Understanding Of Health Literacy Research Articles

Multimorbidity-associated emergency hospital admissions: a “screen and link” strategy to improve outcomes for high-risk patients in sub-Saharan Africa: a prospective multicentre cohort study protocol

Background The prevalence of multimorbidity (the presence of two or more chronic health conditions) is rapidly increasing in sub–Saharan Africa. Hospital care pathways that focus on single presenting complaints do not address this pressing problem. This has the potential to precipitate frequent hospital readmissions, increase health system and out-of-pocket expenses, and may lead to premature disability and death. We aim to present a description of inpatient multimorbidity in a multicentre prospective cohort study in Malawi and Tanzania. Primary objectives Determine prevalence of multimorbid disease among adult medical admissions and measure patient outcomes. Health Economic: Measure economic costs incurred and changes in health-related quality of life (HRQoL) at 90 days post-admission. Situation analysis: Qualitatively describe pathways of patients with multimorbidity through the health system. Secondary objectives Determine hospital readmission free survival and markers of disease control 90 days after admission. Health Economic: Present economic costs from patient and health system perspective, sub-analyse costs and HRQoL according to presence of different diseases. Situation analysis: Understand health literacy related to their own diseases and experience of care for patients with multimorbidity and their caregivers. Methods This is a prospective longitudinal cohort study of adult (≥18 years) acute medical hospital admissions with nested health economic and situation analysis in four hospitals: 1) Queen Elizabeth Central Hospital, Blantyre, Malawi; 2) Chiradzulu District Hospital, Malawi; 3) Hai District Hospital, Boma Ng’ombe, Tanzania; 4) Muhimbili National Hospital, Dar-es-Salaam, Tanzania. Follow-up duration will be 90 days from hospital admission. We will use consecutive recruitment within 24 hours of emergency presentation and stratified recruitment across four sites. We will use point-of-care tests to refine estimates of disease pathology. We will conduct qualitative interviews with patients, caregivers, healthcare providers and policymakers; focus group discussions with patients and caregivers, and observations of hospital care pathways.

Improving the Readability of Patient Education Materials in Physical Therapy.

Introduction Printed patient educational materials (PEM) are often written above the recommended sixth- to eighth-grade reading levels, resulting in decreased client understanding and subsequent poor health literacy. Researchers have demonstrated that it is possible to improve readability to enhance clients' understanding and health literacy. The purpose of this study was to evaluate the readability of physical therapy (PT) PEM with and without modifications for improvement. Methods A convenience sample of 38 PT PEM of at least 10 sentences was obtained from a large suburban hospital system in the Midwestern region of the United States. Original and three modified versions (exclusion, revision, and combined exclusion/revision of words with >3 syllables) of the documents were assessed with the Simple Measure of "Gobbledygook" (SMOG). All document means were compared to the recommended reading levels, and the original document means were compared with modified conditions. Results A majority of the documents were above an eighth-grade reading level. All modified conditions resulted in statistically significant reading level decreases, but only the combined modified condition decreased to the eighth-grade level. Conclusion Even with modifications, most PEM were above the recommended reading levels. Additional methods for improving readability and increased education about health literacy for healthcare professionals may be necessary to improve client comprehension.

Are We Missing the Mark? Understanding Health Literacy in A Rural-Border Hospital.

Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population. In addition, personal factors (i.e., demographics) were analyzed to determine their influence on the nurse's predictions and patients' HLL. Data were collected from 84 participant patient-nurse couplets admitted to a medical-surgical unit in a rural setting located on the United States-Mexico border. In addition to demographic information collected via survey, RNs were asked to predict their patient's health literacy abilities while the Newest Vital Sign, a health literacy assessment tool, was deployed to determine the actual HLL of patients participating in the study. Data were analyzed using descriptive statistics, t-tests, and chi-square tests while a Spearman correlational model was used to examine the relationship between predicted HLL and actual HLL. Finally, a logistic regression model was used to analyze the relationship between personal factors and HL data for RNs and patients. Analysis of the data revealed that RNs consistently overestimated patients' abilities, as evidenced by the disparity between patients' actual HLL (mean 1.71) and predicted HLL (mean 4.26) by RNs, with a moderately strong positive relationship (rs = .418). Notably, higher academic preparation and years of experience did not enhance the RNs' ability to identify LHL while the highest level of education completed was the only statistically significant predictor of adequate health literacy in the patient population sampled. These findings emphasize the need to prioritize effective health literacy education in RN academic preparation and clinical practice to support the detection of LHL when a standardized health literacy assessment tool is not utilized in the clinical setting. By recognizing the presence of LHL, healthcare professionals can better support patients' needs and bridge the knowledge gap, ultimately improving patient outcomes.

