Low Levels Of Health Literacy Research Articles

The Use of a Two-Phase Online Delphi Panel Methodology to Inform the Concurrent Development of a School-Based Ovulatory Menstrual Health Literacy Intervention and Questionnaire.

IntroductionThere are a high prevalence of ovulatory-menstrual (OM) dysfunction and low levels of menstrual health literacy in adolescents, yet few evidence-based OM health education resources for schools.MethodThis two-phase study used an online Delphi methodology to build consensus across thirty-five purposively selected professionals from the diverse professions of health and education. The panellists were tasked to inform the development of a school-based OM health literacy resources.ResultsIn Round One, 86% of panellists determined the scope of these resources using guided and open-ended questions. The study then split into two phases which ran concurrently. In the first phase informing the intervention's development, 57% of panellists participated in Round Two, and 29% reviewed selected lessons. In the second phase informing the questionnaire's development, 51% of panellists participated in Round Two, and 69% in Round Three. The overall consensus reached for the intervention phase and questionnaire phase were 82% and 84%, respectively. The Panel's recommendations included a strengths-based position to counter menstrual stigma, teaching accurate self-report of cycle biomarkers, addressing multiple menstrual dysfunctions and adopting a whole-school approach.ConclusionAlthough time-consuming and requiring a sustained interest, this two-phase Delphi methodology offered anonymity to panellists from distinct professions which facilitated their independent contribution to developing OM health literacy school resources.

P346 HEALTH LITERACY ASSESSMENT AND HOSPITAL LENGTH OF STAY: A RETROSPECTIVE STUDY

Abstract Background Cardiovascular diseases (CDs) were the leading cause of death worldwide in 2020. The risk of increasing CD is related to low Health Literacy (HL). HL can be defined as the individual’s ability to understand and process health information. Low HL has a risk ratio of 1.90 on mortality and 1.35 on readmission. A low level of HL was related to poorer use of health care services. Several inconsistencies were found about the relationship between HL and Length of stay (LOS). Although CDs are increasing because of the aging population, HL is often underestimated in the hospital setting. For this reason, HL assessment is important to identify patients at risk of poor HL. Therefore, this study aimed to describe the HL level in inpatients with CDs and to analyze the relationship between HL and LOS Method A retrospective design was used to randomly select 134 patients with CDs in eight cardiovascular and internal medicine units of an Italian hospital from 10 January to 10 May 2021. Clinical data were collected using a nursing information system (NIS) and the hospital discharge register. Single Item Literacy Screener (SILS) was used to measure HL and was systematically reported on NIS. Results The mean age of the sample was 71.28 (SD 13.19); 59% were male. HL‘s mean score was 2.43 (SD 1.2). A statistically significant linear association (Spearman’s correlation coefficient) was observed between the HL score and LOS. Patients with inadequate HL were 50.7% and had a longer LOS than patients with adequate HL (mean 9.1 ± 7.1 Vs 7.2 ± 5.9 days respectively, p = 0.05). Conclusion HL is poor and has been shown to be associated with LOS. These results should be confirmed after considering other variables through multivariate analyses. These findings suggest that the adverse effects of low HL may extend into the inpatient cardiovascular setting

Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study.

Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24–48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of “literacy in breastfeeding”, in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.

Predictors of Uncertainty and Unwillingness to Receive the COVID-19 Vaccine in Men Who Have Sex with Men in France.

The development of vaccines against COVID-19 has given hope to populations. Public acceptability of vaccination is a major driver in containing the disease. However, in marginalized and stigmatized populations, uncertainty and unwillingness may be a challenge. This study aimed to analyze the factors associated with uncertainty and unwillingness to vaccinate against COVID-19 in men who have sex with men (MSM) living in France. The data used came from Rapport au Sexe (ERAS) 2021, a voluntary, cross-sectional, anonymous, self-administered, online survey conducted from 26 February to 11 April 2021. Among the 15,426 respondents included in the analysis, 60.5% were willing to vaccinate (these included persons already vaccinated), 17.5% were not, and 22% were uncertain. Factors independently associated with uncertainty and unwillingness were lower education level, low health literacy level, financial hardship, being under 30 years of age, and living in a rural area. HIV-positive MSM were less likely to report vaccination uncertainty and unwillingness than HIV-negative MSM and those with unknown serostatus. Although more impacted by COVID-19, socioeconomically vulnerable MSM were the sub-group most unwilling to vaccinate. To improve acceptability of COVID-19 vaccination in MSM, policy makers and researchers must increase access to and understanding of medical information by considering the general public’s health literacy when developing information sources. Moreover, a dedicated global care approach, which ensures these populations can be reached, is necessary.

