Health Literacy Measures Research Articles

Measurements of traditional Chinese medicine health literacy regarding chronic pain: a scoping review

AbstractChronic pain is a prevalent health condition that imposes a significant burden on the global health system. Health literacy is a determinant of the quality of pain management which directly impacts public and individual health. However, the existing health literacy measurements have predominantly focused on medical models stemmed from Western culture and the knowledge of non-Western health models has largely been neglected. This review scopes refereed health literacy publications with regard to traditional Chinese medicine and chronic pain to explore and identify 1) the conceptual basis underlying the development of traditional Chinese medicine health literacy in this area, and 2) measurement tools used in this area and their associated psychometric qualities. Twenty-eight journal articles were assessed and the results showed that most studies’ conceptual frameworks were unable to cover three key health literacy aspects defined by the World Health Organization (access, understand, and apply). Furthermore, the identified health literacy measurement tools generally lacked rigorous psychometric evaluation. Future studies should focus on exploring a comprehensive model that encompasses various health models and developing measurement tools with more culturally representative psychometric assessments.

Health literacy and COVID-19 pandemic impacts among adults in rural northern Arizona.

Limited health literacy - the ability to access, process, and use health information and services - contributes to persistent health inequities. Yet little is known about associations of limited health literacy with impacts from the COVID-19 pandemic, particularly for US adults in rural areas. This study sought to determine associations of limited health literacy with impacts from the COVID-19 pandemic among a diverse sample of adults in rural Northern Arizona. A cross-sectional, interviewer-administered survey was conducted with 119 adults from June 2020 to August 2021. Participants were recruited from two federally qualified health centers and by word of mouth. The Newest Vital Sign was used to measure health literacy, and the Epidemic-Pandemic Impacts Inventory was used to measure the effects of the COVID-19 pandemic on various aspects of personal and family life (eg spent more time on screens and devices, had family celebrations canceled or restricted). Descriptive, bivariate, and multivariable linear regression statistics were computed. Nineteen percent of participants had limited health literacy, and participants had an average of 22 individual impacts and 2 household impacts of the 92 COVID-19 impacts assessed. Multivariable regression model results showed that being male versus female or having public only versus any private insurance was significantly associated with fewer individual COVID-19 impacts on average. Being black, Indigenous, people of color versus White or being Hispanic, Latino, or Spanish versus not were each associated with significantly more individual COVID-19 impacts on average. Limited versus adequate health literacy was significantly associated with more household COVID-19 impacts on average. Sensitivity analysis results further showed that limited versus adequate health literacy was associated with significantly higher adjusted rates of household social, emotional, and infection COVID-19 impacts. This study's findings highlight the importance of assessing and accounting for health literacy in clinical practice and health services research addressing the impacts of the COVID-19 pandemic and future emergency events.

1.K. Scientific session: Health literacy of children and adolescents across Europe

Abstract Health literacy is developed throughout the life course. Enhancing health literacy at an early age is especially important since it may impact both current and future health skills and outcomes. Low health literacy in child and adolescent populations has been linked to worse health outcomes and health disparities in Europe, making health literacy of children and adolescents an important public health topic. Developing and delivering targeted interventions and services for these age groups requires insight and data on the development and state of health literacy in early age. However, child and adolescent health literacy is still an under-researched topic. This is partly due to a lack of appropriate measurement instruments and methods to involve children in research. In the past years, new studies on child and adolescent health literacy have emerged in several European countries. In this workshop, innovative studies from Germany, the Netherlands and the UK on HL in childhood and adolescence are introduced and discussed. Both methodological findings as well as empirical data will be presented. In Germany, an instrument to measure child health literacy was developed and validated for primary school children. This instrument, the HLS-Child-Q15, has been used both in Germany and in the Netherlands to study the relationship between children’s health literacy and their health behaviors and outcomes. In the UK, methods of involving primary school children in health literacy research were studied. Experiences with a Children’s Advisory Group will be shared. Another study in the Netherland focuses on the health literacy profiles and needs of adolescent patients with rheumatic diseases. The format of this workshop will be 4x10-minute presentations (including questions) followed by a 20-minute interactive discussion, reflecting on the relevance of these results to further research, health promotion and health services. which will be followed by Q&A and an open discussion with the audiences. This workshop offers a forum for researchers, health educators, practitioners and policy-makers interested in health literacy measurement and research in children and adolescents. Key messages • Child and adolescent health literacy is an important, yet under-researched public health topic. • Child health literacy is an important predictor of their health behavior and outcomes.

