Adult Literacy Research Articles

Association between community-level health literacy and frailty in community-dwelling older adults.

We aimed to investigate whether high community-level health literacy, beyond individual-level health literacy, is associated with a low prevalence of frailty among community-dwelling older adults. A large cross-sectional questionnaire survey was conducted among citizens in Maizuru City, Kyoto, Japan, aged 65years or older who were not certified as "support" or "care" level according to Japan's public long-term care insurance system, who could perform basic activities of daily living, and who did not have dementia or Parkinson's disease. Frailty status was assessed using the Kihon Checklist, with a score ≥ 8 indicating frailty. Health literacy was assessed using the Communicative and Critical Health Literacy Scale. The mean health literacy score of 20 school districts was used as the community-level health literacy index. We investigated demographic data and other potential confounding factors, including education, living arrangement, body mass index, comorbidity, smoking status, depressive symptoms, social networks, and community-level covariates. The primary analysis included 6230 individuals (mean age = 74.3years [SD = 6.1]). In each school district, the prevalence of frailty was 21.2-34.2% (mean: 26.2%), and community-level health literacy index was 3.1-3.5 (mean: 3.4). Multilevel logistic regression model including school district as random effect showed that the community-level health literacy was significantly associated with frailty (odds ratio [95% confidence interval] = 0.28 [0.08 to 0.96]) after adjusting for the covariates. Not only high individual-level health literacy but also high community-level health literacy is associated with a low prevalence of frailty in community-dwelling older adults.

Fiscal Decentralization and Social Service Delivery Policy Response in Nigeria

This study examines the impact of fiscal decentralization on social delivery policy response in Nigeria, utilizing panel data for fourteen states in Nigeria for the period covering from 2000 to 2019. Specifically, this study evaluates the impact of fiscal autonomy on social indicators such as infant mortality rate, maternal mortality rate and adult literacy rate. The panel vector error correction mechanism (PVECM) the granger causality test was employed as the estimation techniques. The result of the granger causality test to determine the direction of causality relationship among the variables in the estimated model showed that there was one way directional causality running from maternal mortality rate (MMR) to fiscal autonomy (FISA); adult literacy rate (ADLIT) to population (LPOP); population (LPOP) to maternal mortality rate (MMR), adult literacy rate (ADLIT) to maternal mortality rate (MMR), and education expenditure (LEDU) to fiscal autonomy (FISA). This means that maternal mortality granger caused fiscal autonomy in Nigeria. The result also implies that adult literacy rate granger caused growth in population, and growth in population granger caused maternal mortality rate in Nigeria. The error correction variable in the infant mortality rate equation has the coefficient of 0.069. This indicates that approximately 6.9 percent of the distortion in the system would be corrected each whenever the system moves away from equilibrium. This depicts a slower speed of adjustment mechanism from the disequilibrium in the short run to equilibrium in the long run. The estimated infant mortality rate equation has a very good fit on the data and very high explanation power, given the adjusted R-squared of 0.736. The adjusted R-squared of 0.736 showed that approximately 74 percent of variation in the dependent variable (infant mortality rate) was accounted for by variations in the independent variables. This result is not in agreement with the theoretical postulate. In real term, the result showed that an increase in education expenditure by one percent would lead to a decrease in adult literacy rate by 0.22 percent, other things being equal. This result showed that spending in education has not improved the literacy rate in Nigeria. This suggests that it is either the fact that spending in education by the government has been so small that it cannot bring about improvement in the literacy or that funds meant for educational projects are siphoned into private pause, thereby resulting to huge decline in terms of literacy rate. Lastly, growth in population has a declining effect on adult literacy rate in Nigeria. This inference is in accordance with a priori expectation showing that as population increase, pressure is being put on the existing educational facilities and overwhelm it, leading to the decline in adult literacy rate. In concrete term, an increase in population by one percent resulted to a decrease in adult literacy rate by 0.73 percent, other variables remaining the same. Based on our result, the study made some policy recommendation for the states to double their efforts in generating their internal revenue to become fiscally autonomous less reliance on the federal government for allocation. Also, there is need for the government to raise her expenditure in education and health sectors so as to increase the literacy rate and health sector outcomes in the country.