Understanding the hidden epidemic of metabolic syndrome in people accessing community rehabilitation: a cross-sectional study of physical activity, dietary intake, and health literacy

Purpose To determine the prevalence of metabolic syndrome in patients attending outpatient community rehabilitation in Melbourne, Australia and to compare health literacy, physical activity, and dietary intake of people with and without metabolic syndrome. Materials and methods A cross-sectional, multi-centre, observational study of adults (n = 193) presenting to rehabilitation with various health complaints. Metabolic syndrome was determined according to the International Diabetes Federation joint consensus worldwide definition. Health literacy was assessed using the Rapid Estimate of Adult literacy in Medicine (REALM) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Physical activity was assessed using accelerometers and dietary intake was assessed using a food frequency questionnaire. Results One hundred and twenty three participants (64%) had metabolic syndrome. Of these, only three (2%) knew they had it. People with metabolic syndrome scored lower on health literacy (S-TOFHLA MD −2.10, 95% confidence interval (CI) −3.98 to −0.22) and took 1311 (95%CI 375 to 2246) fewer daily steps than those without metabolic syndrome. There were no differences in dietary intake. Conclusions Metabolic syndrome is a prevalent and under-recognised condition in community rehabilitation. Community healthcare professionals and health services may need to consider a broader approach to management including lifestyle assessment and intervention of patients with various conditions. Implications for rehabilitation Almost two-thirds of adults in community rehabilitation had underlying, undetected metabolic syndrome. Adults with metabolic syndrome completed less objectively measured physical activity and had lower health literacy levels than those without metabolic syndrome. A broader approach to management may need to be considered in community rehabilitation where patients presenting for rehabilitation of various conditions would likely benefit from lifestyle assessment and intervention.

Functional, communicative and critical health literacy among older Polish citizens.

The level of health literacy possessed by an individual (functional, communicative, critical) determines their ability to effectively self-manage a chronic disease. The aim of the study was to assess the level and functional, communicative, and critical determinants of health literacy in the group of chronically ill older adults. The study was conducted on a representative sample of chronically ill people (N = 400) aged ≥65 years, living in Poland. Three levels of health literacy were measured on the basis of the Functional, Communicative and Critical Health Literacy scale (FCCHL), employed in Polish social research for the first time. The conducted research showed that the average health literacy score of the surveyed older adults, measured on the basis of the FCCHL scale, was 2.81±0.71 (M±SD), whereas for the functional subscale of health literacy it was 3.06±0.58 (M±SD), for communicative health literacy it was 2.82±0.86 (M±SD), and for critical health literacy - 2.71±0.92 (M±SD). In terms of functional health literacy, the surveyed seniors most frequently reported problems with reading health-related information, resulting from the use of inadequate font size in information leaflets and brochures. Questions included in the subscale representing communicative health literacy revealed that the majority of the respondents understood the provided information about diseases, nevertheless they were reluctant to share thoughts about their health with other people. Within the framework of critical health literacy, one-third of the respondents did not search for any additional information, trusting that the information obtained was accurate and reliable. The surveyed elderly people rated worse their level of communicative and critical health literacy compared to the functional level. As a consequence of the low level of communicative and critical health literacy of the surveyed older adults, a certain deficit in their self-managing a disease entity is forecast. Med Pr. 2022;73(3):191-9.