Multimorbidity-associated emergency hospital admissions: a “screen and link” strategy to improve outcomes for high-risk patients in sub-Saharan Africa: a prospective multicentre cohort study protocol

Background The prevalence of multimorbidity (the presence of two or more chronic health conditions) is rapidly increasing in sub–Saharan Africa. Hospital care pathways that focus on single presenting complaints do not address this pressing problem. This has the potential to precipitate frequent hospital readmissions, increase health system and out-of-pocket expenses, and may lead to premature disability and death. We aim to present a description of inpatient multimorbidity in a multicentre prospective cohort study in Malawi and Tanzania. Primary objectives Clinical: Determine prevalence of multimorbid disease among adult medical admissions and measure patient outcomes. Health Economic: Measure economic costs incurred and changes in health-related quality of life (HRQoL) at 90 days post-admission. Situation analysis: Qualitatively describe pathways of patients with multimorbidity through the health system. Secondary objectives Clinical: Determine hospital readmission free survival and markers of disease control 90 days after admission. Health Economic: Present economic costs from patient and health system perspective, sub-analyse costs and HRQoL according to presence of different diseases. Situation analysis: Understand health literacy related to their own diseases and experience of care for patients with multimorbidity and their caregivers. Methods This is a prospective longitudinal cohort study of adult (≥18 years) acute medical hospital admissions with nested health economic and situation analysis in four hospitals: 1) Queen Elizabeth Central Hospital, Blantyre, Malawi; 2) Chiradzulu District Hospital, Malawi; 3) Hai District Hospital, Boma Ng’ombe, Tanzania; 4) Muhimbili National Hospital, Dar-es-Salaam, Tanzania. Follow-up duration will be 90 days from hospital admission. We will use consecutive recruitment within 24 hours of emergency presentation and stratified recruitment across four sites. We will use point-of-care tests to refine estimates of disease pathology. We will conduct qualitative interviews with patients, caregivers, healthcare providers and policymakers; focus group discussions with patients and caregivers, and observations of hospital care pathways.

Understanding health literacy of deaf persons with hypertension in South Korea: A cross-sectional study.

Health literacy is strongly associated with health inequality among persons with deafness, and hypertension (HTN) is the most prevalent chronic disease among persons with deafness in South Korea. Despite its importance, research regarding the health literacy levels of persons with deafness with HTN in South Korea is lacking. This study aimed to comprehensively assess the health literacy levels of persons with deafness with HTN in South Korea, including linguistic, functional, and internet health literacy. In this descriptive cross-sectional study, 95 persons with deafness with HTN were recruited through facilities associated with the deaf community. From August 2022 to February 2023, data were collected through face-to-face surveys attended by a sign language interpreter and online surveys. The data were analyzed using descriptive statistics and Spearman's correlation. Approximately 62.1% of the participants exhibited a linguistic health literacy level corresponding to less than that of middle school students, and the total percentage correct of functional health literacy was 17.9%. Each domain of internet health literacy was low. Significant correlations were found between some aspects of health literacy. The study's findings highlight the low health literacy levels across various facets among persons with deafness with HTN in South Korea. Based on these findings, several strategies are suggested for developing HTN self-management interventions for persons with deafness. This study contributes to the foundational understanding of health literacy among persons with deafness with HTN in South Korea and provides valuable insights and guidance for developing HTN self-management interventions.

Health Literacy Concepts, Themes, and Research Trends Globally and in Latin America and the Caribbean: A Bibliometric Review.

