Insufficient Health Literacy Research Articles

SATISFACTION OF THE RESIDENTS OF THE CIRCUMPOLAR REGION WITH THE STATE HEALTHCARE SYSTEM, DEPENDING ON THE LEVEL OF THEIR HEALTH LITERACY

Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the 'healthy' citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of 'healthy' people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

Assessing COVID-19-related health literacy and associated factors among school teachers in Hong Kong, China.

The coronavirus disease 2019 (COVID-19) pandemic developed rapidly, with changing guidelines, misinformation, inaccurate health information and rumors. This situation has highlighted the importance of health literacy, especially among educators. The aims of this study were (i) to assess COVID-19-specific health literacy among school teachers in Hong Kong and (ii) to examine its association with demographic factors, self-endangering work behaviors (i.e., work intensification, work extensification and work quality reduction), secondary burnout symptoms (i.e., exhaustion related to work and psychosomatic complaints), the level of knowledge of COVID-19- or pandemic-related information and the level of confusion about COVID-19-related information. A self-report survey was administered to 366 Hong Kong school teachers from April 2021 to February 2022. COVID-19-specific health literacy was measured using the HLS-COVID-Q22 instrument. Other instruments, including self-endangering work behavior scales (i.e., extensification of work, intensification of work and work quality reduction) and two dimensions of the Burnout Assessment Tool (i.e., psychosomatic complaints and exhaustion) were also used for assessment. Data were analyzed using an independent samples Student's t-test, analysis of variance, correlation analysis and adjusted multilinear regression models. The results showed that 50.8% of school teachers had sufficient health literacy, 38.3% had problematic health literacy and 10.9% had inadequate health literacy. The HLS-COVID score did not vary by sex, but varied according to the type of school, the number of working hours per week and the number of students attending the school. Teachers with sufficient health literacy scored significantly lower for two types of self-endangering work behavior-intensification of work (p = 0.003) and work quality reduction (p = 0.007)-than those with insufficient health literacy. After excluding those who had already been vaccinated, respondents with sufficient health literacy felt more positive about COVID-19 vaccination than those with insufficient health literacy (t[180] = 4.168, p < 0.001). In addition, teachers with sufficient health literacy felt more informed (p < 0.001) and less confused (p < 0.001) about COVID-19-related information than those with insufficient health literacy. Multiple linear regression analysis revealed that age (β = 0.14, p = 0.011) and the number of teaching hours per week (β = -0.206, p < 0.001) were significant predictors of the HLS-COVID score. The findings of this study may serve as a guide for addressing health literacy gaps among school teachers.

Health Literacy in Patients Wearing Prosthetic Eyes: A Prospective Cross-Sectional Study

Purpose To investigate general and electronic health literacy (HL) levels in prosthetic eye wearing patients, to define factors associated with reduced HL, and to identify a potential healthcare gap. Methods In this prospective cross-sectional study 148 prosthetic eye wearers were screened using the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the 8-item electronic Health Literacy Scale (eHEALS). HLS-EU-16 and eHEALS scores were correlated to health levels, vision functioning, and sociodemographic factors. Results A total of 85 patients (57%) had adequate, 38 (26%) problematic, and 9 (6%) inadequate general HL, while 16 (11%) had no valid HLS-EU-Q16 score. General HL was positively correlated with physical health (p = 0.009) and negatively with a migration background (p = 0.023). There was a positive correlation between electronic HL and educational level (p < 0.001), social status (p = 0.048), and mental health (p = 0.013). Higher age was associated with lower electronic HL (p < 0.001). Conclusions More than 30% of the prosthetic eye wearers had problematic or even inadequate general HL, suggesting a significant health care gap. To identify patients with reduced HL, a standardized screening tool should be implemented as part of routine clinical care. Within integrated care, patients with insufficient HL should be offered barrier-free advisory services and information brochures in various languages.