Does School Education Improve Children’s Health Literacy? Evidence from a Performance-Based Survey

Abstract Background Children begin using digital sources of health information at a young age and are quickly exposed to a variety of unmoderated health content. Health literacy helps children navigate, understand, evaluate, and act on this content. But is the educational system preparing young people for these tasks? This study develops a validated, performance-based measure of health literacy and applies it to a sample of 9- to 13-year-old children (grades 4 to 7). Methods A performance-based tool to measure children’s health literacy was developed through expert consultation and qualitative and quantitative pretesting. The tool uses vignettes and quizzes and captures three dimensions of health literacy: nutrition, physical activity, and psychosocial health. The validated tool was then used in a cross-sectional survey of Austrian children aged 9 to 13 years (n = 780): Diet, Physical Activity, and Psychosocial Health. Results Results show that the performance-based health literacy scores do not correlate with self-reported scores. Girls (vs. boys) and native speakers perform better on the performance-based literacy test, while boys and children reporting more robust financial backgrounds overestimate their literacy on self-reported questions. Most importantly, the data do not show meaningful increases in performance-based health literacy across grade levels. For nutrition literacy, the study even shows a slight negative trend across grade levels. Conclusions This study questions the heavy reliance on self-reported health literacy, which is often confounded with self-efficacy and social environment. Performance-based instruments are needed to measure health literacy as an educational outcome. This study presents one of the first validated instruments. Most importantly, the study shows that the current educational system may not produce meaningful increases in performance-based health literacy, calling for deeper educational reforms. Key messages • Performance-based health literacy is a distinct concept from the subjective health literacy measures that dominate current health literacy research. • Performance-based health literacy did not increase with grade level, indicating a poor performance of the education system in strengthening health literacy.

Generating qualitative evidence of the validity of the Health Literacy Questionnaire Parent

Abstract Background Health literacy refers to the skills needed to access, understand, and navigate health information and services. The Health Literacy Questionnaire (HLQ) is a widely used validated measure of health literacy capturing nine distinct domains. The HLQ-Parent is a recent adaption of the HLQ which has been designed to capture the nuanced health literacy skills required by primary care givers of children. Generating qualitative evidence of validity of such tools is an important element of the validation process as it captures understanding and interpretation of items which is not achievable by quantitative methods alone. Therefore, the purpose of this study was to generate qualitative evidence of the validity of the HLQ-Parent. Methods A qualitative study implementing the HLQ-Parent during face-to-face cognitive interviews with concurrent probing was conducted. Primary carers of children aged 16 or under living in England were recruited via voluntary organisations supporting families. Qualitative data analysis was conducted on the audio recordings in the form of text summaries. Parents’ chosen HLQ-Parent responses were compared to their narrative responses and coded by the researcher as match, no match or unclear. Parents’ narrative responses were also compared to the HLQ-Parent item intent descriptions and coded as concordant, discordant, or unclear. Results Overall, participants (n = 9, mean age 40 years, 88.9% female) narrative responses matched to their chosen HLQ-Parent response, while their narrative responses were concordant with the HLQ-Parent item intent descriptions. Two participants narratives did not match their responses for the item:’ I have enough information to help me deal with my child’s health’. Conclusions The qualitative data provided evidence that participants understood and answered the HLQ-Parent items as intended. Study results contribute validity evidence for the use of HLQ-Parent to measure parental health literacy. Key messages • This study contributes evidence to the validity of the HLQ-Parent. • Qualitative methods provide valuable insights that enhance the overall understanding of health literacy measurement tools.