(1) Background: Health literacy (HL) debates have increased significantly in the last two decades. HL concepts/themes and models have achieved substantial development in the US and Europe. Although there have been some efforts to develop HL in Latin America and the Caribbean (LAC), these seem to be few and scattered. This paper reviews and discusses developments of HL concepts and themes globally and in LAC over the last two decades. (2) Purpose: This study aimed to identify the prevalent health literacy concepts/themes deployed globally and in LAC as reported in academic journals from 2005 to 2022. We looked into which fields of knowledge have been informing HL research over the last decades. (3) Methods: We conducted a structured search on the Web of Science (WoS), Scopus, PubMed, and SciELO databases to extract the textual data for bibliometric analysis. We analyzed the textual data with VOSviewer and Biblioshiny to better understand health literacy themes and strands currently being researched in the LAC region. We conducted the searches in two periods: the first in May 2023 and the second in October 2023. (4) Results: The bibliometric study highlighted five WoS categories informing most HL global studies: (i) public environmental occupational health; (ii) environmental sciences; (iii) health policy services; (iv) health care science services; and (v) communication. The two predominant categories in LAC are public environmental occupation health and health policy services. Journals hosting HL publications come from these WoS categories. Themes in HL publications can be organized into four thematic clusters: (i) analytical (research designs, analytic techniques, and criteria for examining HL data); (ii) psychometric (measurement properties of data collection tools); (iii) pragmatic (practical issues related to implementing HL programs); and (iv) well-being (effectiveness of HL programs on mental health and illness treatment). (5) Conclusions: There is expanding interest in health literacy among scholars. The number of publications has increased substantially, particularly over the last five years. These are dominated by the Global North. The metrics show that LAC and Africa are trailing in publications. There is an emerging focus on adult literacy, functional/low health literacy, and their effect on improving capabilities, comprehension, and communication regarding health-related topics.

Health literate maternity care of forced migrant women in Germany

Understanding health literacy in maternity care of forced migrant women in Germany provides invaluable insights into the health literacy-related barriers forced migrant women face and the resources available to them. These are integral to building health literate maternity care, which is diversity-sensitive and responsive to forced migrant women's needs. This study conducted a secondary qualitative analysis of health care providers' perspectives on the role of health literacy in maternity care of forced migrant women in three federal states in Germany (North Rhine-Westphalia, Brandenburg, Berlin). 59 problem-centered interviews were analyzed using Framework Analysis and the European Health Literacy Survey's health literacy model. The model was revised to better reflect the dimensions and determinants of the forced migration context (e.g., the healthcare system was included as a determinant). The results showed that barriers and resources related to accessing, understanding, appraising, and applying information in maternity care were present throughout pregnancy until after birth. Barriers were predominantly at the healthcare level (e.g., lack of language interpreters) and situational level in encounters with health care providers (e.g., diversity sensitivity). The main resources were forced migrant women's digital networks and the mediating role of providers and their networks. The results made clear that health literate maternity care requires three main factors: diversity-sensitive health care providers and healthcare structures, involvement of forced migrant women in research and practice, and health literate communication. The study proposes an adapted model of health literacy, which could be applied in future research on health literacy and migration.

Food, Nutritional Status and Health Literacy

Abstract Introduction Azores is an autonomous region of Portugal situated in the middle of the Atlantic Ocean. As a catchment area of cultural identity, it can be an interesting setting to better understand Health Literacy (HL) personal & community development. Therefore developing ChildRen and ADolescents’ health Literacy (CrAdLiSa) become a local government strategy for all children and adolescents in the region. The aim of this study, is to explore the relationship between several components of adolescents living in Azores, like sustainable life style, focusing food, nutritional status, e.g. water intake (WI), and HL. With this situation diagnosis local authorities aim to develop policies towards HL increment while fighting health disparities. Methods A population (N = 852) cross-sectional study included (n = 515)) children enrolled in the 7th school year 2018/2019 of six schools in Ponta Delgada, Azores. Several indicators like anthropometric data, water intake, HL levels (using the HLS-EU-PT questionnaire) were collected with the CrAdLiSa online self-administered questionnaire. Results The instrument to measure HL (HLS-EU-PT) (Cronbach's alpha coefficient 0,94) allowed to consider that there is an association between HL and WI (p = 0,029), i.e. children with higher levels of HL have greater WI as they have a broader perception of the adequate amount of water needed to be healthy. Discussion These results continue to explore CrAdLiSa study, to better inform with ground base data policy makers regarding HL development.