Investigation of the Relationship Between the Level of Health Literacy and Vaccine Hesitancy

Objective: The objective of the study was to investigate the relationship between the level of health literacy and vaccine hesitancy. Furthermore, the dependence of the level of health literacy and vaccine hesitancy on socio-demographic variables were analyzed. Material and Methods: The study was conducted with 403 individuals via online and the questionnaire included the socio-demographic questions and two scales. The study was designed as a cross-sectional study and carried out during February- March, 2022 in Turkey. The online survey included a brief information on the study objective, anonymity and confidentiality of the collected data and voluntary participation. Data were collected through Turkish Health Literacy Scale-32 (TSOY-32) which was developed on the basis of the HLS-EU Study Conceptual Framework for Turkey and Vaccine Hesitancy Likert Scale. Data were analyzed by using SPSS-25 ve Lisrel 8.80. Results : The study suggested that there was a positive weak association between the level of health literacy and vaccine hesitancy, meaning as health literacy of participants increased the vaccine hesitancy of participants decreased. In terms of socio-demographic factors, both health literacy average index scores and vaccine hesitancy average scores were found to be differing in relation with education and income status of participants. Discussion and Conclusion: According to the recent European Health Literacy Survey study conducted in Europe, the findings indicated that 12% of the people who participated in in survey had insufficient general health literacy, and 35% had problematic health literacy. Our findings showed that 43% of respondents fell into a problematic category, and 30% were in the insufficient category. There is a need to conduct new studies using multiple measurement tools that are specific to vaccine literacy and those used to measure general health literacy. Keywords: Health literacy, Vaccine hesitancy, Turkish health literacy scale-32 DOI: 10.7176/JHMN/104-04 Publication date: November 30 th 2022

COVID-19-Related Health Literacy of School Leaders in Hong Kong: A Cross-Sectional Study.

To date, we know little about COVID-19-related health literacy among school leaders, particularly in East Asia. The present study aimed to assess the level of COVID-19-related health literacy and associated factors (vaccine hesitancy, self-endangering behaviour, and work satisfaction) among school leaders in Hong Kong. A cross-sectional study of 259 school leaders was carried out during the COVID-19 pandemic between April 2021 and February 2022. COVID-19-related health literacy using HLS-COVID-Q22, three subscales of self-endangering work behaviour scales (i.e., “extensification of work”, “intensification of work” and “quality reduction”), and two dimensions of Burnout Assessment Tool (BAT) (i.e., psychosomatic complaints and exhaustion) were used. The study employed independent sample t-test, ANOVA, and multilinear regression models. The findings show that more than half (53.7%) of school leaders had insufficient health literacy. Participants with insufficient health literacy scored significantly higher in the following factors: exhaustion related to work situation (p = 0.029), psychosomatic complaints (p < 0.001), attitude about vaccination (i.e., less agree with vaccination) (p < 0.001), level of informing on COVID-19 related information (i.e., felt less informed) (p < 0.001), and level of confusion about COVID-19-related information (i.e., felt more confused) (p < 0.001). In a linear regression model predicting attitude about coronavirus vaccination, age (β, −0.188, 95% CI, −0.024, −0.005, p = 0.002) and health literacy (β, −0.395, 95% CI, −0.716, −0.361, p < 0.001) were the negative predictors, F(5, 214) = 11.859, p < 0.001. For the linear regression model adjusted for sex and age for predicting health literacy, the model was insignificant. Despite being a highly educated group, this study reveals that one in two Hong Kong school leaders have insufficient health literacy. Inadequate health literacy was strongly associated with a negative attitude about vaccination, low information, and confusion about COVID-19-related information. Additionally, insufficient health literacy was associated with the two secondary symptoms of burnouts. The study highlights an urgent need to develop intervention programmes to promote the COVID-19-specific as well as overall health literacy of the school leaders.

Predictors of Health Literacy among Caregivers of Patients with Multiple Sclerosis: A Family-Centred Empowerment Approach

Abstract With regards to the importance of multiple sclerosis (MS) and the sufferers’ caregivers, and also by focusing on the importance of identifying factors influencing health literacy based on theoretical principles, it is necessary to detect the most effective factors involved in forming these direct or indirect effects. This study aimed to determine the relationship between health literacy and self-efficacy, and knowledge among caregivers of individuals with MS in Iran. One hundred and twenty caregivers of individuals with MS participated in this cross-sectional study. Data were collected through TOFHLA health literacy. Data were analysed using SPSS with independent t-tests, Pearson correlation and linear regression. More than 80 per cent of the participants had border and insufficient health literacy. Statistically, there was a significant relationship between health literacy level and self-efficacy, income source, economic situation and education. The results showed that for every 1 score increase in knowledge, self-efficacy, self-esteem and health literacy increased by 2.17, 0.62 and 2.71, respectively. Considering that there is a significant relationship between health literacy, self-efficacy and the knowledge of caregivers of people with MS, which plays a role in caring for patients, effective strategies should be developed in order to promote health literacy and consequently, the individuals' self-efficacy.