Public Health Literacy: a concept to develop – Qualitative study among public health professionals

Abstract Background Health literacy can be defined as individuals’ motivation and skills to access, understand, evaluate, and utilize information to make decisions about their health. Despite Sorensen’s widely used definition encompassing both individual and population levels, also known as Public Health Literacy, it remains poorly detailed and is rarely taken into account by measurement tools. As evidenced by the Covid-19 health crisis, limited public health literacy impacts reluctance to accept government recommendations, vaccine hesitancy, and fosters mistrust of science and conspiracy theories in the health field. The main objective of this study was to derive specific public health knowledge and skills from public health professionals for the general population constituted the first step of the development of a public health literacy measurement tools. Methods A qualitative study, based on ten semi-structured interviews with public health professionals from various settings (academic, hospital, health prevention, and promotion), working across various public health fields (nutrition, sexual health, mental health), has been conducted since March 2024. Results Preliminary analysis identified three main themes: (1) fundamental concepts including identification of health determinants, epidemiology and the purpose of public health interventions, (2) critical skills including the assessment of the level of evidence and reliability of public health information, and (3) civic orientation including environmental impact on health and community approach to interventions. Conclusions These detailed insights will guide the creation of a valid measurement tool for public health literacy. This will facilitate the investigation of specific impacts on people’s adherence to public health interventions or messages and the development of actions targeting literacy in a more holistic manner. Key messages • Specific public health dimensions have been identified to enrich the existed definition of health literacy. • Public health concepts, reliability of public health information and community approach constitute the core of public health literacy.

Associations between maternal health literacy and prenatal micronutrient intake in Hungarian women

Abstract Background Adequate level of health literacy (HL) is an important factor in pregnancy. Low HL may increase the risk of maternal and fetal complications (e.g., gestational diabetes mellitus, low birth weight). This study aimed to measure the levels of maternal HL and its associations with the consumption of folic acid (FoA), vitamin D (VD), and omega-3 fatty acids (FAs) during pregnancy in Hungarian women. Methods The questionnaire-based study was conducted at the Department of Obstetrics and Gynecology, University of Szeged among women who gave birth between June and September 2023 (N = 294). Sociodemographic, lifestyle, conception and pregnancy related questions were asked. HL was measured by the Maternal Health Literacy Inventory in Pregnancy (MHELIP) questionnaire (after the Hungarian adaptation); it contains 48 items representing four subscales (maternal health knowledge, search for maternal health information, assessment of maternal health information, and maternal health decision making and behavior). Data analysis was performed by SPSS 29.0. (Ethical permission: 5351) Results The mean age of women was 31.53 +-4.75 years. During pregnancy 84.5% of women consumed FoA, 61.8% VD and 41.8% omega-3 FAs. The total mean score of MHELIP on a scale 0-100 was 78.93 (95%CI: 77.77-80.08); the score of “search for maternal health information” subscale was the lowest [57.68 (95%CI: 56.20-59.16)], and the score of “maternal health decision making and behavior” was the highest [86.75 (95%CI: 85.62-87.87)]. Omega-3 FAs and VD consumption was significantly higher in women with higher total and subscales mean scores (except “search for maternal health information”), while FoA consumption was significant in case of “assessment of maternal health information”. (The results are preliminary.) Conclusions The association between micronutrient consumption and HL supports that using this tool during pregnancy the mothers who needs more support and health information can be identified. Key messages • The Maternal Health Literacy Inventory in Pregnancy questionnaire is a reliable tool for measuring health literacy in Hungarian pregnant women. • Maternal health literacy plays an important role in the healthier lifestyle, including prenatal vitamin/micronutrient consumption.