Public Libraries and Houseless Patrons

Public libraries play a vital role in their communities as information providers offering programs ranging from early literacy programs for infants to resume help and career coaching for adults re-entering the workforce. As complex socioeconomic realities continue to evolve around Covid-19, and government and non-profit agencies appear limited in the scope of assistance they provide, libraries offer critical services for a variety of needs shouldered by the marginalized in their communities. Specifically, public libraries support houseless patrons through a variety of initiatives ranging from employing on-site social workers to providing programs specific to adult literacy and the development of social connections. Consequently, public libraries show a rare commitment among public establishments to serve all members of their community with dignity and equality.

“The most outstanding institution I am grateful for” (Indatwa ihora kw’isonga nshimira)

The following poem was composed by a learner enrolled in an adult literacy and numeracy program provided by an organization called Rwanda Children that offers a diverse array of educational programs to adults and children in the Ntarama sector, Bugesera district and country of Rwanda.

Providing Health-Literacy-Level-Appropriate Health Education to Older Adults in the Post-Pandemic Era

The rapidly changing and high-risk nature of communicable diseases for older adults require individuals in this age group to appropriately change their lifestyle and healthcare habits and engage in self-care more actively and seriously. Good self-health management relies on good health literacy in order to be able to read, understand, and apply relevant health information; to communicate clearly with healthcare providers; and to take health-related decisions and actions. The results of research indicate the health literacy of over 50% of older adults in Taiwan to be inadequate, which may be expected to negatively impact on related health outcomes. After introducing the content, determinants, and impacts of health literacy, the author suggests strategies to improve health literacy in older adults in five activity domains based on current theories and research findings. These domains include: formulate public policies for health literacy, adjust the orientation of health services, construct a friendly healthy information environment for health literacy, strengthen community health literacy education resources, and promote gerontological education and shared decision-making in health care.

E-Health Literacy Scale, Patient Attitudes, Medication Adherence, and Internal Locus of Control.

Health literacy is related to a variety of health outcomes, including disease control, health-related quality of life, and risk for death. Few studies have investigated the relation of electronic health literacy (e-health literacy) to outcomes or the mechanism by which they may be related. Secondary data were drawn from participants in a larger study on chronic disease self-management who were age 40 years and older, had at least one chronic health condition and a health literacy score of 8th grade or below on the validated short form of the Rapid Estimate of Adult Literacy in Medicine. Participants completed the e-Health Literacy Scale (eHEALS), the Multidimensional Health Locus of Control scale, a modified version of the Attitudes Toward Health Care Providers Scale (ATHCPS), the Wake Forest Physician Trust Scale (WFPTS), and the Gonzalez-Lu adherence questionnaire. Hypothesized relations were evaluated in a bootstrapped path analytic model using the Mplus statistical software. Participants included 334 individuals (mean age: 57.5 years; 173 women and 161 men) with Black, Indigenous, and People of Color accounting for 83.3% of the participants and White individuals making up 16.7% of the participants. Model results showed that after controlling for age, education, gender, and race, the eHEALS score was significantly related to the ATHCPS and WFPTS but not to the Gonzalez-Lu adherence questionnaire (p < .05). The eHEALS score was significantly related to the Multidimensional Health Locus of Control scale. Analysis of indirect effects showed that a portion of the relation between e-health literacy and patient attitude and adherence was mediated by internal locus of control (all p < .05). In this study, e-health literacy was related to important patient attitude and behavior variables via locus of control. This finding has implications for the importance of improving patients' ability to use the internet to access and effectively use health information. [HLRP: Health Literacy Research and Practice. 2023;7(2):e80-e88.].