The status of sexual health literacy in Iranian women: A cross-sectional study

Context: Promoting of women's sexual health literacy depended to the study of this variable. This study aimed to determine the status of women's sexual health literacy and its dimensions.Setting and Design: This cross-sectional study conducted in health centers in Amol, Iran, from July to September 2019.Materials and Methods: A total of 400 women of reproductive age who registered with Iran's integrated health record system selected via two-stage sampling technique. The Sexual Health Literacy for Adults questionnaire consists of 40 items regarding four dimensions of access, reading and understanding, analysis, and appraisal, and application was used to collect data.Statistical Analysis Used: Data were analyzed in SPSS version 16 using the descriptive and Friedman test with significance level of (P < 0.05).Results: According to the results, 23.3% of the participants had insufficient sexual health literacy. The highest mean score of sexual literacy was related to reading and understanding, whereas the lowest score was related to the application dimension. There was a significant difference in the mean scores of various dimensions of sexual health literacy (P < 0.001). The mean rank of scores was lower for the application dimension in all age groups, education (except primary and secondary levels), and participation in training courses (P < 0.001).Conclusions: Approximately one-fourth of the research sample had insufficient sexual health literacy, with their lowest score being related to the application dimension. Further studies should be designed to better perceive the application dimension of sexual health literacy and its effective factors.

Health Literacy Cross-Sectional National Survey in Cameroon General Population

<i>Background: </i>Health literacy (HL) is the ability of an individual to obtain and translate knowledge and information in order to maintain and improve health in a way which is appropriate to that individual and system contexts. It has become a priority for health in the 21^st century, and many countries have included HL as a key priority in their policies and practices. However, in many African countries, such as Cameroon, information about the status of HL among population remains scarce. <i>Objective:</i> This study sought to describe the HL level of the Cameroonian population and its determinants.<i> Methods: </i>A cross-sectional national survey using the European Health Literacy Survey Questionnaire short forms (HLS-EU-Q16) was conducted. Both English and French version of HLSEU16 were used due to the fact that the country is bilingual. 1,226 persons (50.5% females, ages 15-96 years, mean age 27.99 years, standard deviation 9.73) completed an online (47%) and paper (53%) questionnaire. <i>Results:</i> At least one quarter (1/4) of respondents (24.6%) showed insufficient HL and 74.3%, almost three quarter (3/4) had limited (insufficient and problematic) HL. Sufficient HL was predominant in all subcategories of the population. Subgroups within the population with low HL were those with more than two chronic diseases (<I>F</I>(3; 1,222) = 4.673, p = .003) and those living in rural areas (<I>F</I>(2; 1,223) = 21.870, p < .001). Participants with high HL evaluated their health as very good (<I>F</I>(3; 1,222) = 24.586, <i>p</i>< .001) and were satisfied with their life (<I>F</I>(3; 1,222) = 15.317, <i>p</i>< .001). <i>Discussion and conclusion:</i> Limited HL represents an important challenge for health policies and practices across Cameroon like in many European countries. The influence of socio-cultural aspect in HL must be taken into account when developing HL tools to ensure quality measurement and to improve health equity around the world.

Acceptance of digital health applications in non-pharmacological therapies in German statutory healthcare system: Results of an online survey.

On the way to a modern digital healthcare system, Germany becomes a driver of innovation by integrating digital health applications (Digitale Gesundheitsanwendungen (DiGAs)) into standard care. Although all insured persons of the statutory health insurance are eligible for a registered DiGA, utilisation has been rather restrained so far. There seems to be a lack of acceptance among healthcare providers. The aim of this study is to analyse the acceptance of DiGAs in non-pharmacological therapies. A total of 150 therapists from the fields of physical therapy, occupational therapy, and speech-language pathology participated in an online survey. The questionnaire captured knowledge, intention to use, opinions on advantages and disadvantages of DiGA usage as well as general technology acceptance and commitment. About 36% of the therapists knew DiGAs, while about 64% had not yet heard of these offers. In addition, 87% of the respondents can imagine integrating DiGAs into their treatment or were already doing so at the time of the survey. Potentials for using DiGAs are seen especially in the quality improvement of therapy, in the increase of the sustainability of the therapy and in promotion of patients' health literacy. The therapists stated barriers in the lack of technical infrastructure and in the patients' insufficient digital health literacy. The results indicate the potential for DiGAs to be further implemented in non-pharmacological therapies. The facilitators and barriers identified allow recommendations to be derived for relevant stakeholders.