Health literacy, nutrition literacy, and B vitamins status in patients with recurrent ischemic heart disease episodes: A hospital-based cross-sectional study

Background: In Oman, ischemic heart disease (IHD) is the most common type of cardiovascular disease, and there are multifactorial causes, including nutritional deficiencies of B vitamins (folate and B12) and health illiteracy. Objective: This study aimed to characterize the health literacy, nutrition literacy, and B-vitamin (folate and B12) status of patients with recurrent episodes of IHD. Methods: This cross-sectional study was conducted over a period of 5 months from February to June 2022. The enrolled study participants had an angiographically proven recurrence of IHD, and they were interviewed using a study questionnaire to identify their sociodemographic data, health status, and nutrition status. Folate and B12 were measured in the sera of the study participants. Results: Most participants were in their middle age (62%), and the frequency of the IHD recurrence was noticed among men, married, and unemployed. The serum values of folate and vitamin B12 were within the normal range among the IHD patients. Health literacy categories were affected by the employment status (χ2 1 = 6.05, P = 0.01), and the binary logistic regression confirmed the statistical significance between employment status and health literacy (odds ratio; 1.7, P = 0.005). Nutrition literacy had a significant difference regarding the education variable (χ2 1 = 8.34, P = 0.004), and the sociodemographic variables were not associated with nutrition literacy. Conclusion: The investigated health and nutrition literacy measures might be used for assessing IHD patients’ literacy and detecting any deficits that needed to be improved.

Health literacy after traumatic brain injury: characterisation and control comparison.

Background Little is known about health literacy in traumatic brain injury (TBI) survivors. The aims of this study were to compare health literacy in individuals with TBI with that of a control group; to examine the association between health literacy in individuals with TBI and demographic, injury, and cognitive factors; and compare the relationship between health literacy and physical and mental health outcomes. Methods A cross-sectional observational study design was used. Adults (≥18years) were recruited from an outpatient research centre in Victoria, Australia. There were 209 participants with a complicated mild to severe TBI at least 1year previously (up to 30years 6months) and 206 control participants. Results Individuals with TBI did not have poorer health literacy than controls (IRR=1.31, P =0.102, CI95% [0.947, 1.812]). Further analysis could not be completed due to the highly skewed Health Literacy Assessment Using Talking Touchscreen Technology - Short Form (Health LiTT-SF) data. Conclusion Health literacy performance in individuals with TBI was not significantly different to controls. Premorbid education may provide a critical cognitive reserve upon which TBI survivors can draw to aid their health literacy. These findings are specific to the Health LiTT-SF measure only and require replication using more comprehensive health literacy measures in culturally diverse samples.

Low caregiver health literacy is associated with non-urgent pediatric emergency department use.

Caregivers with low health literacy are more likely to overestimate illness severity and have poor adherence with health-promoting behaviors. Our primary objective was to relate caregiver health literacy to the urgency of emergency department (ED) utilization. The secondary objective was to explore the relationship between social and demographic characteristics, health literacy, and urgency of ED use. This sub-study was a descriptive cross-sectional survey with health record review. Data were collected from ten Canadian pediatric EDs. Study variables included demographics, visit details, and the Newest Vital Sign measurement of health literacy. ED visits were classified as urgent or non-urgent based on the resource utilization method. The response rate was 97.6% (n = 2005). Mean (SD) caregiver age was 37.0 (7.7) years, 74.3% (n = 1950) were mothers, 72.6% (n = 1953) spoke English as a primary language, 51.0% (n = 1946) had a university degree, and 45.1% (n = 1699) had a household income greater than $100,000. The mean (SD) age of the children was 5.9 (5.0) years and 48.1% (n = 1956) were female. 43.7% (n = 1957) of caregivers had low health literacy. Being a caregiver with a child < 2years old [aOR 1.83 (1.35, 2.48)] and low health literacy [aOR 1.56 (1.18, 2.05)] were associated with greater non-urgent pediatric ED use. Interprovincial variation was evident: Quebec caregivers were less likely to use the pediatric ED for non-urgent presentations compared to Alberta, while those in Nova Scotia, Manitoba, British Columbia, and Ontario were more likely compared to Alberta. Almost half of caregivers presenting to Canadian pediatric EDs have low health literacy, which may limit their ability to make appropriate healthcare decisions for their children. Low caregiver health literacy is a modifiable factor associated with increased non-urgent ED utilization. Efforts to address this may positively influence ED utilization.