REACHING CHILDREN ACROSS THE GLOBE: THE EFFECT OF ENGLISH CHILDREN’S BOOKS ON TANZANIAN ORPHAN LITERACY

We found that there are disproportionately intractable challenges such as poverty and inequality in an area of Tanzania, Eastern Africa. There was a need to identify and develop the factors critical for their success. Data were collected in rural Iringa, Tanzania on a case study basis, using a semi-structured interview and communication with leaders in this area of Africa, and we analyzed data with a coded transcript. We identified ten factors that are critical for the success of the orphanage literacy. These findings advance understanding of non-governmental organizations (NGOs) and have important practical applications for such enterprises. When the United Nations literacy decade (UNLD, 2003–2012) reached a mid-point, we decided to add to the global awareness of literacy. With initiatives and policy shifts providing a stronger basis for action on literacy, we reached out to Africa. Our concern is that the rise in the global adult literacy rate (15+) from 76 to 83.6 percent over the last two previous decades shows steady progress, with the rates in developing countries showing an even sharper rise from 68 to 79 percent (Richmond, Robinson, &amp;amp; Sachs-Israel, 2008). Thus, we focused on students from grades four to twelve to foster their literary progress as well. This study included 58 students who were also orphans in Kihesa-Iringa, Tanzania. By creating a Coalition of Children’s Book Authors, we established a common ground for global literacy in the form of an NGO. However, the complication in literacy levels exists due to the digital-divide challenges coupled with the expense and delay of material delivered to Africa from the United States. Thankfully, our concern has succeeded to have influence even through the digital divide posed several objectives. Our course of action included a comprehensive plan to reach the 58 orphans, train their leaders, and create interactive learning modules. Thus, our contribution to the literature has reacted to the needs of an African community that could use help in not only literacy but also literacy-leadership communication and knowledge-management.

ДІЯЛЬНІСТЬ ТОВАРИСТВА «ПРОСВІТА» С. ВИСОКА ПІЧ ЖИТОМИРСЬКОГО ПОВІТУ У 1920 Р.

The article examines the process of formation of the cultural and educational society «Prosvita» in the village of Visoka Pich of Zhytomyr County in 1920. Considering the lack of any historical materials about the educational center on the Internet, this article is actually the first attempt to analyze archival materials and carry out a comprehensive study of the activities of rural educators. The circumstances of the formation of «Prosvita» are clarified, its educational activities are reflected, in particular, the organization of training for illiterate and literate adults. The financial activity of «Prosvita» was tracked, thanks to which funds were obtained and expenses were incurred for the needs of the cell. As can be seen from archival materials, the society had the most diverse sources of income and expenses, which testified to its diverse work. Among the various forms of cultural and educational work, as evidenced by the documents, enlightened people paid special attention to the organization of concerts, plays, and rallies. In addition to material profit, they contributed to the education, development and entertainment of the population. The authors drew attention to the ascetic work of rural enlighteners: O. Mysko, M. Stolyar, V. Shtuly, and others. It was thanks to their dedicated work that it was possible to achieve acceptable results in 1920. The place and role of family parties in the lives of enlightened people and their families is analyzed. The publication presents tables showing the cultural and educational activities of the «Prosvita» society. They provide statistical information that testifies to the dynamic work of enlightened people. Its analysis makes it possible to trace achievements and gaps in the functioning of the village center.