Relationship between Health Literacy and Frailty in Older Adults with Chronic Kidney Disease

ABSTRACT Background Chronic kidney disease (CKD) is associated with an increased risk of frailty, morbidity, and mortality in older adults. Limited health literacy (HL) is a condition that can cause frailty in CKD. Frailty leads to a decreased resistance to stress situations caused by activities of daily living and increased morbidity and mortality. The aim of this study was to investigate the relationship between HL and frailty in older adults with stage 4–5 CKD. Methods A total of 109 patients with stage 4–5CKD were included. All patients underwent a comprehensive geriatric assessment. Health literacy was assessed by the Turkish version of the European Health Literacy Questionnaire. Frailty status was measured using the Fried Frailty Index. Results The median age was 72 (68–80) years and 72 patients (66.1%) had lowHL. Forty-six patients (42.2%) were frail, and frailty was more common in the low HL group. Conclusion The present study demonstrated that low HL level was common in geriatric patients with stage 4–5 CKD and was associated with frailty, as well as a decrease in daily and instrumental life activities, decrease in acceptance of illness scale, and compliance with medical treatment.

An analysis of the gender and social determinants of health in urban poor areas of the most populated cities of Pakistan

BackgroundRecent surveys, studies and reviews in urban areas of Pakistan have highlighted the impacts of social inequities on access of women and children to health services for women and children in Pakistan.ObjectivesThe Urban Slum Profiles and coverage surveys were conducted between 2017 and 2019. The objective of the profiles was to obtain an updated listing of slums and other underserved areas, and to better understand current vaccination and health service coverage in these areas. Utilising findings from these studies, this paper aims to better understand the gender and social determinants of health that are giving rise to health inequalities in the slums.MethodsThe Urban Slum Profiles adopted a mixed methods approach combining both qualitative and quantitative methods. The study was comprised of two main survey approaches of Urban Slum Profiles and Immunisation Coverage Survey in 4431 urban poor areas of the 10 most highly populated cities of Pakistan.ResultsFindings are classified into six analytic categories of (1) access to health services, (2) female workforce participation, (3) gender-friendly health services, (4) access to schools and literacy, (5) social connections, and (6) autonomy of decision making. Out of a national sample of 14,531 children in urban poor areas of 10 cities, the studies found that just over half of the children are fully immunised (54%) and 14% of children had received zero doses of vaccine. There are large shortages of health facilities and female health workforce in the slums, with significant gaps in the quality of health infrastructure, which all serve to limit both demand for, and supply of, health services for women and children. Results demonstrate low availability of schools, low levels of female literacy and autonomy over decision making, limited knowledge of the benefits of vaccination, and few social connections outside the home. All these factors interact and reinforce existing gender norms and low levels of health literacy and service access.ConclusionThe Urban Slum profiles and coverage studies provide an opportunity to introduce gender transformative strategies that include expansion of a female health workforce, development of costed urban health action plans, and an enabling policy environment to support community organisation and more equitable health service delivery access.

Assessment of Factors Influencing Non-Communicable Diseases Literacy Levels in Vihiga County–A Qualitative Cross-Sectional Study

Background: Health outcomes are closely influenced by health literacy levels. In most cases, lower health literacy levels have been found to be related to higher prevalence and incidence of non-communicable diseases (NCDs)–including cardiovascular and cerebrovascular diseases, cancer, diabetes, hypertension, and other chronic respiratory diseases. Despite this wealth of knowledge on the relationship between literacy levels and NCDs, most previous studies have been on the incidence and the prevalence of NCDs. Aims: This study therefore sought to assess the factors influencing non-communicable diseases literacy levels, Vihiga County (Kenya). Methodology: The study used a qualitative cross-sectional study design to collect data through though questionnaires and interview guides administered through focused group discussions and key informant interviews. A sample size of 55 respondents was used in this study–mostly the IPAB project (Improving Priority and Budget Allocation to NCDs in Vihiga County) beneficiaries. The data collected from this study was coded using Microsoft excel version 25 and analyzed using statistical packages for social sciences (SPSS version 25) and inductive data analysis (IDA) for the qualitative data collected was analyzed through traditional significance test. Results: The study reported that community health programs and initiatives on NCDs, patient support groups, culture and misinformation influence NCD literacy levels. The study findings indicate that culture and misinformation, patient support groups, and community health programmes and initiatives are three key components that need to be considered when improving NCDs literacy levels. Conclusion: The study also concludes that IPAB project helped boost the resident’s knowledge and understanding of NCDs. The findings of this study offer critical insights to Vihiga County Government to tailor their NCDs advocacy programs to fit local context thereby enhancing the knowledge and understanding on NCDs.

