Understand Health Information Research Articles

Health Literacy among Undergraduates in Selected Faculties of Eastern University, Sri Lanka

A healthy life is a wealthy life. To be healthy, everyone has to understand the basic health information that is needed to make appropriate health decisions, which can aid them in avoiding illness and safeguarding their health. In this context, the necessity of health literacy which is a type of information literacy is being considered. Health literacy is the understanding and use of health information effectively to make appropriate decision making. The study aimed to evaluate the health literacy level of undergraduates of Eastern University, Sri Lanka, and the factors influencing health literacy. A cross-sectional study was carried out among undergraduates in selected faculties of Eastern University, Sri Lanka. A validated standard questionnaire called “Health Literacy Instrument for Adults (HELIA)” was adopted to collect online data from 1085 individuals. The data were analyzed using descriptive statistics and binary logistic regression. The results revealed that the mean score of overall health literacy is 65.7±13.5% which ranges between somewhat inadequate to sufficient ranks. The analysis considered the five domains of health literacy. Accordingly, a significant proportion (p<0.05) of undergraduates had adequate literacy skills for understanding health information (67.4%), and access to health information (73.7%), while the majority had a limited level of literacy for domains of reading (53.7%) and appraisal (84.1%). However, there is no significant deviation (p>0.05) between adequate and limited levels in the domain of decision-making/behavioural intention. The difference between the proportion of adequate (50.8%) and limited levels (49.2%) in overall literacy is not significant (p>0.05). The binary logistic regression proved that the health literacy of undergraduates is influenced by faculty, alcoholic habits and doctor’s advice (p<0.05), while age, gender, family income, family members who work in the healthcare field, academic year, respondents' perceptions of their health, and smoking habits, do not influence on health literacy.

IJCM_133A: E- Health Literacy and Satisfaction regarding Medical Care among Patients attending a Tertiary Care Hospital in Mangalore

Background: Health literacy is crucial for understanding health information and making informed decisions. It encompasses the ability to obtain, process, and understand basic health information. Factors like education, income, and age influence health literacy, impacting health outcomes negatively when low. E Health literacy extends to navigating electronic health resources. Patient-doctor communication suffers when doctors overestimate patient literacy. Poor health literacy leads to misunderstandings, medication errors, and poorer health outcomes. In today’s healthcare landscape, patient satisfaction is key. Understanding the link between eHealth literacy, communication, compliance, and satisfaction is vital. The study aims to evaluate patients’ e-health literacy levels, evaluate the degree of patient satisfaction with healthcare services, to ascertain the relationship between patient satisfaction and eHealth literacy. Methodology: The study involved 234 patients who visited the hospitals affiliated to Kasturba Medical College, Mangalore. eHealth literacy was assessed using eHEALS, patient satisfaction was assessed using Patient Satisfaction Questionnaire Short Form (PSQ-18). The correlation between eHealth literacy scores and patient satisfaction scores was tested using Pearson correlation coefficient where P is less than 0.05 was considered statistically significant correlation. Results: Preliminary findings suggest that majority of the participants found the Internet to be useful in making decisions about health. The results of our study show that 65% of our participants have good eHealth literacy and 27.8% have moderate literacy. The comparison of patient satisfaction based on eHealth literacy showed that there was no significant difference in patient satisfaction between participants who had good literacy or poor literacy. Conclusion: Both eHealth Literacy and Patient Satisfaction among our study participants were good, however there was no correlation found between eHealth Literacy and Patient Satisfaction.