Causal Model of Health Literacy in Thai Older Adults with Knee Osteoarthritis

Knee osteoarthritis is the most common form of arthritis causing disability among older adults. Proper self-care is vital and achievable with health literacy. Thai older adults with knee osteoarthritis have been found to have inadequate health literacy, and poor selfcare behaviors for this condition. The purpose of this descriptive cross-sectional study was to test a causal model of health literacy in Thai older adults with knee osteoarthritis, depicting relationships among provider-patient communication, patient engagement, cognitive function, knowledge of knee osteoarthritis, Internet use, social support, social participation, and health literacy. Participants comprised 318 older adults with knee osteoarthritis, selected using multi-stage random sampling from nine community hospitals in a northern Thai province. Data were collected using a demographic data form, the European Health Literacy Survey Questionnaire, the Provider-patient Communication Scale, the Patient Health Engagement Scale, the Montreal Cognitive Assessment-Basic, the Arthritis Knowledge Scale, the Internet Use Questionnaire, the Social Support Questionnaire, and the Community Participation of the Elderly Questionnaire. Data were analyzed using descriptive statistics, Pearson’s product moment correlation, and structural equation modeling. The final model fitted with empirical data and explained 36% of the variance in health literacy with Internet use as the strongest predictor directly affecting health literacy. Internet use and social participation had positive direct and indirect effects on health literacy via cognitive function. Cognitive function and social support positively directly affected health literacy. Patient engagement negatively affected health literacy indirectly via Internet use. Knowledge of knee osteoarthritis and provider-patient communication did not affect health literacy directly or indirectly. In conclusion, nurses should design interventions to promote health literacy of this population by highlighting Internet use, social participation, cognitive function, social support, and patient engagement, with testing in clinical practice.

Information Technology, Inequality, and Adult Literacy in Developing Countries

The studyassesses linkages between information technology, inequality, and adult literacy in 57 developing countries for the period 2012–2016. Income inequality is measured with the Gini coefficient while six dynamics of information technology are taken on board, namely use of a virtual social network, Internet access in schools, Internet penetration, mobile phone penetration, fixed broadband subscription, and a number of personal computer users. The empirical evidence is based on interactive Tobit regressions. The findings show that only Internet access in schools unconditionally promotes adult literacy. The corresponding inequality threshold that should not be exceeded for Internet access in schools to continue promoting adult literacy is 0.739 of the Gini coefficient. Policy implications are discussed.

Development and validation of a short nutrition literacy scale for young adults.

Due to their high media use, young adults are frequently exposed to contradictory or even erroneous nutrition information. To properly handle and critically assess nutrition information, young adults (both general population and patient populations) need adequate levels of nutrition literacy. Currently there is a lack of suitable instruments to measure nutrition literacy in young adults (18-25 years). Therefore the aim of this study was to develop and validate a Short Nutrition Literacy (S-NutLit) scale for use in this age group. Development and validation of the S-NutLit consisted of six phases: (1) item generation based on literature, (2) expert assessments to evaluate content validity, (3) cognitive interviews with the target population to assess face validity and readability, (4) pre-test to reduce the number of items, (5) validation survey to assess dimensionality with exploratory factor analyses, internal reliability with Cronbach alpha, construct and criterion validity by examining associations with age, gender, education level, health literacy, general literacy, dietary behaviors and physical activity with correlations, ANOVAs, and t-tests, (6) two-week follow-up survey to assess test-retest reliability with intra-class correlations. Starting from an initial pool of 53 items, expert assessments and cognitive interviews led to the reformulation, removal, and construction of items. Young adults aged 18-25 years participated in cognitive interviews (n = 12), pre-test (n = 101), validation survey (n = 300), and reliability survey (n = 92). The final S-NutLit consisted of 11 items rated on a 5-point scale distributed across two subscales (i.e., information skills and expert skills). Cronbach alpha values ranged from 0.79 to 0.83 and intraclass correlations from 0.61-0.79 (p < 0.001). Significant associations were observed with health literacy (r = 0.27, p < 0.001), general literacy and numeracy (rs = 0.12, p = 0.046), and education level (rs = 0.13, p = 0.025). Findings indicate that the S-NutLit is a valid and reliable tool to assess nutrition literacy among young adults. The S-NutLit fills a gap in the field by offering a short measure of nutrition literacy and may be incorporated in digital technology to support the nutrition care process.

