimal glycemic control in Nepalese with T2DM. This study presents essential social determinants of glycemic control in this population. Therefore, healthcare providers, particularly nurses, should pay more attention to assessing social determinants and provide targeted interventions to patients with T2DM who have low income, are illiterate, have no health insurance coverage, have insufficient health literacy, and have low resources for food availability.

Healthcare providers’ insights on enhancing health literacy and access for Arab Bedouin in Israel

Abstract Background The Arab Bedouin minority is considered as one of the most vulnerable populations in Israel due to socio-cultural factors that affect their healthcare utilization patterns. This study investigates continuity of care and health literacy within the Bedouin community, aiming to identify gaps and barriers to healthcare services (HS) utilization for Bedouins, as perceived by healthcare providers serving this community. Methods A qualitative study was conducted June 2019 and January 2022, involving in-depth semi-structured interviews with 32 healthcare providers from community health centers/clinics in Bedouin villages and towns in Southern Israel, as well as Soroka Medical Center. Thematic analysis was used to analyze the collected data, and trustworthiness was ensured through audit, reflexivity, and peer debriefing. Results Healthcare providers identified factors that hinder HS utilization and the absence of various healthcare options for Bedouin patients. Interviews revealed discontinuity in treatment due to insufficient health literacy and unaffordability of medications. Additionally, many Bedouins choose to forgo or delay their visits to the community health services and visit the Emergency Department directly, because of physical, cultural, and gender barriers. Elderly Bedouins are a particularly vulnerable subgroup, susceptible to complications from chronic diseases such as diabetes and hypertension. Conclusions This study highlights the necessity of targeted interventions to improve healthcare access for Bedouin minority population, particularly tailoring HS to elderly subgroups. Potential interventions comprise health education programs designed to enhance health literacy, address medication affordability, and confront cultural and gender barriers obstructing access to primary care services. These findings hold implications for public health policies and initiatives addressing healthcare disparities among minority groups worldwide. Key messages • Health literacy is a key barrier for the Bedouin minority in Israel, with global implications for addressing healthcare disparities in minority groups. • Targeted interventions, like health education programs, are needed to improve healthcare access for Bedouin minority, especially the elderly subgroup.

The roles of health literacy in parents’ honey use and the use of complementary alternative medicine in a Turkish population

BackgroundAs a biologically based therapy, honey is used by parents in many parts of the world as a home remedy for their children. While information exists regarding the traditional use of honey for health issues in children, data regarding its relationship with health literacy is lacking. The aims of this study were to determine the use of honey to address children’s health issues among parents of children aged 0–72 months and to explore the relationship between the use of complementary and alternative medicine (CAM) and health literacy.MethodsThe data for this descriptive, cross-sectional study were collected between October and November 2022 via an online survey of 907 parents of children aged 0–72 months. A sociodemographic data collection form, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and the Turkey Health Literacy Scale-32 (THLS-32) were used to collect the data. A t-test, one-way analysis of variance, and Pearson correlation analysis were used to analyze the data.ResultsThe majority (86.5%) of the parents used honey for their children’s health problems. Among the parents, 83.1% utilized honey as a remedy for alleviating cough symptoms, 10.4% employed it as a treatment for diarrhea, and 14% administered it for the management of oral mucositis. The mean THLS-32 and HCAMQ scores of the parents were 29.39 and 21.31, respectively, and there was a moderate correlation between the parents’ THLS-32 and HCAMQ mean scores (r = 0.662, p < 0.001).ConclusionThis study revealed that a significant proportion of parents who used honey to alleviate their children’s health issues displayed positive attitudes toward complementary and alternative medicine (CAM) while concurrently exhibiting insufficient or limited health literacy levels. Therefore, it is advisable to enhance health literacy regarding the proper and safe utilization of honey, which functions as a biologically based CAM therapy.

Analysis of hindering and facilitating factors of help-seeking behavior in schizophrenia based on COM-B model: a descriptive qualitative study.

Timely and systematic professional treatment is crucial in schizophrenia prognosis, but the global rate of mental health service, now, use or help-seeking behavior is low. In-depth semi-structured interviews were conducted with 13 participants with the diagnosis of schizophrenia between October to December 2021. The participants were purposively sampled from a psychiatric hospital's. Interviews were recorded and transcribed verbatim into NVivo 12.0. The findings were summarized under 3 themes and 12 subthemes: (1) capability (lack of knowledge due to insufficient mental health literacy or lack of insight, inability to access disease information due to a lack of mental health literacy, and symptoms-related barriers); (2) opportunity (lack of disease information sources, inability to balance work and study during prolonged hospitalization, accessibility and convenience of medical resources, and the acquisition and utilization of social support); and (3) motivation (awareness of the disease and professional treatment, negative experiences of disease episodes, past medical experience, confidence in tcuring the disease, and the fulfillment of daily life and self-worth). The medical help-seeking behavior of people with the diagnosis of schizophrenia is the result of the interaction of many barriers and facilitators, and challenges persist today. Interventions can be implemented with the BCW framework and our results to precisely eliminate delays in the diagnosis and treatment of mental problems.