Subjective health status and health literacy of African refugees and asylum seekers in Germany: a cross-sectional survey

Purpose Many refugees and asylum seekers in Germany experience a high disease burden and low health literacy. The current study aims to focus on assessing these issues among African refugees and asylum seekers in Bavaria, Germany. The authors evaluated their self-perceived health status and health literacy, and identified barriers and gaps in health care utilization, intending to improve health care services for this group. Design/methodology/approach The authors conducted a cross-sectional, questionnaire-based study involving 69 refugees and asylum seekers from Ethiopia, Eritrea and Nigeria. The authors performed descriptive and exploratory statistical analyses. Findings The authors found a substantial disease burden in the early stages of resettlement in Germany, particularly mental health symptoms (53.6%) and musculoskeletal problems (47.8%). Challenges in health literacy were observed, such as difficulties in understanding health information and managing emergency situations. Access to interpreters was limited, and understanding treatment certificates was more challenging than using electronic health cards, with 18.2% of participants reporting denial of medical treatment. Practical implications These findings highlight the need for early and tailored health support for refugees, with a particular focus on mental health. Efforts should be made to reduce language barriers and improve navigational skills within the health-care system, particularly in emergency situations. Addressing the restricted access to health care and bureaucratic obstacles is crucial for improved health outcomes among refugees. Originality/value To the best of the authors’ knowledge, this research is the first to specifically explore the self-reported health status and health literacy of African refugees and asylum seekers in Bavaria, Germany, providing valuable insights into the unique healthcare challenges of this often underrepresented and overlooked population.

Barriers to COVID-19 Vaccination in a Troop of Fleet Antiterrorism Security Team Marines: Observational Study.

In 2019, the World Health Organization declared the reluctance to vaccinate despite the availability of vaccination services as one of the top 10 threats to global health. In early 2021, self-reported reluctance to vaccinate among military personnel might have been considered a significant threat to national security. Having a choice architecture that made COVID-19 vaccination optional rather than required for military personnel could have inadvertently undermined military readiness if vaccination uptake did not reach an acceptable threshold. The purpose of this observational study was to examine Marines' self-reported reasons for planning to decline the COVID-19 vaccine to understand their barriers to vaccination. As the vaccination became available to 1 company of Fleet Antiterrorism Security Team (FAST) Marines in early 2021, company command required those planning to decline vaccination to write an essay with up to 5 reasons for their choice. These essays provided the data for this study. Qualitative descriptive analysis with elements from grounded theory was used to thematically categorize FAST Marines' written reasons for planning to decline the COVID-19 vaccine into a codebook describing 8 key behavioral determinants. Interrater agreement among 2 qualitatively trained researchers was very good (κ=0.81). A troop of 47 Marines provided 235 reasons why they planned to decline the COVID-19 vaccine. The most frequent reasons were difficulty understanding health information (105/235, 45%), low estimates of risk (33/235, 14%), and fear of physical discomfort (29/235, 12%). Resulting interventions directly targeted Marines' self-reported reasons by reducing barriers (eg, normalized getting the vaccine), increasing vaccine benefits (eg, improved access to base gyms and recreational facilities), and increasing nonvaccine friction (eg, required in writing 5 reasons for declining the vaccine). Understanding the barriers military personnel experience toward COVID-19 vaccination remains critical as vaccine acquisition and availability continue to protect military personnel. Insights from subpopulations like FAST Marines can enhance our ability to identify barriers and appropriate intervention techniques to influence COVID-19 vaccination behaviors.

Communication in Healthcare Discourse: A Cultural and Linguistic Exploration of Exchanges between Healthcare Practitioners and Patients among Jukuns of Nigeria