Developing and Validating a Contextualized Science Literacy Assessment for Adults: The Case of Parents of Hard of Hearing Children

&lt;p style="text-align:justify"&gt;The diversity of definitions of science literacy has resulted in a diversity of measurement tools. However, adult science literacy is mainly assessed on short standardized and non-contextualized questions, thus making the study of adult science literacy more qualitative than quantitative. Here we describe the rationale, development, and validation of a questionnaire that associates the use of science in the specific science-related setting of parents of hard of hearing children with general and topic-specific science knowledge. The questionnaire went through four developmental steps: (1) gathering input from hearing rehabilitation experts and parents, (2) testing the close-ended questionnaire (n=10), (3) open-ended questionnaire (n=24), (4) online close-ended questionnaire (n=91). These all assessed general science knowledge, contextual science knowledge in the field of hearing and parents' advocacy knowledge and attitudes. These steps and the resulting assessment tool can thus inform the further development of measures of adult science literacy in context. The findings suggest that although general science knowledge enables the application of science to everyday science-related problems it only explained a small proportion of the variance in contextual science knowledge. Thus, the results strongly point to the importance of measuring adults' science literacy in a context that is relevant to the responders. The findings also underscored the disappointing outcomes of secondary science education, in that formal scientific background predicted general science knowledge but did not account for contextual science knowledge at all. This should elicit concern as to the ability of students to use science knowledge in future personally important science related contexts.&lt;/p&gt;

Does Health Literacy Affect Colorectal Cancer Screening Rates?

ABSTRACT This study aims to determine the relationship between adult colorectal cancer screening behaviors and health literacy levels. This cross-sectional study aims to determine the relationship between adult colorectal cancer screening behaviors and health literacy levels. Of the participants, only a small proportion had undergone this screening (9.3%). Having an intestinal disease (OR = 23) and having a relative with colorectal cancer (OR = 8) had the highest effect on colorectal screening. There were significant differences between the colorectal screening groups concerning most THLS-32 subgroup scores, including the THLS-32 total score. Health literacy affects colorectal cancer screening rates. Primary care workers, especially community health nurses, are in an ideal position to increase health literacy and thereby increase cancer screening rates.

The impact of oral health literacy on dental anxiety and utilization of oral health services among dental patients: a cross sectional study

BackgroundLow oral health literacy levels and deficient oral health knowledge jeopardize the communication between dentists and patients in different communities. This study aimed to examine the impact and association of oral health literacy with patients’ levels of dental anxiety and their utilization of dental health services.MethodsThis cross-sectional study was conducted at the Misr International University (MIU) dental clinics. The study utilized a structured, interview led questionnaire that was administered by second year dental students, over the period of two successive academic years 2018–2019 and 2019–2020. A total of 440 student interviewed a convenience sample of 440 dental patients: including 269 females (61.1%) and 171 males (38.9%). The questionnaire consisted of four sections; a demographic section, a modified Arabic Rapid Estimate of Adult Literacy (ARELAD-30) Tool that measures the ability of the participants to read 30 commonly used dental terms. This questionnaire was modified by the authors to measure the participants’ knowledge by asking them to choose the most accurate meaning for each word based on their previous knowledge. Scoring was dependent on the participant’s immediate correct pronunciation, as well as comprehension of each word. The Arabic Modified Dental Anxiety Scale (AMDAS) was used to measure the level of dental anxiety, and the dental health service utilization was measured using the Utilization of oral health services questionnaire.ResultsOne quarter (24.1%) of the participants read the 30 items of the A-REALD correctly. The average percentage of correct responses to the meaning of the dental terms was 71.2%. There was no statistically significant association between A-REALD and knowledge scores (Spearman’s Correlation coefficient ρ = -0.008, p-value = 0.872). There was a statistically significant inverse correlation between age and MDAS (Correlation coefficient ρ = -0.146, p-value = 0.002). A-REALD scores were inversely correlated with time since last visit (Regression coefficient = -0.027, p-value = 0.036, with 95% CI: -0.052 – -0.002).ConclusionWithin the limitations of this study, it can be concluded that oral health literacy is significantly associated to dental health services utilization, while, dental anxiety is related to other variables, such as age and gender.