COVID-19 Care Challenge in Refugees Residing in the Islamic Republic of Iran

Background. The first cases of COVID-19 disease in the world, and thus its prevalence in Iran, caused numerous public health issues and significantly hampered the provision of health services. Due to its particular geographical location, Iran is among the ten most refugee-hosting countries in the world. These populations have been living in different rural and urban areas of Iran for the last four decades. This study aimed to determine the care challenges of COVID-19 in a population of refugees and foreign immigrants. Methods. This article is based on the reports of the rapid response teams of the Ministry of Health and Medical Education (MOH) and the visits made to the accommodations for refugees and foreign immigrants in the country's provinces. Results. According to studies, refugees and foreign immigrants face several challenges in receiving standard health services which are mainly related to low insurance coverage, a low level of literacy and health literacy, a reluctance to use health services, a large family size, overpopulated households, and living in poor conditions, as well as ignoring early symptoms of disease and referring to health centers in an emergency. Conclusion. According to the results, organizing the housing of foreigners and immigrants and increasing insurance coverage are the leading health priorities. Regarding the common culture and language, regular planning should be done to attract these populations’ participation.

Effective Approaches to Combat Vaccine Hesitancy.

Effective Approaches to Combat Vaccine Hesitancy.

A narrative review of patient education in emergency departments: challenges and solutions

Patient education in emergency departments faces complexities and challenges due to the wide variety of clinical care provided in this setting. Despite widespread recognition of the value and benefits of education, we frequently see that patient education in hospital emergency departments is less than optimal and that emergency departments are not employed as venues conducive to providing suitable and effective patient education. This study was conducted to ascertain the issues associated with patient education in emergency departments and the most relevant solutions. In this narrative review, the data were collected by searching the keywords patient education, emergency department, emergency medical services, health education, challenges of patient education, the importance of patient education, and barriers to patient education in Persian and English both separately and in combination using Boolean operators. The databases comprised Sid, Iranmedex, Magiran, Pubmed, Elsevier, Medlin, and Scopus, as well as the Google Scholar search engine. Sixty-five full-text articles were included in the study based on inclusion and exclusion criteria. Results from the review of articles revealed that hospital emergency departments face challenges in educating patients, including environmental factors (overcrowding, lack of time), patients’ low health literacy levels, communication skills, nurses’attitudes, and interest in patient education, and nurses’ scientific knowledge. To revive and enhance patient education, nursing managers and emergency department nurses should work proportionately to the current challenges by developing novel, innovative approaches or implementing appropriate practical solutions that will drastically alter how this critical issue is carried out in hospital emergency departments.

Effectiveness of a health literacy intervention based on transformative learning and incorporating positive psychology on health behavior and well-being of Thai families with NCDs risk.