Initial development of a sleep health literacy scale

ObjectivesHealth literacy includes the skills necessary for effective communication with health professionals, understanding health instructions, and recognizing health needs. Our study aimed to create a novel measure of sleep health literacy—an individual's capacity to comprehend sleep-related information and navigate sleep-related healthcare services. MethodsThe Sleep Health Literacy scale consists of two subscales: “Sleep Health Communication” (11 Likert-scale items assessing access to resources and communication with healthcare providers) and “Sleep Health Knowledge” (46 true/false items assessing specific knowledge of sleep health). The Sleep Health Literacy scale was completed by 154 undergraduate students (mean age=20.96years; 79.87% female) in study 1. In study 2, an additional sample of 251 participants (mean age=20.23years; 79.87% female) completed the Sleep Health Literacy scale, along with measures of convergent and discriminant validity. ResultsExploratory factor analysis results in study 1 revealed a two-factor structure for the “Sleep Health Communication” subscale (“comprehension” and “critical application”). The subscale demonstrated good internal consistency (α = 0.81) and inter-item and item-total correlations. On the “Sleep Health Knowledge” subscale, participants answered 76.36% of items correctly. In study 2, the Sleep Health Literacy had good convergent validity with Sleep Beliefs Scale and the All Aspect of Health Literacy Scale. ConclusionsThe Sleep Health Literacy scale offers a standardized measure to assess sleep health literacy, an understudied domain that has important links to health. This measure may allow researchers and clinicians to better understand how to improve sleep health. Further validation of the Sleep Health Literacy scale is warranted in more diverse samples.

Health literacy in adolescents and young adults in Benin: French translation and validation of the health literacy measure for adolescents (HELMA).

The Health Literacy Measure for Adolescents (HELMA) is a self-assessment validated tool used to measure health literacy in adolescents. This study aims to evaluate the psychometric properties of the French translation of the Health Literacy Measure for Adolescents (F-HELMA). The HELMA questionnaire was translated according to the World Health Organization's (WHO) recommendation for translation and adaptation of instruments. It was pre-tested with 30 students. Subsequently, 495 adolescents and young adults from five senior secondary high schools in Benin completed the questionnaire. A sample of 44 participants completed the questionnaire twice over a 2-week period to determine the test-retest reliability. Construct validity was evaluated using confirmatory factor analysis (CFA) and convergent validity was analyzed the Health Literacy Assessment Tool. The F-HELMA-French translation of the Health Literacy Measure for Adolescents, showed moderate to good psychometric properties. CFA showed good fit indices for a seven-factor model. Reliability figures fell within an acceptable range; Cronbach's alpha ranged from 0.64 (moderate) to 0.89 (good) across the different subscales, and the intraclass coefficient (ICC) ranged from 0.82 to 0.96, indicating good test-retest reliability. Pearson correlation with HLAT-8 showed good convergent validity (r = 0.54, p < 0.001). This study provides support for the use of the F-HELMA, as a valid and reliable instrument to measure health literacy in adolescents and young adults in West African French speaking countries.

Neuropsychological and Health Literacy Correlates of Science Knowledge Among Older and Younger Healthy Adults.

Science knowledge refers to the depth and breadth of facts acquired within the life, social, and earth sciences, and it has implications for both public and personal health. Drawing from cognitive aging theory, we examine whether levels of science knowledge are associated with age, neuropsychological functioning, and personal health literacy. Fifty-two younger and fifty older healthy adults completed our telephone-based study that included a commonly used test of science knowledge, as well as measures of neuropsychological functioning, health literacy, and relevant descriptives (e.g., mood). Adjusting for other demographics and neuropsychological functioning, older adults had significantly lower science knowledge test scores than younger adults. In the full sample, lower science knowledge showed medium-to-large associations with episodic memory, executive functions, and health literacy, independent of years of education. These results suggest that older adults' science knowledge falls slightly below that of their younger counterparts and is independently associated with higher order neuropsychological functions and aspects of personal health, which may have implications for accessing, understanding, and using relevant public health information across the lifespan.