Understanding refugee and immigrant health literacy and beliefs toward antimicrobial resistance

Background: Antimicrobial resistance (AMR) is a global health threat, particularly in refugee populations, due to challenges posed by migration. Little guidance has been provided by public health agencies regarding antimicrobial stewardship specific to this demographic. Studies have primarily focused on encampment areas abroad. We sought to better understand health literacy and beliefs regarding AMR in local refugee and immigrant populations in southeastern Michigan. Methods: From November 1, 2022 to March 10, 2023, we distributed an anonymous questionnaire to adult patients at four primary care clinics in Southeastern Michigan and made it available online. The questionnaire collected demographic information and used 5-point Likert scale responses regarding antibiotic use in children with symptoms of respiratory infection. We binarized the questions and responses to determine whether respondents provided the preferred response and added these to create an overall health literacy score, then used simple linear and multivariable linear regression modeling to identify demographic variables independently associated with the health literacy score. Chi-squared and Mann-Whitney tests were also performed where appropriate. Results: Immigrants and refugees/asylum-seekers from low or middle-income countries (group A, n = 109) were compared to native-born Americans and immigrants from high-income countries (group B, n = 171) with participants from 40 countries (Figure 1). Age distribution did not differ between groups, while group B had generally longer duration of living in the United States (Figure 2). Differences were found in other demographic categories except female gender, with group B reporting higher income, educational levels, and English ability (Figure 3). Simple linear regression revealed that all demographic variables except age significantly correlated with responses (Figure 4). Multivariable linear regression showed that female gender, educational level, and age correlated with greater health literacy, while being in group A trended towards significance with respect to correlating with lesser health literacy (Figure 5). Conclusions: Immigrants and refugees/asylum-seekers from LMICs demonstrated beliefs suggesting deficits in knowledge of AMR compared to native-born Americans and those from high-income countries, independent of other potentially confounding demographic characteristics. Female gender, educational level, and age independently correlated with greater health literacy. These results could inform future patient-centered antimicrobial stewardship educational interventions in certain target populations such as immigrants and refugees/asylum-seekers in the United States.Disclosures: None

The role of health literacy in simulation education: needs assessment and call to action

Understanding health literacy is crucial to improve health and reduce disparities. Simulation is an effective active learning strategy to teach health literacy. Our aim was to perform a needs assessment of health literacy education using simulation, to guide faculty development for simulation educators. Utilizing Kern’s curricular development process, problem identification, general and targeted needs assessments were performed. PubMed, CINAHL and PsycINFO searches were conducted using terms for health literacy and ‘prioritized health literacy competencies’ (PHLCs). Abstracts and full texts were screened. Simulation events that could feasibly incorporate health literacy were included. Data were collected regarding learners, type of event and incorporation of PHLCs. A targeted needs assessment used electronic survey to identify knowledge, attitudes and beliefs of local simulation educators regarding health literacy. Health literacy components of local simulation events (2018–2019) were assessed using a tool developed by the investigative team. Literature search identified 614 published articles, and 67 were included in analysis. ‘Avoidance of jargon’ (14/67) and ‘patient-centred approaches’ (11/67) were the most commonly cited PHLCs. No articles mentioned ‘delivery of information in 1–3 need-to-know elements’. Of the 57/881 local simulation events that could feasibly incorporate health literacy, 17/57 did so. ‘Jargon’ and ‘patient-centred’ care were the PHLCs most often present in learning objectives. Survey response rate was 77%. Only 18% (3/17) of local simulation educators demonstrated ‘comprehensive understanding’ of health literacy. Educators reported understanding ‘using universal precautions in written and oral communication’ (mean Likert 3.3) and ‘need-to-know/need-to-do concepts’ (3.4) least well. The majority felt including health literacy was important in simulation and believed they did this. There is a critical need to formalize and standardize language used when creating and studying simulations involving health literacy. An interprofessional faculty education program may assist faculty understanding of PHLCs when designing focused simulations for future healthcare providers.