Background: Thailand has a higher global non-communicable disease (NCD) mortality rate in comparison to the rest of the world, accounting for 75% and 71% of all deaths. WHO focused increasingly on health literacy (HL) in order to decrease NCDs. This study aimed to assess the effectiveness of an HL intervention utilizing transformative learning and positive psychology with mindfulness training in terms of changing levels of HL, health behavior (HB), and health outcomes.Design and methods: The study was a randomized control trial from May to September 2019. The participants were a rural Thai population with low levels of HL, living in an area with high levels of NCDs. The 200 participants were cluster randomly allocated to an eight-week intervention, and the control group. The data were collected by Likert questionnaires and physical exams, and analyzed via ANOVA.Results: The intervention group mean scores for HL, psychological capital, HB, and family well-being increased from baseline to post-intervention, but decreased during the follow-up but were still significantly higher than the control group and baseline scores. The increases in HL and HB were matched by improvements in physiological measurement. The BMI scores of the intervention group decreased in each phase, while the control group scores remained largely unchanged. An intervention group had significantly lower fasting blood sugar than the controls at the intervention and in the follow-up. There was no interaction between social support and any other variables.Conclusions: This program demonstrated improvements in HL, HB and the well- being of Thai families at risk of NCDs in rural communities. Significance for public health The WHO highlighted concerns about the rise of NCDs worldwide and tried to establish healthy populations to promote well-being and quality of life. Global conferences on health promotion in Shanghai prioritized increasing health literacy and well-being to decrease NCDs globally as part of a sustainable development agenda. Hence, the improvement in health literacy, family well-being and the good health outcomes of NCD risks were challenge for public health providers as changing health behaviors of individuals and communities. This study confirmed that the most often used health literacy and mindfulness-based intervention via the transformative learning process can provide effective alternative therapies and controlling BMI, blood pressure, and blood sugar for NCD risks worldwide, especially Asian people in endemic areas of hypertension and diabetes. This health literacy intervention can contribute to all health providers for their effective health care services.

IDF21-0509 Concerns about cardiovascular complications among type 2 diabetes mellitus patients: a qualitative approach

Background: Cardiovascular (CV) disease is the leading cause of death and morbidity in individuals living with type 2 diabetes mellitus (T2DM). T2DM is associated with a higher risk to develop CV disease. However, identifying factors representing a significant concern for individuals living with T2DM remains to be investigated. Understanding people's concerns and the impacts of diabetes on various aspects of life is critical to meet individual healthcare needs and develop a patient centric approach. The CONCORDIA study evaluates individuals living with T2DM main concerns, impacts on their lives, and factors individuals most value in their health care, confronting them with the perspective of the health care professionals (HCPs). Aim: In this CONCORDIA sub-analysis we have identified main concerns related to cardiovascular complications of Diabetes and compared perspectives between individuals living with T2DM, in different stages of disease, and HCPs. Method: Five focus groups were conducted: two with HCPs (physicians and nurses) and three with individuals living with T2DM in different stages of disease, using a semi-structured format. The study was implemented at Portuguese Diabetes Association (APDP), and an intentional sampling was used to maximize the differences within participants' characteristics. Individuals living with T2DM were grouped according th the following criteria: G1-diagnosed at least 12 months ago without complications; G2-diagnosed at least 12 months ago with minor complications (CKD stage 3a and R1 retinograms) or G3- with major complications (patients followed by a nephrologist and/or undergoing laser treatments and/or intravitreal injections in Ophthalmology). Data were transcribed and analyzed using thematic analysis. Results: Forty-seven items of concerns were identified and grouped into fourteen themes. Twelve items of concerns were identified within “complications” theme, three of them specifically related to CV complications - blood pressure, stroke, and heart problems. Stroke and heart attacks were only mentioned by HCPs. Regarding individuals living with T2DM, CV and blood pressure concerns were only identified in the “complications” theme. Despite being a risk factor for CV disease, in this analysis blood pressure was considered a concern. Blood pressure was only mentioned by the group of individuals with T2DM with major complications. Moreover, individuals living with T2DM refer heart problems in an unspecific way, showing relative difficulty in differentiating risk factors from actual CV disease. Discussion: The results revealed that concerns related to CV complications, such as heart problems, blood pressure, and stroke, were not the most mentioned and when verbalized were done so in a general and unspecific way by individuals living with T2DM. This data is the first step in the development of a questionnaire that aims to assess concerns, compare perspectives, and analyze differences in two different scopes of a complex disease like T2DM. In conclusion, even if CV disease is the first cause of death among individuals living with T2DM, it is rarely referred as a concern in this population. It is extremely important to understand if this lack of awareness could be a problem of communication among stakeholders increased by a low health literacy level, within the scope of T2DM’s complex picture.