This paper explored the cultural and linguistic aspects of health exchanges between healthcare practitioners and patients among the Jukuns of Wukari in Nigeria, within the health centres in the town. It focused on patient-healthcare-provider dynamics and found out how language and culture influenced healthcare communication within formal settings. Integrating ethnographic, sociolinguistic, and anthropological approaches, the study unveiled how language and culture impacted interactions and health-seeking behaviours in these centres. It revealed the roles of language and culture in understanding health information, healthcare provider-patient exchanges, and treatment adherence within the distinct sociolinguistic context of the Jukun. Using such qualitative techniques as interviews and observations in the health centres, the study captured the intricate verbal and nonverbal communication, specific cultural discourse patterns, and communication strategies used by patients and healthcare practitioners. Findings highlighted diverse cultural and linguistic methods employed by Jukuns, such as using proverbs, ironies, metaphors, and nonverbal cues, to express themselves in healthcare settings. The research showed that these methods could facilitate communication with familiar practitioners but might complicate interactions with those from different ethnic backgrounds. Ultimately, it offered crucial perspectives for refining healthcare provision, aligning with the precise linguistic and cultural contexts of the Jukun community within formal healthcare settings in Wukari and other parts of Jukunland. Based on the foregoing, the researchers recommended that health practitioners should make use of interpreters and familiarise themselves with the cultural and linguistic norms of their immediate communities for effective health discourse that would enhance quality healthcare delivery.

Health literacy in adult patients with atopic dermatitis: A cross-sectional study

BackgroundHealth literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make appropriate health decisions. Patients with limited health literacy are less likely to manage chronic diseases appropriately. ObjectiveTo assess the prevalence of limited health literacy in patients with atopic dermatitis (AD), and its association with other patient-reported outcomes. MethodsA cross-sectional questionnaire-based study was conducted at a tertiary referral centre for AD. Patients diagnosed with AD by a dermatologist between 2019 and 2021 were identified from medical records. Perception-based health literacy was assessed by the European Health Literacy Survey Questionnaire 16 (HLS-EU-Q16) and performance-based health literacy by the Newest Vital Sign (NVS). Patients completed the Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), and Atopic Dermatitis Control Tool (ADCT) to measure AD severity, quality of life and AD disease control, respectively. ResultsIn total, 322 patients were included (response rate 48.3%). Based on the HLS-EU-Q16, 32.4% had limited health literacy (8.4% inadequate and 24.0% problematic) which was associated with impaired quality of life. According to the NVS, 20.3% had inadequate health literacy which was associated with older age. ConclusionUp to one-third of the patients with AD showed signs of limited health literacy, which was associated with impaired health related quality of life and older age. Further research should evaluate the influence of inadequate health literacy on health outcomes and focus on strategies to improve organizational health literacy to eventually enhance patient-centered care.

The Impact of Social Determinants of Health on Australian Women's Capacity to Access and Understand Health Information: A Secondary Analysis of the 2022 National Women's Health Survey.

The ability to access, understand, judge, and use health information is crucial for making informed decisions about health and optimal health outcomes. This secondary data analysis investigated associations between social determinants of health and Australian women's ability to access and understand health information using data from 10,652 women who responded to the 2022 National Women's Health Survey. A score (0-5) was created based on five questions assessing the participants' ability to access and understand health information, which was dichotomised into low (≤3) and high (≥4) scores. The data were analyzed using descriptive statistics, univariate comparisons, and multivariable binary logistic regression. Almost a quarter of the women had a low score. Non-native English speakers were approximately four times more likely to have low health literacy than native English speakers. Additionally, women without tertiary education, financially disadvantaged women, and First Nations women were almost twice as likely to have lower health literacy than other women. These findings suggest that social determinants of health decrease the capacity to access and understand health information. To reduce health inequalities, healthcare systems and health professionals must consider the factors that reduce women's capacity to access and understand health information and address the health information needs of socioeconomically disadvantaged women.

Health literacy of home care service professionals in a Brazilian capital

Objective: To evaluate professionals working with healthy literacy in the Home Care Service (HCS) in a Brazilian capital. Method: This was a cross-sectional, analytical study of 29 professionals working in the HCS, using a sociodemographic questionnaire and the Brazilian version of the Health Literacy Questionnaire (HLQ). Results: Most respondents were female (93.10%), licensed practical nurses (31.03%); had another employment relationship (53.57%); daily workload of 12 hours (37.93%); parents schooling elementary level (34.48%); had a reading habit (86.21%); average amount of reading (48%). Limitations were identified in the scales "Sufficient information to take care of health" and "Social support for health". Strenghts were related to "Understanding health information and knowing what to do" and "Ability to find good health information". Conclusion: The disseminate the theme among HCS professionals, enabling reflection on the care offered to patients and caregivers in home care, as well as improving the approach and communication between professionals and caregivers.