Understanding health literacy from a traditional Chinese medicine perspective

Health literacy is critical to improving individual and public health. However, indigenous perceptions of health are largely absent from Western-derived measurements, contributing to disparities in health outcomes between indigenous and non-indigenous populations. China is the country with the world’s largest population and only officially introduced the term “health literacy” in 2008. Current measures of health literacy in China are primarily based on Western-derived constructs, which have been shown to have poor comparability to the unique dual medical system in China. Given its significant importance to health management globally, understanding health perceptions from a traditional Chinese medicine perspective is essential. This review explores the concept and core elements of indigenous health literacy, evaluates the existing definitions and measurement tools as applied to the concept, and proposes a new model of traditional Chinese medicine health literacy.Please cite this article as: Qian Z, Wang GY, Henning M, Chen Y. Understanding health literacy from a traditional Chinese medicine perspective. J Integr Med. 2023; 21(3): 215–220.

Understanding Health Literacy among Bisexual Living with HIV: A Preliminary study

OBJECTIVES: This preliminary study aims to evaluate health literacy among bisexual men living with HIV. MATERIALS AND METHODS: A cross-sectional survey was conducted among 26 adult bisexual male HIV-infected patients in the HIV Clinic from October 2021 to May 2022. We applied the Thai version of the HIV-HLT to investigate health literacy among bisexual men living with HIV. RESULTS: The average age of the participants was 41.34 ± 12.41 years. 61.5% were single and 34.6% had divorced marital status. 50% had finished their bachelor degrees. Approximately half of the participants had been diagnosed with HIV infection for more than 5 years. 57.7% had adequate HIV health literacy and 26.9% had inadequate HIV health literacy, respectively. The laboratory outcome showed that 96.2% had a CD4 count of more than 200 cells/cm3 and 76.9% had a viral load of less than 20 copies/ ml. CD4 and viral load were not associated with the level of health literacy. However, all participants had no previous history of opportunistic infections within the past 6 months. CONCLUSION: Most bisexual men living with HIV have adequate health literacy. The level of health literacy is not associated with CD4 and viral load. However, opportunistic infections within the past 6 months are not reported. Therefore, a Thai version of HIV-HLT may be applied to measure health literacy among bisexual men living with HIV and could be a potential for clinical use.

Application of the optimizing health literacy and access (Ophelia) process in partnership with a refugee community in Australia: Study protocol.

Refugees experience health inequities resulting from multiple barriers and difficulties in accessing and engaging with services. A health literacy development approach can be used to understand health literacy strengths, needs, and preferences to build equitable access to services and information. This protocol details an adaptation of the Ophelia (Optimizing Health Literacy and Access) process to ensure authentic engagement of all stakeholders to generate culturally appropriate, needed, wanted and implementable multisectoral solutions among a former refugee community in Melbourne, Australia. The Health Literacy Questionnaire (HLQ), widely applied around the world in different population groups, including refugees, is usually the quantitative needs assessment tool of the Ophelia process. This protocol outlines an approach tailored to the context, literacy, and health literacy needs of former refugees. This project will engage a refugee settlement agency and a former refugee community (Karen people origin from Myanmar also formerly knowns as Burma) in codesign from inception. A needs assessment will identify health literacy strengths, needs, and preferences, basic demographic data and service engagement of the Karen community. This community will be engaged and interviewed using a semi-structured interview based on the Conversational Health Literacy and Assessment Tool (CHAT) will cover supportive professional and personal relationships, health behaviors, access to health information, use of health services, and health promotion barriers and support. Using the needs assessment data, vignettes portraying typical individuals from this community will be developed. Stakeholders will be invited to participate in ideas generation and prioritization workshops for in-depth discussion on what works well and not well for the community. Contextually and culturally appropriate and meaningful action ideas will be co-designed to respond to identified health literacy strengths, needs, and preferences of the community. This protocol will develop and test new and improved methods that are likely to be useful for community-based organizations and health services to systematically understand and improve communication, services and outcomes among disadvantaged groups, particularly migrants and refugees.

A literature review to understand health literacy in men with prostate cancer on active surveillance.