A Smart Mobile App to Simplify Medical Documents and Improve Health Literacy: System Design and Feasibility Validation.

BackgroundPeople with low health literacy experience more challenges in understanding instructions given by their health providers, following prescriptions, and understanding their health care system sufficiently to obtain the maximum benefits. People with insufficient health literacy have high risk of making medical mistakes, more chances of experiencing adverse drug effects, and inferior control of chronic diseases.ObjectiveThis study aims to design, develop, and evaluate a mobile health app, MediReader, to help individuals better understand complex medical materials and improve their health literacy.MethodsMediReader is designed and implemented through several steps, which are as follows: measure and understand an individual’s health literacy level; identify medical terminologies that the individual may not understand based on their health literacy; annotate and interpret the identified medical terminologies tailored to the individual’s reading skill levels, with meanings defined in the appropriate external knowledge sources; evaluate MediReader using task-based user study and satisfaction surveys.ResultsOn the basis of the comparison with a control group, user study results demonstrate that MediReader can improve users’ understanding of medical documents. This improvement is particularly significant for users with low health literacy levels. The satisfaction survey showed that users are satisfied with the tool in general.ConclusionsMediReader provides an easy-to-use interface for users to read and understand medical documents. It can effectively identify medical terms that a user may not understand, and then, annotate and interpret them with appropriate meanings using languages that the user can understand. Experimental results demonstrate the feasibility of using this tool to improve an individual’s understanding of medical materials.

Barriers to the use of mental health services by Syrian refugees in Jordan: a qualitative study.

More than 650 000 Syrian refugees are hosted in Jordan. Refugees are at high risk of mental health problems. To explore the perspectives of Syrian refugees and their host communities and community leaders in Jordan on barriers and facilitators to the use of mental health services by Syrian refugees. A qualitative descriptive design was used to collect data through individual, semistructured interviews conducted between May and December 2019 in Jordan. A purposive sample was recruited from different sites. Twenty-four individual interviews were conducted: 16 for the clients and 8 for the community leaders. Three themes emerged as barriers to accessing mental health services: (1) lack of awareness of mental illness and available services; (2) availability, accessibility and affordability of mental health services; and (3) stigma and social discrimination. Findings show that respondents had low mental health literacy levels. Policy-makers, care providers and decision-makers should take the findings of this study into consideration by facilitating the use of mental health services through awareness-raising about mental illness and the provision of services at primary health care centres. Making the service available near to the people who require it and incorporating mental health services into a broad-based community environment such as schools, primary health centres, or case management system are recommended as a common strategy that could help address refugee needs.

Parents of children with epilepsy: Characteristics associated with high and low levels of health literacy

Parents of children with epilepsy play a key role in the management of their child’s condition. Their level of health literacy (HL), which refers to their ability to seek, understand, assess, remember, and utilize health information, is essential for handling the child optimally. The aim of this study was to investigate characteristics associated with high and low levels of different dimensions of HL in parents. HL was assessed with the multidimensional Health Literacy Questionnaire (parents’ version) and the electronic Health Literacy Scale, using data from a cohort of 254 parents of children <12 years. Bivariate correlation and multiple hierarchal linear regression (STATA version 16 SE) were used to investigate variables associated with HL. Self-efficacy (St. β = 0.14–0.34) was the only variable that predicted higher scores on every HL scale. Being older than 35 years (St. β = 0.18–0.21), level of education (St. β = 0.16–0.27), and the child having a coordinator of services (St. β = 0.16–0.28) were associated with higher scores, while sick leave due to the child’s epilepsy (St. β = −0.13 to −0.16), child comorbidities (St. β = −0.15 to −0.19), and higher levels of mental distress (St. β = −0.13 to −0.19) were associated with lower scores in several of the different HL dimensions. A total of 44.8% of the parents scored over the cutoff (≥1.85) predicting a mental disorder on the Hopkins symptom checklist. This is the first study to investigate multidimensional parental HL in a childhood epilepsy context. Our results highlight the need to investigate multiple variables, especially mental distress, to determine characteristics that may predict low parental HL. Further qualitative studies are needed to explore the underlying reasons for the parents’ HL scores and to develop inventions tailored to meet different HL needs.