COVID-19-related health literacy and preparedness to what may come: a cross-sectional study

BackgroundSince the first report of COVID-19 in 2019, information released has been fast and vast. Health literacy focuses on individual skills to obtain, process, and understand health information and services necessary to make informed health decisions. Increasing the level of health literacy can be addressed by the provision of high-quality, trustworthy, easy-to-access, and easy-to-understand information about COVID-19. This work aimed to assess COVID-19-related health literacy in the Egyptian population living in Alexandria and determine its associated factors. This cross-sectional study was performed during the second wave of the COVID-19 pandemic, using a questionnaire assessing COVID-19-related health literacy, adapted from HLS-EU-Q. The work included four phases. The first phase was questionnaire designing and tools used. The second phase included questionnaire filling by participants. The third phase was concerned with increasing population awareness about the COVID-19 pandemic. The fourth phase was the statistical analysis of the data.ResultsThe sample compromised 3960 persons. More than half of the Egyptian population living in Alexandria have inadequate or problematic COVID-19-related health literacy scores. Female gender, younger age, higher socioeconomic status, professions with a medical background, and level of education were positively correlated with COVID-19-related health literacy.ConclusionCOVID-19-related health literacy levels in the Egyptian population living in Alexandria are not sufficient. Policymakers, healthcare providers, and media must act proactively to increase the level of the citizens’ COVID-19-related health literacy and prepare them for other pandemics that may come later.

Coronavirus-Related Health Literacy: A cross-sectional study during the COVID-19 infodemic in a developing country

Health literacy is the ability to obtain, read, understand, and use healthcare information to make appropriate health decisions and follow instructions for treatment. With the onset of Covid-19 disease, the public needs to have access to new and accurate information. The present study investigated the Coronavirus-related health literacy in Covid-19 patients referred to a teaching hospital in a developing country and its relationship with demographic variables. Method: This survey research is a descriptive-analytical type. The research instrument includes LS-COVID-Q22). Patients with Covid-19 were referred to the hospital from December 5, 2020 to July 5, 2021.The samples were selected using a sample size determination formula of 190 people. Statistical analysis was performed with SPSS software version 26. Results: The overall average score of health literacy related to coronavirus in patients with Covid-19 at Imam Reza teaching hospital in is 84.31 which is the desired level. Among the dimensions of health literacy, the highest score belonged to “Understanding health information” and the lowest score belonged to “Evaluate health information”. “Age” as a demographic factor, is the only factor that has been associated with health literacy related to the coronavirus. Conclusion: Although the level of Coronavirus-related health literacy is favorable in this study, the participants in this study were mostly patients who were able to answer the research questions, were not hospitalized, had a sufficient level of literacy to understand the questionnaire questions, and most of them were medical staff who were familiar with the components of health literacy. However, considering that health literacy training related to coronavirus has an effective role in disease prevention and control, therefore, creating and promoting the necessary platform for teaching the components of health literacy , especially  for elders is recommended by trustees and policymakers. Lack of proper evaluation of information sources leads to improper health practice.

Association between physical activity and health literacy in patients with Parkinson’s disease: an online web survey