Assessing vaccine literacy and exploring its association with vaccine hesitancy: A validation of the vaccine literacy scale in China

BackgroundAssessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a psychological state. This study aimed to validate the applicability of the HLVa-IT (Vaccine Health Literacy of Adults in Italian) scale in Chinese settings and to explore the association between vaccine literacy and vaccine hesitancy. MethodsFrom May to June 2022, we conducted an online cross-sectional survey in mainland China. Potential factor domains were obtained by the exploratory factor analysis. Cronbach's alpha coefficient, composite reliability values, and square root values of average variances extracted were calculated to determine the internal consistency and discriminant validity. The association between vaccine literacy, vaccine acceptance, with vaccine hesitancy was assessed using logistic regression analysis. ResultsTotally, 12,586 participants completed the survey. Two potential dimensions, the functional and the interactive/critical, were identified. Cronbach's alpha coefficient and composite reliability values were >0.90. The square root values of average variances extracted exceeded the related correlations. The functional dimension (adjusted odds ratio (aOR): 0579; 95 % Confidence Interval (CI); 0.529, 0.635), interactive (aOR: 0.654; 95%CI: 0.531, 0.806)/critical (aOR: 0.709; 95%CI: 0.575, 0.873) dimension were significantly and negatively associated with vaccine hesitancy. Similar results were also found in different vaccines acceptance subgroups. LimitationsThis report is limited by the convenience sampling method. ConclusionsThe modified HLVa-IT is suitable for use in Chinese settings. Vaccine literacy was negatively associated with vaccine hesitancy.

Interventions to support decision-making, health literacy and self-management in ethnic-minority adults living with chronic kidney disease: a systematic review.

Optimal patient care is directed by clinical practice guidelines, with emphasis on shared decision-making. However, guidelines-and interventions to support their implementation-often do not reflect the needs of ethnic minorities, who experience inequities in chronic kidney disease (CKD) prevalence and outcomes. This review aims to describe what interventions exist to promote decision-making, self-management and/or health literacy for ethnic-minority people living with CKD, describe intervention development and/or adaptation processes, and explore the impact on patient outcomes. Six databases were searched (MEDLINE, PsychINFO, Scopus, EMBASE, CINAHL, InformitOnline) and two reviewers independently extracted study data and assessed risk of bias. Twelve studies (n=291 participants), conducted in six countries and targeting nine distinct ethnic-minority groups, were included. Intervention strategies consisted of: (i) face-to-face education/skills training (three studies, n=160), (ii) patient education materials (two studies, n=unspecified), (iii) Cultural Health Liaison Officer (six studies, n=106) or (iv) increasing access to healthcare (three studies, n=25). There was limited description of cultural targeting/tailoring. Where written information was translated into languages other than English, the approach was exact translation without other cultural adaptation. Few studies reported on community-based research approaches, intervention adaptations requiring limited or no literacy (e.g. infographics; photographs and interviews with local community members) and the inclusion of Cultural Health Liaison Officer as part of intervention design. No community-based interventions were evaluated for their impact on clinical or psychosocial outcomes. All interventions conducted in the hospital settings reported favourable outcomes (e.g. reduction in blood pressure) compared with routine care but were limited by methodological issues.

Rethinking Education Reform in Morocco Beyond the Imperatives of Determinism

The deterministic tradition abides by the principles of intuitionistic logic, in which the current state of all systems is determined by prior versions of what they are. Systemic determinism, where the present simultaneously substantiates pre-existing conditions and predicts imminent realities, has long championed the logic of the natural sciences, providing substance and legitimacy for an infallible cause-effect agency. Advocacy for deterministic agency is well sensed in the organization and administration of education. Many educational reforms are conceived with practices that espouse the logic of linear progression. The intent of this paper is to interrogate the legitimacy of the deterministic approach to educational reform in Morocco against its capacity to predict change. In particular, the outputs from five educational reforms carried out in Morocco over the 1999-2022 period were subjected to content analysis for obtaining data on the statistical distribution of changes in relation to three research dimensions: access to primary education, adult literacy and gender equality . In a later stage, the outputs from the quantitative analysis were optimized to enable inferential modes of analysis. The findings from this study revealed that systemic determinism is incapacitated by the principle of cause-effect agency that hyperbolizes the influences of the past on the imperatives of the present.&#x0D; &#x0D; Received: 25 October 2022 / Accepted: 24 February 2022 / Published: 6 March 2023