Gebelerde sağlık okuryazarlığı ile yaşam kalitesi arasındaki ilişkinin incelenmesi

Aim: The research was carried out to determine the relationship between health literacy and quality of life in pregnant women.Materials and Methods: This analytical cross-sectional study was conducted with 219 pregnant women in a private hospital in Ankara. Data were collected through the Turkish Health Literacy Scale-32, the WHOQOL-BREF Quality of Life Scale, and the Socio-demographic Form. Statistical analyses included numbers, percentages, means, standard deviations, Pearson correlation, and linear regression analysis.Results: In the study, it was determined that the pregnant women had insufficient health literacy (n=15), problematic-limited health literacy (n=41), adequate health (n=87), and excellent health literacy (n=76). This study found a linear and positive relationship between health literacy and quality of life (p&amp;lt;0.05). In addition, a one-unit increase in the Health Literacy Scale was found to cause an increase in all sub-scales of the Quality-of-Life Scale, and this increase was found to be statistically significant (p&amp;lt;0.05).Conclusion: As a result of the data obtained from the study, it was determined that there was a positive, and weak relationship between the health literacy level of pregnant women and their quality of life.

Exploring the factors related to adolescent health literacy, health-promoting lifestyle profile, and health status

BackgroundHealth literacy has been concerned a key factor for determining the use of health information and promoting health. The study aimed to explore adolescent health literacy, health-promoting lifestyle profile, and health status and related factors.MethodsA cross-sectional study design was used; 918 first year junior college students were recruited in Taiwan. The measurements were the Chinese Health Literacy Survey Questionnaire (HLS-C-Q), the Chinese Health-Promoting Lifestyle Profile (HPLP-S), and the Health Status Questionnaire.ResultsThe mean score for health literacy was 36.15 (±6.21), with 30.17% of the participants having insufficient or problematic health literacy. Further, 19.9% of participants were obese and 11.2% experienced emotional instability. Health literacy and health-promoting lifestyle profile showed significant positive and negative correlations with perceived health status and depression, respectively (p < 0.05). An exercise frequency of ≥3 times/week was a predictor of health literacy, health-promoting lifestyle profile, and emotional stability.ConclusionsAdolescent health literacy, health-promoting lifestyle profile, and health status require careful consideration. In adolescents, developing regular exercise may increase health literacy, thereby developing healthy lifestyle profiles and ameliorating obesity and depression-related issues.

Reproductive Health Literacy and Its Relationship With Some Demographic Factors in Men Referring to One Infertility Center in Mashhad City, Iran

Background: Infertility is one of the important concerns for couples. Men have rarely been the focus of research, and their knowledge and attitude have been less studied so far. This study investigated health literacy and attitude in men with infertility. Methods: In this descriptive-analytic cross-sectional study, 196 men referred to one infertility center in Mashhad City, Iran, in 2019 were selected by a convenience sampling method. The study data were collected using a 20-item health literacy questionnaire and 5 attitude items towards infertility. The relationships between age, education, occupation, income, duration of infertility, Assisted Reproductive Technologies (ART), history with reproductive health literacy, and attitude were investigated with t test, ANOVA, and linear regression in SPSS v. 20 software at a significance level of less than 0.05. Results: The Mean±SD age of men was 35.02±6.06 years. Their Mean±SD reproductive health literacy score (3.2±0.3) did not show significant relationships with age (P=0.336), education (P=0.33), job (P=0.493), income (P=0.856), infertility duration (P=0.136), and history of ART (P=0.057). All attitude questions were not related to the education and history of ART. Attitude about surrogacy (P=0.011) and the possibility of separation of each couple in case of infertility (P=0.001) (P=0.015) for men and women respectively were different according to age. Most participants chose the answer “I don’t know” in the reproductive health literacy questionnaire. Conclusion: Because of insufficient health literacy of men about infertility, educational planning in this area seems essential.

How doctors make themselves understood in primary care consultations: A mixed methods analysis of video data applying health literacy universal precautions.