Active surveillance (AS) has been established as an important treatment option for patients with localised prostate cancer (PCa). Current evidence suggests that health literacy is an important facilitator or barrier to choosing and adhering to AS. We aim to understand how the level of health literacy has an impact on choosing and adhering to AS for PCa patients. We performed a narrative literature review in accordance with the Narrative Review guidelines through the MEDLINE online database via PubMed using two different search strategies to identify the relevant literature. We looked at literature until August 2022. A narrative synthesis was performed to identify if there is any evidence on how studies report health literacy as an outcome in the AS population and if there are any interventions targeting health literacy. We identified 18 studies which looked at health literacy in the PCa context. Health literacy was measured in the context of comprehension of information of patients across PCa stages, decision making across PCa stages and quality of life (QoL) across PCa stages. Lower health literacy had a negative impact on the identified themes. Nine of the identified studies used validated health literacy measures. Interventions targeting health literacy have been used to improve health literacy with a positive impact across the patient journey. Health literacy plays an important role in enabling men to take an active part in their treatment journey. In this review, we presented how health literacy is measured and which interventions targeting health literacy are implemented across PCa. These examples of interventions targeting health literacy should be studied further and translated into the AS setting to improve treatment decision making and adherence to AS.

Health Literacy in Children and Adolescents: A Review of the State of the Art

Health literacy has been defined as the ability of people to access quality health information and apply it, making appropriate decisions in the process of health and a correct use of health services. Despite the large body of literature produced since the first studies of this topic on the adult population, there is less scientific documentation regarding children and adolescents. The research team conducted a literature review of health literacy in children and adolescents; as well as the role of digital health literacy and other divides in the health status of this specific group of the population. The results of the literature review showed that health literacy is crucial to obtain a good physical, emotional and cognitive development. It is also related with the acquisition of healthy behaviors and lifestyles. The level of health literacy depends on many factors such as personal health status, the existence of health problems or diseases; as well as socio-economic status, cultural, social, and demographic determinants of health, among other variables. These aspects at the family level, friends, and school life, moreover, influence children and adolescents. In this group of the population, health status and healthy lifestyles are not only influenced by the level of individual (or parental) health literacy, but also by the social context in which the child or youth is immersed. In addition, these variables related to socio-economic and cultural factors are associated with the existence of gaps or divides in certain groups. In this scenario, an adequate conceptualization of health literacy during childhood and adolescence is necessary when designing appropriate interventions and policies for this group of the population. In order to achieve this, it is necessary to define what we mean by health literacy and how we are going to measure it. In summary, it is important not to focus only on an individual perspective; on the contrary, it is necessary to understand health literacy in the context where children and youth live and develop, as well as their interactions with the health, educational and social system. Further research is needed to explore more in depth the importance of health literacy in children and adolescence.

The Relationship between Health Literacy and COVID-19 Vaccination Prevalence during a Rapidly Evolving Pandemic and Infodemic.

The gap between how health information is communicated and what people understand and can use to make informed health decisions is called health literacy. This gap was exacerbated by the rapidly changing and excessive volume of information, misinformation, and disinformation during the COVID-19 pandemic. People with lower health literacy may not have understood the importance of COVID-19 vaccination for themselves or for their communities. Our aim was to understand health literacy levels within Fulton County, Georgia, and their relationship to vaccine prevalence. Fulton county residents ages 18 and over (n = 425) completed an on-line Health Literacy Questionnaire. Individual, organizational, functional, interactive, and critical health literacy scales were created. Vaccination prevalence data were collected from the Georgia Vaccine Distribution Dashboard. All data were divided into one of three county areas. There were statistically significant variations in vaccine prevalence χ2(3) = 29.325, p < 0.001 among the three county areas. All levels of health literacy predicted overall county vaccination prevalence F (4,420) = 85.941, p < 0.001, There were significant differences in health literacy levels among two of the three county area pairs; the lowest resourced county area had the lowest vaccination prevalence and health literacy rates. This is the first example of relating direct health literacy measures across a major metropolitan US county with vaccine prevalence data.

Understanding Health Literacy among University Health Science Students of Different Nationalities.