A - 7 An Examination of the Predictive Roles of Healthy Literacy and Age in Online and Print Health Information Search Performance among Older Adults

Abstract Objective As older adults increasingly seek health information online, evaluating complex technology-based everyday behaviors is important. This study examined the predictive roles of health literacy and age in health information search accuracy across online and print sources. Methods Participants were 96 community-dwelling older adults (age: M = 70.09, SD = 8.69; education: M = 16.57, SD = 2.14; 75% female; 96.88% White). Participants completed the Newest Vital Sign, a health literacy measure that required participants to interpret verbal and numerical information on a nutrition label, and a health search task (HST), which examined the ability to navigate web and print sources to search for health information. Results A multiple regression was conducted in which HST accuracy was regressed onto health literacy and age for web and print subtasks separately. Cognitive status (MoCA total score) was a covariate. Although health literacy was not a significant predictor of HST accuracy, age was a significant predictor for the web-based subtask, β = −0.29, b = −0.05, SEb = 0.02, 95% CI [−0.08, −0.02], t(92) = −2.94, p = 0.004, and cognitive status for the print-based subtask, β = 0.36, b = 0.18, SEb = 0.05, 95% CI [0.08, −0.28], t(92) = 3.50, p = 0.001. Conclusions Compared to health literacy, age and cognitive status were stronger predictors of health information search performance across online and print sources in community-dwelling older adults. Future studies should consider the impact of age and comfort with technology in examining older adults’ ability to successfully navigate online health sources.

The society human immunodeficiency virus health literacy scale: the development and psychometric assessment

Society human immunodeficiency virus (HIV) related health literacy is an essential behavioural skill that contributes to understanding the disease and responding to people living with HIV. Measuring HIV health literacy in the community requires reliable tools to produce an objective health literacy index. This study aimed to design and examined the society HIV health literacy scale's (SHIVAL) psychometric properties. A cross sectional study was conducted on 381 people without HIV. Sample recruitment used convenience sampling. Instrument development and psychometric analysis include item pool construction and content validity examination, consistency reliability test, and exploratory and confirmatory factor analysis. A standardized four factor model fits the HIV health literacy measure well. This scale has 15 items with good Cronbach's Alpha reliability index and content validity index. The final SHIVAL Scale has been determined reliable and appropriate for measuring health literacy related to HIV. Nurses or healthcare professionals can use this scale to predict an individual's HIV health literacy, thereby influencing the social intervention of HIV disease and enabling effective community health literacy strategies.

Adaptation and validation of the Chinese Health Literacy Scale for Low Salt Consumption—Hong Kong (CHLSalt-HK) for Malaysian Population

High consumption of sodium is often associated with an increased risk of hypertension, heart disease, and premature death. Thus, it is vital to have comprehensive data on knowledge, practices, and health literacy levels pertaining to sodium intake for strategized and informed public health initiatives. This study aims to adapt and validate the Chinese Health Literacy Scale for Low Salt Consumption &amp;ndash; Hong Kong population (CHLSalt-HK) instrument to be used as assessment tool on health literacy pertaining to salt intake among Malaysian adults and this paper reports the translation and validation process of the instrument. The original CHLSalt-HK in English was translated to Malay by using forward-backward translation, and the preliminary version was obtained with cross-cultural adaptation based on review by three technical experts. A cognitive testing was conducted among 30 patients based on sociodemographic differences such as ethnicity, location, and education level. Their feedback was gained pertaining to comprehension of the instrument in terms of language and terminologies used, the flow and clarity of the instructions, and the questions given. The improvised version of the instrument was then pre-tested among 200 adults&amp;rsquo; respondents in Klang Valley for the reliability purposes. The internal consistency of the instrument was acceptable, with Cronbach&amp;rsquo;s alpha values ranging between 0.624 and 0.830 and 0.825 for the entire instrument. The temporal stability was good, and the intraclass correlation coefficient was &amp;gt;0.6. The adapted and translated version CHLSalt-HK demonstrates adequate psychometric properties for measuring health literacy pertaining to salt intake among Malaysian populations.

Impact on step count by commitment-based health application.