PurposeTo mitigate the health risks that result from low health literacy and difficulty identifying patients with insufficient health literacy, health organizations recommend physicians apply health literacy universal precaution communication skills when communicating with all patients. Our aim was to assess how health literacy universal precautions are delivered in routine GP consultations, and explore whether there were differences in how GPs used universal precaution approaches according to areas of deprivation in England.MethodsThis was a mixed methods study using video and interview data. Ten physicians conducted 217 consultations in primary care settings with adults over 50 years old between July 2017 and March 2018 in England. Eighty consultations (N = 80) met the inclusion criteria of new or persisting problems. Descriptive quantitative analysis of video-recorded consultations using an observation tool and qualitative thematic analysis of transcribed scripts. Meta-themes explored differences in physicians’ communication by areas of deprivation.ResultsDescriptive statistics showed physicians used a caring tone of voice and attitude (n = 73, 91.3%) and displayed comfortable body language (n = 69, 86.3%) but infrequently demonstrated profession-specific health literacy universal precaution communication skills, such as the teach-back technique (n = 3, 3.8%). Inferences about physicians’ communication from qualitative analysis converged with the quantitative findings. Differences in physicians’ communication varied according to areas of deprivation.ConclusionsPhysicians need health literacy universal precautions communication skills to improve population health.

COVID-19 and college students: health literacy experiences and training needs

Objective To explore health literacy (HL) experiences, needs, and future training directions among college students enrolled in health-related degree programs during the COVID-19 pandemic. Participants Students (n = 169) enrolled in a health-related degree program at a state university in the mid-western U.S. completed an online survey. Methods Forty-five questions were developed assessing: (1) demographics; (2) HL; (3) health behaviors; (4) health/well-being; and (5) academic/financial impacts. A HL score across four domains (access, understand, appraise, apply) was calculated. Participants were categorized as having sufficient or insufficient HL. Associations between HL and categorical variables were tested (Chi-square/Fisher’s exact tests). Comparisons between sufficient and insufficient HL were performed (Wilcoxon rank-sum tests). Results Participants had sufficient (55.6%) and insufficient (44.4%) HL. Age was statistically significant with HL (p < 0.5). The top three future training needs were identified (psychological impact, diagnostic/prevention/treatment, racial/ethnic disparities). Conclusions Emerging health professionals reported sufficient HL, yet information gaps and training needs remain.

Health literacy of Icelandic patients with coronary heart disease

Abstract Funding Acknowledgements Icelandic Nurses" Assoc., Landspitali Univ Hosp., Icelandic Reg Dev Instit, Univ of Akureyri, Akureyri Hosp, OnBehalf KRANS Background Sufficient health literacy (HL) is vital for patients to effectively manage their chronic disease. There are indications that around 50% of the public have limited HL, which can lead to difficulties in self-care, such as medication adherence and lifestyle management. In order to develop effective patient education for patients with coronary heart disease (CHD) and support their self-care, more knowledge is needed on their HL. This is one of the first studies on HL in Iceland and the first on HL in the cardiac patient population. Purpose To describe HL and related factors in patients, 6 months after hospital admission for their CHD. Methods Data was collected from patients with questionnaires (in 2018-2019), six months following an acute or elective treatment for their CHD. Patients answered the European Health Literacy Survey Questionnaire- short version (HLS-EU-Q16), a 16 items instruments with scores ranges from zero (low/no HL) to 16 (high HL). A score of 0 to 8 is considered an indicator of "insufficient" HL, a score from 9 to 12 as "limited" health literacy, and a score of 13 or more as "sufficient" HL. Data on educational needs (on 19 CHD related topics), disease-related knowledge (CADE-Q SV), general (mental and physical) health (SF-12V2) and self-care (SC-CHDI) were collected from patients as background data. Results Preliminary data analysis shows that patients (N = 376, mean age 65 (SD 8.9), 80% male, 30% with basic education only) had a mean HL score of 13.7 (SD 2.5). Sufficient HL was observed in 71.7% of patients, limited HL in 24.5% and 3.8% had insufficient HL. Health literacy was inversely associated with educational needs (odds ratio (OR) 0.58 (0.35;0.98). An increase in HL level was associated with an increase in knowledge (OR 1.13 (0.01; 1.26), self-care maintenance (OR 1.03 (1.01; 1.06), self-care confidence (OR 1.03 (1.01; 1.04) and mental health (OR 1.02 (1.01;1.04). Conclusions The health literacy of patients in this study is satisfactory. Their HL is associated with their disease-related knowledge, educational needs, confidence, mental health and self-care maintenance. HL should be assessed when planning patient education for patients with CHD and the education tailored to individual needs.