Associations between maternal health literacy, neonatal health and breastfeeding outcomes in the early postpartum period.

Maternal health literacy is a social skill that is relevant to successful postnatal newborn adaptation, neonatal feeding, and neonatal health outcomes, given the importance of maternal health literacy in newborn healthcare. The study aims to identify and assess the associations between maternal health literacy, neonatal health, and breastfeeding outcomes during the early postpartum period. Five hundred women who gave birth to full-term newborns at Vilnius University Hospital were invited to the study from 1 May to 30 September 2022. The 47 questions of the European Health Literacy Questionnaire (HLS-EU-Q47) were used to assess maternal health literacy on days 2 and 3 after birth. Each subject's health literacy indices were divided into four categories: inadequate, problematic, sufficient, and excellent. The neonatal health indicators were birth weight and height, along with the APGAR score and the outcomes of feeding either exclusively with breast milk or with adapted formula in addition to breastfeeding. Most women who participated in the survey had insufficient or problematic health literacy (69%). The study showed that women's higher health literacy is associated with a lower risk of obesity, a healthier diet, regular physical activity, and a higher birth weight and height of their newborns (p<0.05). Mothers with inadequate/problematic health literacy were more likely to feed their newborns with adapted formula in addition to breastfeeding. Women's health literacy is a factor that affects women's healthy lifestyle choices before and during pregnancy and is significant for newborns' health indicators.

Disease-Related Knowledge and Need for Revision of Care for Patients with Atrial Fibrillation: A Cross Sectional Study.

To evaluate the disease-related knowledge of outpatients with atrial fibrillation (AF), and the relationship with health literacy and other background variables. In this cross-sectional survey study, conducted in Iceland, patients with AF scheduled for an electrical cardioversion or AF catheter ablation were recruited from a hospital outpatient clinic. They completed the validated Atrial Fibrillation Knowledge Scale (AFKS), a 11-item instrument (with possible score 0-10, 10 being the best knowledge) which evaluates knowledge pertaining to AF in general, AF symptom detection and AF treatment. Health literacy was assessed with the 16 item European Health Literacy Survey Questionnaire (HLS-EU-Q) and patients answered questions about their background. Data was analysed with parametric tests. In total, 185 participants completed the questionnaire (mean age 63 ±10), 77% were male, 74% with previous electrical cardioversion and 76% were on non-vitamin K antagonist oral anticoagulants (NOAC) medication. The mean score on the AFKS was 6.5 (±1.8). The best knowledge was concerning oral anticoagulation therapy (96% answered correctly) and the least knowledge was regarding responses to AF episodes (17% answered correctly). Patients with sufficient health literacy (52%) had better knowledge of AF (M 6.8 ±1.7 vs M 6.3 ±1.9, p = 0.05). Age, educational level, health literacy and AF pattern explained 22% of the variance in AF knowledge. Patients with AF have inadequate knowledge of their condition, potentially as a result of insufficient health literacy. AF knowledge may be improved using integrated management where patients are actively involved in the care and health literacy is considered in the provided patient education.

The health literacy level and its related factors in Iranian women with breast cancer undergoing chemotherapy.

Breast Cancer (BC) is the most common cause of female mortality throughout the world. Promoting public awareness about this disease is the most crucial method of its prevention or control. The present study was carried out to determine the health literacy level and its related factors in women with BC. This cross-sectional study was conducted on BC patients undergoing chemotherapy in two teaching hospitals affiliated to Zahedan University of Medical Sciences in 2020. A total of 210 patients referred to these chemotherapy centers were selected by purposive sampling. The data collection tools included a demographic information form and a health literacy questionnaire for Iranian women with BC. The collected data were analyzed using descriptive and inferential statistics (logistic regression) in SPSS-22. p-values less than 0.05 were considered statistically significant. The mean total score of the health literacy of women with BC undergoing chemotherapy was 40.35 ± 19.01, which suggests an insufficient health literacy. The health literacy had a significant relationship with variables including university education (OR = 4.41, p = 0.005) and supplementary insurance coverage (OR = 5.83, p < 0.001). The findings showed that university education and supplementary insurance coverage are associated with a higher health literacy among women with BC. Improving these factors and paying further attention to their role in the promotion of health literacy can help enhance the health literacy of women with BC.