Prior research has implied that promoting sustaining physical activity through nudges is challenging and boosting health literacy is important for the long-term establishment of behaviors. This study aimed to investigate the effects of commitment-based health application on step count and health literacy. A control experiment was conducted involving employees from companies located in Shizuoka Prefecture, Japan. Participants were divided into three groups: the commitment app group (utilizing a commitment-based application "Minchalle," where teams of around five members were randomly assigned to declare a target step count and report daily step count with pictures), the self-commitment group (individuals declaring a target step count and endeavoring on their own), and the control group (no intervention). Changes in step count and health literacy were examined over one month. A total of 109 employees from 7 companies participated. The changes in step count were an increase of 893 steps for the commitment app group, 243 steps for the self-commitment group, and 178 steps for the control group, with a significant increase in the commitment app group compared to the control group. Regarding health literacy measures, there was significant progress in four items out of five for the commitment app group compared to the control group, and significant progress in one item for the self-commitment group compared to the control group. Communication within the app teams, such as commitment, sharing photos of their goal achievements and provide encouraging comments to others, functioned as social nudges, suggesting the potential for an immediate increase in step count and long-term behavioral reinforcement through improved health literacy.

Measuring health literacy to inform actions to address health inequities: a cluster analysis approach based on the Australian national health literacy survey.

Measuring health literacy can inform interventions to address health inequities. This study used cluster analysis to examine health literacy data to determine if it can provide more insightful information than standard descriptive analysis to better inform intervention development. Using data from the Australian National Health Survey (2018), this study compared descriptive analysis and cluster analysis results of two states-New South Wales (NSW) and Victoria-generated from the Health Literacy Questionnaire (HLQ). Based on the nine scale scores of the HLQ, a hierarchical cluster analysis using Ward's method for linkage was undertaken. The number of NSW and Victoria respondents was 1018 and 923, respectively. The nine HLQ scale full sample mean scores from both states were similar. However, the cluster analyses identified 11 clusters for NSW and 12 clusters for Victoria. While six clusters from each state presented similar health literacy patterns, five and six clusters from NSW and Victoria, respectively, displayed unique health literacy patterns. The results demonstrate that descriptive analysis only provides an overview and may lead to one-size-fits-all interventions. The varying health literacy patterns among subgroups resulting from the cluster analysis pave the way to inform tailored actions to improve health equity.

Reproductive and sexual health literacy and associated factors among late-adolescent high school students in Arba Minch and Sawla towns, Southern Ethiopia, 2023: a cross-sectional study

BackgroundAdequate literacy in reproductive and sexual health is essential for adolescents to obtain, comprehend, evaluate and apply information necessary for making well-informed decisions, as low literacy leads to harmful decision-making,...

Validating the short-version European Health Literacy Survey Questionnaire for community-dwelling older adults in Japan.

The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is available in multiple languages, and shortened versions have also been developed. This study aimed to examine the reliability and validity of the short version of the questionnaire (HLS-Q12) developed for community-dwelling older adults in Japan. The HLS-Q12 was developed using 12 of the 47 items of the Japanese version of the HLS-EU-Q47. In this study, the survey was conducted by distributing self-administered questionnaires to community-dwelling individuals aged 65 years and older who consented to participate; their responses were collected by mail. The correlation between the HLS-Q12 and the HLS-EU-Q47 was tested to assess criterion validity. To test construct validity, nine novel hypotheses were proposed. We also conducted a confirmatory factor analysis of the HLS-Q12. Based on a resurvey after 5-7 days, test-retest reliability was examined using interclass correlation coefficients (ICCs) and Bland-Altman analysis. In total, 118 individuals provided valid responses to the questionnaire. The Spearman rank correlation coefficient between the HLS-Q12 and the HLS-EU-Q47 was r = 0.98 (p < 0.001), and eight of the nine hypotheses were supported. The ICC was 0.96 (p < 0.001), and the 95% limit of agreement was -0.26 ± 5.9, suggesting no systematic error. Thus, the Japanese version of the HLS-Q12 was found to be reliable with high criterion validity and reproducibility. Hence, the HLS-Q12 is a useful scale for measuring health literacy among older adults in Japan.