The Impact of Health Literacy on the ERCP Process

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive method commonly used for the diagnosis and treatment of hepatopancreaticobiliary diseases. The aim of this study is to assess whether there is a relationship between Health Literacy (HL) levels and the ERCP process. &#x0D; Material and Methods: The study prospectively evaluated the HL data of 72 patients who had ERCP in our hospital between July-November 2020. The Turkish version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to assess health literacy. The patients’ demographic characteristics, duration of referral to hospital, duration of the ERCP procedure, white blood cells (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), and total-direct bilirubin levels and HLS-EU-Q47 results were recorded and evaluated.&#x0D; Results: In our study, 77.7% of the patients had insufficient HL levels. The median body mass index (BMI) was statistically higher in patients with an insufficient HL level (p= .046). GGT, total and direct bilirubin levels were higher in patients with a low HL level (p= .009, p= .031, p= .008, respectively). The assessment of the duration of referral for ERCP revealed that the median duration of referral was statistically significantly longer in patients with an insufficient HL level (p&lt; .001). The median duration of cannulation during ERCP was statistically higher in patients with an insufficient HL level (p= .002).&#x0D; Conclusions: The level of Health Literacy affects the early diagnosis and the success of the procedure in hepatopancreaticobiliary diseases that require ERCP.

Determining Health Literacy Level and Its Related Factors Among Pregnant Women Referred to Medical and Health Centers of Tehran in 2019: A Cross-sectional Study

Background: The ability to acquire, process, and understand health information to make informed decisions about health is defined as health literacy. A low level of health literacy disrupts women’s ability to understand and use health information in order to take appropriate and timely measures during pregnancy. Objectives: Due to the importance of health literacy during pregnancy and its direct impact on fetal health, this study was conducted to determine the level of health literacy and its related items among the pregnant women referred to medical and health centers in Tehran. Methods: This descriptive-analytical study was conducted on 270 pregnant women referred to the medical and health centers of Tehran in 2019. The participants in this study were selected by the mixed sampling method (cluster and random methods to select health centers and the convenience method to select participants). Data collection tools included a questionnaire for demographic and midwifery characteristics and a specialized questionnaire for maternal health literacy in pregnancy (MHELIP). Data analysis was performed by SPSS-19 software. Results: The mean age of the participants was 28.16 ± 5.70 years, and the mean gestational age was 24.50 ± 9.25 weeks. The mean score of health literacy among pregnant women was 63.14 ± 9.63, and 48.9% of them had limited (inadequate and insufficient) health literacy. The results showed positive correlations between the total score of health literacy and the demographic variables of age (P = 0.025), education (P = 0.003), and income (0.008), but no significant relationship was found between the mean total score of health literacy and employment status (P = 0.614) or parity (P = 0.614). Conclusions: It was found that limited health literacy had a high prevalence among pregnant women. Given the importance of pregnancy, it seems necessary for healthcare policymakers to design programs to promote women’s health literacy during pregnancy.

OR7. Health Literacy and the Inpatient Nurse: Defining Core Competencies at an Academic Medical Center