Diagnostics Literacy Advocacy Model for Vulnerable Populations

Evidence shows that vulnerable populations have lower levels of health literacy, resulting in poor health-seeking behavior and poor uptake of diagnostics. Being health literate promotes health care-seeking behavior and improves engagement with diagnostic services. In this editorial, I define health literacy in the context of access to technology for enabling disease screening, diagnosis and linkage to care. I refer to health literacy in this context as diagnostics literacy. The COVID-19 pandemic has taught us that vulnerable populations are disproportionately disadvantaged by the disruptive measures put in place to control the spread of the virus. Many vulnerable populations are still experiencing short-and longer-term socio-economic consequences. I propose a multi-level diagnostics literacy advocacy model to help improve diagnostic uptake among vulnerable populations.

Periodontitis-Related Knowledge and Its Relationship with Oral Health Behavior among Adult Patients Seeking Professional Periodontal Care.

Background: Periodontitis is a chronic inflammatory disease that not only damages the stomatognathic system, but may also adversely influence other systems and organs. Patients with low oral health literacy levels are more prone to gingivitis/periodontitis and have a more severe disease course. Methods: A written questionnaire was carried out to assess the knowledge of patients of the Outpatient Clinic of Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, Poland. The questions concerned knowledge regarding the causes of periodontal disease, its risk factors, and the connection between periodontal disease and general health status. To analyze the population, patients were divided according to gender, age and if they were first-time or regular outpatients. Results: Written questionnaires were completed by a total of 302 patients. In the studied population, we noted knowledge deficits, particularly related to weaker periodontal disease risk factors (stress, diabetes, osteoporosis, obesity) and the genetic factor, which is the determinant of periodontitis. The patients’ awareness of the role of plaque bacteria and the effect of smoking on the periodontium was at a relatively high level. The respondents were also aware of the impact of periodontal disease on general health as well as the role of oral hygiene in preventing the disease. At the same time, few of them (26%) used interdental brushes or an irrigator (8%). Conclusions: We demonstrated that patients have an insufficient level of knowledge related to risk factors as well as the prevention of periodontal disease. Awareness of the extent of oral health literacy among patients will help to identify key issues connected with health education interventions

Multidimensional health literacy profiles and health-related behaviors in the elderly: A cross-sectional survey

ObjectivesTo investigate health literacy profiles using a multidimensional tool in the elderly, analyze the factors related to health literacy, and explore the relationships between health literacy and health-related behaviors. MethodsA cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha, Hunan Province, between June 2020 and August 2020. We used the Health Literacy Questionnaire (HLQ) to assess the elderly’s health literacy. Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire. Latent profile analysis, Pearson’s chi-squared and ordinal logistic regression were used to analyze the data. ResultsThe median age of the 440 respondents was 68 years. The participants had the lowest scores in the “appraisal of health information” subscale (2.22 ± 0.52), followed by “navigating the healthcare system” subscale (2.89 ± 0.81) of HLQ. Based on the analysis of three profiles, respondents who were 60–74 years (OR = 2.06, 95% CI: 1.23–3.42, P = 0.006), living in urban areas (OR = 3.28, 95% CI: 2.17–4.94, P < 0.001), with secondary education or above (OR = 2.86, 95% CI: 1.92–4.27, P < 0.001), and having health insurance (OR = 1.89, 95% CI: 1.02–3.51, P = 0.042) were significantly associated with health literacy. Statistically significant associations were found between health literacy level and health-related behaviors, including medical service-seeking behavior (χ2 = 25.14, P < 0.001), exercising regularly (χ2 = 34.08, P < 0.001), and taking a medical examination in the past 12 months (χ2 = 24.76, P < 0.001). ConclusionThe multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings. It revealed the relationships of sociodemographic characteristics, including age, education level and residence, with health literacy. These findings emphasized the importance of health literacy in promoting health behaviors, guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.