BackgroundFor patients with Parkinson's disease (PwPD), promotion of habitual physical activity (PA) assists in the prevention of disease progression. Patients' health literacy (HL) is integral for meeting PA standards and turning it into a habit. This study evaluated the association between PA level and each HL domain in PwPD.MethodsOnline web-based assessment instruments and self-administered questionnaires, including the PA Questionnaire (IPAQ) Short Form and the Functional, Communicative, and Critical Health Literacy (FCCHL) scale, were used to assess PA levels and health literacy domains of PwPD.ResultsThe mean age of PwPD (n = 114) was 65.9 (SD = 11.6) years; 59.6% female, and the mean duration of disease was 6.4 (SD = 5.1) years. Of participants, 47.4% met the recommended criteria for PA. When comparing each HL domain by PA level, participants with lower PA had significantly lower critical HL (p = 0.03). Logistic regression analysis revealed that PA level correlated with critical HL (OR = 2.46; 95% CI = 1.16–5.19; p = 0.02).ConclusionsAdherence to recommended PA standards was associated with critical HL, but not other HL domains. Proactive attitudes to critically evaluate and utilize as well as understand health information may positively influence the promotion of PA.

Social disconnectedness co-exists with health literacy and treatment burden in individuals with CVD

Abstract Background Social disconnectedness (e.g., loneliness and social isolation) is associated with increased risk of morbidity and mortality, including cardiovascular disease (CVD). However, loneliness and social isolation do not merely increase the risk of incident CVD; rather, they seem to also aggravate the course of disease. Low health literacy and patient-perceived treatment burden are common among individuals with CVD, and may further impact health outcomes. Understanding the potential mechanisms linking social disconnectedness with CVD and disease prognosis is crucial for clinical practice. However, research investigating the associations between social disconnectedness, health literacy, and treatment burden in individuals with chronic disease remains sparse despite its apparent relevance. Methods This study used cross-sectional self-reported data from the 2017 Danish National Health Survey entitled ‘How are you?', investigating the associations of loneliness and social isolation with low health literacy and high treatment burden in individuals with CVD (n = 2,521; mean age = 65.7 years). Results Logistic regression analysis showed that loneliness and social isolation were associated with increased odds of low health literacy in terms of difficulties with ‘understanding health information’ and ‘engaging with healthcare providers'. Likewise, loneliness and social isolation were associated with high treatment burden. Conclusions Our findings showed that loneliness and social isolation coexist with low health literacy and high treatment burden in individuals with CVD. This is of concern as socially disconnected individuals already experience more health issues, and these factors could worsen their condition. Our findings underscore the importance of interventions in clinical care that counter social disconnectedness while considering the individual's health literacy and treatment burden. Key messages • Social disconnectedness coexists with low health literacy and high treatment burden in individuals with CVD. This reflects a potential accumulation of risk factors. • The coexistence of social disconnectedness with low health literacy and high treatment burden highlight the need for efforts addressing social connections in the context of patient care.

The role of health literacy in evaluation of health promotion and prevention interventions

Abstract One specific contribution to the workshop is the consideration of the role of health literacy in the evaluation of health promotion and prevention interventions both as an outcome variable and as a determinant of health-related behaviour. Health literacy has a detectable impact on health status and quality of life and is a necessary prerequisite for health-promoting behaviour. Health promotion should therefore address the determinants of health literacy. The causal relationships reported in the literature between the determinants of health literacy and the dimensions of health literacy (finding health information, understanding, evaluating, implementing) and outcomes can be illustrated in impact models. By using them it becomes clear that health literacy programmes should aim to improve situational determinants as well as individual determinants. It also highlights the central importance of the availability of accessible, understandable and trustworthy health information. Health literacy outcomes are only relevant when they lead to health-related decisions and related actions of individuals. Therefore, measuring health literacy is essential, especially at the decision-making level.

Social determinants of health literacy: a cross-sectional exploratory study.

Despite the importance of health literacy to health-promoting behaviors, few studies have assessed the social determinants of health literacy in a random sample of individuals from the USA. The study evaluated the association of sociodemographic factors with individual health literacy levels. This cross-sectional web-based observational study utilized the Health Literacy Questionnaire (HLQ), a multidimensional instrument measuring nine areas of literacy. Multivariate regression results revealed several factors associated with HLQ scores such as self-rated health rating, frequency of visits to healthcare providers, smoking, gender and rural versus urban residence. Low health literacy was associated with lower self-rated overall health and with less frequent visits to healthcare providers. Males scored higher on engaging with health providers, navigating, understanding the health system and understanding health information well enough to know what to do. These findings can guide healthcare professionals to focus on individuals from groups having lower health literacy scores to promote healthy behaviors.