<h3>Background</h3> Limited health literacy is a national health crisis contributing to poor health outcomes including increased hospital readmissions, increased healthcare cost, decreased use of preventive services, and increased morbidity and mortality. Efforts to improve the health literacy of the nation hinge on healthcare provider-level interventions to address social determinants of health. However, these strategies represent an area of care which inpatient providers may not be prepared. Despite cascading poor outcomes associated with limited health literacy, staff nurses at a large urban medical center are not professionally prepared with integral health literacy competencies, skill sets, or screening tools to identify and support their patients. Setting: A large, urban medical center with a 720-bed specialized acute and critical care hospital serving a racially and socioeconomically diverse population. The Nursing Strategic Plan integrates social determinants of health and health literacy goals into the framework of nursing operations in efforts to demonstrate commitment to health equity initiatives. <h3>Purpose</h3> To evaluate staff nurse competencies in the care of inpatients with low health literacy and complete compulsory groundwork for future health literacy programing at the medical center. <h3>Objectives</h3> (1) Evaluate staff nurse knowledge, attitudes, and skills pertaining to health literacy; (2) test-run the Brief Health Literacy Screen tool on inpatient acute care units; (3) quantify rates of limited health literacy among adult inpatients; (4) design patient education care algorithms and staff training in health literacy; and (5) disseminate findings to the Health Equity Council. <h3>Methods</h3> Pilot goals were developed by a steering group of key stakeholders. Staff nurses in acute care units were surveyed to assess baseline knowledge, attitudes, and skills of health literacy concepts. The Brief Health Literacy Screen was introduced to staff nurses as an option to objectively identify individuals with limited health literacy. A 4-week pilot of the tool was completed. Rates of health literacy level were tallied and analyzed. Statistical analysis of survey responses and pilot results was shared with the Health Equity Council at the medical center. <h3>Results</h3> Despite demonstrating proficiency in health literacy concepts, staff nurses lack clinical skills and resources to effectively identify patients with low health literacy and address these patient's unique clinical needs. Staff nurses are ambivalent about their role as patient education providers. The Brief Health Literacy Screen is a clinically feasible tool to identify patients with limited health literacy and is ideal for the busy inpatient environment. Using this tool, 256 adult inpatients were screened and 57.8% were identified as having insufficient health literacy. Care plans derived from health literacy best practices can serve as a guide for future health literacy training for inpatient nurses. <h3>Conclusions</h3> The medical center has the opportunity to adopt routine health literacy screening for all adult inpatients and professionally prepare staff nurse with clinical skills essential to the care of the patient with limited health literacy via comprehensive health literacy programming.

Health literacy and knowledge of antenatal care among pregnant women.

Health literacy has a direct impact on pregnancy from the perspectives of both the mother and the baby. This study aimed to determine the level of health literacy and assess the knowledge of antenatal care among pregnant women. From among all pregnant women who presented to the hospital's obstetric polyclinic during the study's timeline, the study group consisted of 460 women who agreed to take part (492 women were invited and a response rate of 93.5% was achieved). A questionnaire prepared based on the literature in line with the study's objectives was completed by the participants under supervision. The Turkish Health Literacy Scale (THLS-32) was used to assess health literacy. In order to determine the women's prenatal care knowledge levels, a total of 20 knowledge-testing statements prepared using the literature were applied, 14 of which were true and six of which were false. The internal consistency of antenatal information questions during pregnancy was made and the Cronbach alpha coefficient was calculated as 0.77. It was determined that 33.9% of the participants had a sufficient level of health literacy. Health literacy was sufficient in young married women (19years and less) in their first pregnancy and those who had regular reading habits, participated in healthcare activities and received postpartum care at a family health clinic (p<0.05 for each). While the most accurately evaluated statement about antenatal care was 'It is normal to experience nausea/vomiting in the first trimester of pregnancy', the least accurately evaluated statement was 'Over 35% of women incorrectly believed it was normal to gain 20kg of weight during pregnancy'. It was found that pregnant women with sufficient health literacy had higher levels of knowledge about antenatal care (p<0.05). In this study, it was determined that approximately two-thirds of the participants had insufficient health literacy and the women with insufficient health literacy had low levels of knowledge about antenatal care.

Factors associated with health literacy and medication adherence in the elderly patients with chronic kidney diseases

Context: One of the main factors related to health literacy in chronic kidney disease (CKD) is medication adherence. Aims: The present study aimed to investigate the factors associated with health literacy and medication adherence in older adults with CKD referring to Imam Khomeini Amol Nephrology Clinic in 2018. Setting and Design: This descriptive-analytical study was performed in 2018 in Imam Khomeini Amol Nephrology Clinic. Materials and Methods: This study was performed on 150 elderly CKD patients aged above 60 years. Sampling was done using available sampling method and with the anticipation of confounders. Demographic information, elderly health literacy, and medication adherence were assessed using a questionnaire and interview. Statistical Analysis Used: Data were described with mean, standard deviation, and frequency and analyzed using Chi-square tests. Results: The results showed that the age of the participants was 64.3 ± 3.89 years, and 40% of the elderly had an inadequate health literacy, 39.3% had insufficient health literacy, 20.7% had insufficient health literacy, and excellent health literacy was observed in none of the patients. The results showed that there was a statistically significant relationship between health literacy and medication adherence (P Conclusion: According to the results of the study on the low level of health literacy and its direct relationship with medication adherence, it can be said that more attention of nurses is needed to promote and follow drug adherence by educating patients with low levels of health literacy to prevent the progression of the disease and convert drug therapy to dialysis.