An adequate level of health literacy is essential for clear communication between patients and health care workers. The internationalization of universities is increasing in the field of health care. The aims of our research were to measure (1) the level of health literacy and its correlation among university students and (2) the relationship between the different instruments measuring health literacy. A cross-sectional study was conducted in the 2020/2021 academic year. The questionnaire included questions on sociodemographic status, study data, health status, and health literacy level. According to the HLS-EU-Q16 health literacy questionnaire, more than half of the students had a limited HL level in disease prevention (52.4%) and health promotion (58.4%) subindexes. Nationality was found to be an influencing factor (p < 0.001). According to the NVS, 80.1% of the students had an adequate HL level. A significant correlation was found between the results and nationality (p = 0.005). None of the Chew questions demonstrated a correlation with nationality (q1 p = 0.269, q2 p = 0.368, q3 p = 0.528). Nationality is a key factor in the level of subjective and functional health literacy. We need to measure both types of levels to see the real results.

HealthLit4Kids: teacher experiences of health literacy professional development in an Australian primary school setting.

Health literacy (HL) is a critical asset for 21st century learners to possess given its positive impact on health outcomes and educational attainment. Concerningly, HL is an area that primary school teachers report having a lack of understanding, confidence, and ability to teach. The HealthLit4Kids initiative aimed to address this issue through a series of teacher professional development (PD) workshops. To evaluate how teachers experienced the PD, teacher evaluations collected at the completion of each of the workshops were analysed using a mixed methods approach. According to the teachers, the PD had improved their understanding of HL, including how to implement it into their practice. The study also found that the teachers perceived that collaborative practice was a key strength of the programme, and that at the end of the PD, teachers described valuing HL more in their practice. Teachers reported time as a major barrier to them implementing the professional learning and suggested further resources could help to mitigate this barrier. Additional research is required to help substantiate the claims made in this research. This study also highlights the critical need for additional HL resources for primary school teachers.

Nursing students\u2019 understanding of health literacy and health practices: a cross-sectional study at a university in Namibia

BackgroundA poor understanding of health literacy and inadequate health practices among nurses can be detrimental to a population’s health. The starting point of solving this problem is through the provision of methodical health literacy and health practice education in the nursing curriculum. This study explored nursing students’ understanding of the concept of ‘health literacy’ and their health practices at a university in Namibia.MethodsA descriptive cross-sectional study was carried out among 205 nursing students. A simple stratified sampling method was used and data were collected using a self-reporting Understanding of Health Literacy (UHL) questionnaire. Pearson correlation, independent t-test and One-way ANOVA were used to analyse the data.ResultsThe overall mean Understanding of Health Literacy score was 13.04 ± 1.52. The majority (n = 157; 76.5%) of the students were found to have adequate health literacy scores, 21.5% had moderate health literacy scores, and only 2% had inadequate health literacy scores. The overall mean health practice score was 32.4 ± 5.50. Most (n = 106; 51.7%) of the students were found to have poor health practices, 44.4% had average health practices, and just 3.9% had good health practices. There was no significant relationship between the health literacy levels and health practices of the students (p = 0.63).ConclusionsNursing students have a good understanding of the concept of health literacy, but more effort can be made to translate this understanding into health literacy skills. There is a need to investigate the contributing factors to poor health practices, as well as develop strategies that can support good health practices among nursing students. These health literacy skills could then be transferred into the students' professional careers as nurses.

Development and Initial Validation of the Refugee Health Literacy Assessment Tool (RHLAT)

ABSTRACT Background Culturally and linguistically diverse (CALD) refugees and immigrants in the United States (U.S.) face barriers to accessing health care, and are more likely to have worse health outcomes as it relates to chronic disease. Better understanding health literacy for this population can identify gaps in knowledge, facilitate health education, and improve health outcomes. Purpose The Refugee Health Literacy Assessment Tool (RHLAT) was developed to improve patient-centered chronic disease management by identifying aspects of health literacy for which individual refugees require additional support. Methods RHLAT development involved domain identification, item development, expert reviews, and cognitive interviews. Refugee and immigrant patients with uncontrolled diabetes and cardiovascular risk factors were engaged for RHLAT implementation. Results The tool was valid across different types of interpretation, such as in-person interpreter or over the phone, and revealed a wide range of health literacy in this population. Discussion The RHLAT was developed and tested with a CALD refugee population. The tool revealed gaps in health literacy that could be addressed by the care team. Translation to Health Education Practice: This study provides a tool that can be used in practice to identify areas for additional health education to assist CALD patients in navigating the U.S. healthcare system.