Health behaviors according to the ability to understand health information in Korean adults.

This study aimed to verify the relationship between the level of understanding of health information and health behaviors among Korean adults. In total, 228 984 adults who participated in the 2021 Korea Community Health Survey were included. Participants were divided into three groups according to age (19-44, 45-64 and 65+). The ability to understand verbal and written health information was included, and its association with health behaviors, including smoking, alcohol consumption and preventive health service uptake, was assessed. Associations between the ability to understand health information and health behaviors were analyzed using chi-squared tests and multiple logistic regression analyses. Approximately 22.7% and 20% of the participants responded that verbal and written health information were easy to understand, respectively, with significant differences by age group. Compared to those with easy-to-understand verbal health information, those with difficulty in understanding had a higher risk of current cigarette smoking and monthly drinking and were less likely to engage in more than moderate physical activity, walking, influenza vaccination in 1 year, cancer examination in 2 years and medical examination in 2 years. Difficulty in understanding or no interest in written health information was also associated with unhealthy behaviors. A strong ability to understand health information is related to positive health behaviors. However, there are differences in the associations by age group, which should be considered when establishing a health literacy improvement strategy. These findings could promote health literacy and ultimately contribute to helping individuals make better choices for positive health behaviors.

How Does the Health Literacy of Adults Residing in Social Housing Compare with That of Those Living in Other Housing Tenures in Australia? A Secondary Analysis of the Australian National Health Survey 2017-2018 Dataset.

Social housing tenants have poorer health outcomes than homeowners or those renting privately. Health literacy is associated with access to care and health outcomes. This study aimed to examine the health literacy of Australian adults residing in social housing compared with that of people living in other housing types. A secondary analysis of the Australian National Health Survey 2017-2018 dataset was undertaken. A total of 5275 respondents were included in the sample and completed the Health Literacy Questionnaire (HLQ). Respondents were categorised according to their housing tenure: 163 (3.1%) respondents were living in social housing, 873 (17%) were living in private rentals, 2085 (40%) were homeowners, and 2154 (41%) were homeowners/mortgages. Mean scores were calculated for each of the nine health literacy domains in the HLQ and compared across housing tenure using linear regression models. Social housing tenants had lower mean domain scores than either homeowners, owner mortgagees, or private renters on six of the nine health literacy domains. This included 'having sufficient information to manage my health', 'social support for health', 'ability to engage with healthcare providers', 'navigating the healthcare system' 'ability to find good health information', and being able to 'understand health information enough to know what to do'. However, the differences in mean scores were small. Increasing health literacy may be an important part of multicomponent interventions seeking to improve the health and wellbeing of social housing tenants.

When Positive is Negative: Health Literacy Barriers to Patient Access to Clinical Laboratory Test Results.

Health literacy is a multidimensional set of skills (e.g., narrative, numeracy, digital, medication) that patients need to access and understand health information timely and accurately to make evidence-based informed decisions. Multiple barriers prevent patients from effectively interacting with health information. The most salient barriers are poor overall health literacy skills and linguistic proficiency in English. As patients prefer direct access to laboratory test results, especially those of routine tests, contextualization and provider-directed interpretation of results are required to foster shared decision-making to address their healthcare issues and improve health outcomes. The use of systematic approaches that account for poor health literacy skills and include culturally and linguistically appropriate planning and availability of resources is warranted at individual and population health levels (e.g., human-centered design of patient portals).