Trial lay summaries were not fit for purpose

Background and ObjectivesTo establish if trial lay summaries are suitable for lay readers. MethodsA random sample of 60 randomized controlled trial (RCT) reports (15%) from the National Institute for Health and Care Research (NIHR) Journals Library, UK, were selected from 407 available ones. We extracted the lay summary and determined the readability using the previously validated Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simplified Measure of Gobbledegook (SMOG), Gunning Fog (GF), Coleman-Liau Index (CLI), and Automated Readability Index (ARI) readability scales. This provided us with a reading age. We also assessed the compatibility of the lay summaries with the Plain English UK Guidelines and the National Adult Literacy Agency Guidelines, Ireland. ResultsNo lay summary met the recommended reading age for health care information of 11–12 years. None of them were considered “easy” to read, in fact over 85% were considered “difficult” to read. ConclusionThe lay summary is a key document for disseminating trial results to a broad population who may not necessarily have the medical or technical jargon to read a trial report. Its importance cannot be overstated. Assessing readability in conjunction with plain language guidelines is relatively easy and therefore an immediate change to practice is feasible. However, since specific skills are required to write lay summaries that meet the required standards, it is important that the need for such expertise is recognized and supported by research funders.

Mental health information-seeking behaviors and e-health literacy in Tunisian community adults

IntroductionDue to the convenient and easy access to the Internet, there is an increasing tendency to seek online health information instead of formal help-seeking. To date, there is a very little amount of research on online help-seeking behaviors for mental health problems, with no studies having been performed in Tunisia.ObjectivesWe aimed to explore mental health information-seeking behaviors and e-health literacy in a sample of Tunisian community adults.MethodsWe performed a cross-sectional descriptive study among adults from the general population. All participants were administered the Barriers to Access to Care Evaluation scale (BACE-30), the Columbia Suicide Severity Rating Scale (SIS-5), the Depression Anxiety Stress Scales (DASS-21), and the eHealth Competency Scale (eHEALS).ResultsA total of 44.2% participants reported having searched the Internet for mental health-related information during the last 12 months. Google was the most used tool by participants when searching for mental health related information. The main topics searched were symptoms and management (n=49%), followed by finding a diagnosis (n=47%), researching for medications and physicians (n=41%). We conducted a multivariate analysis to identify factors related to participants’ e-health literacy. A higher depression score (p=0.037), lower levels of education (p=0.011), and perceived barriers to access to care (p=0.004) were substantially linked to worse e-health literacy.ConclusionsWhile a high proportion of participants reported mental health information-seeking behaviors, those with higher depression and who perceived more barriers to care access exhibited lower e-health literacy. These findings may have practical clinical implications.Disclosure of InterestNone Declared

Exploring the phenomenon of hope in adult illiterate Haitians

Snyder's hope theory depicts hope, through the frame of positive psychology, as a cognitive construct with the perceived sense of goal-directed, pathways, and agency thinking (Snyder et al., 1991). Hope levels have been measured in various countries; however, no research to date focused on Haitians. This study, conducted in Petit-Goâve, Haiti, addressed this gap by investigating hope, pathway, and agency levels derived from 135 Haitian-Kreyol adult literacy course participants. This manuscript reports scores of illiterate Haitians' hope levels utilizing Snyder's Adult Hope Dispositional Scale; the scores are explained by Snyder's hope theory taking Haitian cultural and social landscapes into account. Despite the challenging environment and illiterate conditions, Haitian participants reported just below average hope levels, average pathway levels, and low agency levels. These findings suggested this population garnered hope in their everyday lives, despite difficult obstacles.