Levels of health literacy among people living with HIV in outpatient care: a cross-sectional study from Denmark

BackgroundLow health literacy (HL) among people living with HIV (PLWHIV) encounter more disease related complications, more difficulty understanding health-related information and low adherence. Considering that, the HL levels among PLWHIV needs to be further investigated. The objective of this study was to investigate the levels of HL and patient involvement among PLWHIV in an outpatient clinic in Denmark. A second objective was to examine differences in HL levels across socio-demographic characteristics.MethodsIn 2019, a population of 682 PLWHIV from a Danish outpatient hospital clinic were enrolled in cross-sectional study. Patients who had a digital postbox received an electronic questionnaire including following domains; health literacy, patient involvement, and socio-demographic status. Health literacy was measured using the Health Literacy Questionnaire (HLQ) through scores on three subscales: social support for health (HLQ4), engaging with healthcare providers (HLQ6), and understanding health information (HLQ9). An unpaired t-test was used to investigate mean differences in the HLQ scores across socio-demographic variables.ResultsA total of 338 (55%) patients responded to the questionnaire. The included participants demonstrated high levels of HLQ4 (mean = 4.2) and HLQ6 (mean = 4.2), but lower for HLQ9 (mean = 2.9). In total 70–80% reported being involved in decisions about their health. We found a positive association between high level of HL (HLQ9) and living with a partner and higher levels of HL (HLQ4, HLQ6, and HLQ9) and employment.ConclusionPLWHIV in a Danish out-patient care population were found to have high levels of HL despite differences in demographic characteristics. Further research is needed to examine the levels of HL among non-responders to develop HL approaches and strategies to meet the needs of individuals with different HL skills.

Hearing Loss and Sociodemographic Barriers to Health Care Access Using the All of Us Research Program.

To explore how gender and low-income status independently influence general health care access in patients with hearing loss. Cross-sectional study. National database. Patients with a diagnosis of sensorineural hearing loss from the National Institutes of Health All of Us database were included. Data entered from May 2018 to November 2022 was analyzed. Patient demographicssuch as age, gender, educational level, and insurance status were assessed. Multivariate logistic regressions were performed for statistical evaluation. A subset of 8875 patients (48.3% male, mean age 69) were evaluated. After multivariate analysis, female participants were more likely than male participants to report difficulty affording prescribed medications (odds ratio [OR]: 1.7, p < .0005) and specialists (OR: 1.4, p < 0.005). Female patients were also more likely to delay care due to elder care responsibilities (OR: 2.6, p < .0005), employment obligations (OR: 1.7, p < .0005), and feelings of apprehension in seeing a provider (OR: 1.7, p < .0005). Finally, female participants reported feeling less likely to be involved in their own medical care compared to males (OR: 1.2, p < .005). Low-income (<$25,000) participants reported less likely to feel respected (OR: 3.2, p < .0005) and delivered understandable health information (OR: 2.3, p < .0005) by providers compared to participants of higher income. This work suggests that patients with hearing loss, female gender, and lower socioeconomic status independently introduce barriers to health care access and utilization. These factors should be considered in efforts to promote equity in the care of patients with hearing loss.

Online bruxism-related information: can people understand what they read? A Cross- Sectional Study.

Bruxism patients often access the web to search for information. Unfortunately, the low text readability of online material and the limited medical literacy in the general population may prevent patients' understanding of health information. We aimed to assess the home page's readability of the top 10 patients-oriented bruxism-related websites and the educational level required to approach them. Using the word bruxism in the "no country redirect" extension of Google Chrome browser (www.google.com/ncr), we identified the first 10 patient-oriented English language websites. The readability of the material was determined using six commonly recommended readability tests (1): Gunning Fog Index (GFI), Coleman Liau Index (CLI), Automated Readability Index (ARI) Simple Measure of Gobbledygook (SMOG), Flesch Kincald Grade Level (FKGL), Flesh Reasing Ease (FRE). The USA National Institutes of Health requirements, which call for websites to be readable at a 6th to 7th-grade level, were not followed by any of the most popular websites. The average consumer frequently finds the health information on the Internet to be too complex to understand, which can lead to misinterpretation, a delay in diagnosis, and poorer health consequences.