Pub Date : 2022-04-01Epub Date: 2022-05-06DOI: 10.3928/24748307-20220418-02
Flaviane Cristina Rocha Cesar, Katarinne Lima Moraes, Virgínia Visconde Brasil, Angela Gilda Alves, Maria Alves Barbosa, Lizete Malagoni de Almeida Cavalcante Oliveira
Background: Difficulty in understanding and using health information can harm the patient and increase the cost of care provided. So, this study classified and mapped the characteristics and interventions that make health care professionals responsive to the patient's health literacy.
Methods: Medline (PubMed), CINAHL (EBSCO), PsycInfo, ERIC (ProQuest), Lilacs (BVS) and EMBASE (Elsevier) were searched using a combination of controlled descriptors. The selected studies needed to address the concept or main focus of the study among health care professionals in the care or academic environment.
Key results: After reviewing 34 articles, 14 definitions and 10 subcategories of responsiveness were identified, and a broad characterization of health professional responsiveness to health literacy was proposed. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy, classified as (A) expository (n = 18; 94.7%), (B) interactive (n = 9; 47.4%), (C) practice with educational materials (n = 2; 10.5%), (D) practice with standardized patient or simulation (n = 8; 42.1%), and (E) practice with actual patients (n = 4; 21.1%).
Discussion: These characteristics and interventions provide a useful taxonomy for the development of curricula and professional education programs, and for the validation and use of measures to evaluate the health workforce. [HLRP: Health Literacy Research and Practice. 2022;6(2):e96-e103.] Plain Language Summary: We found 14 definitions and 10 categories of professional responsiveness to health literacy. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy.
{"title":"Professional Responsiveness to Health Literacy: A Scoping Review.","authors":"Flaviane Cristina Rocha Cesar, Katarinne Lima Moraes, Virgínia Visconde Brasil, Angela Gilda Alves, Maria Alves Barbosa, Lizete Malagoni de Almeida Cavalcante Oliveira","doi":"10.3928/24748307-20220418-02","DOIUrl":"10.3928/24748307-20220418-02","url":null,"abstract":"<p><strong>Background: </strong>Difficulty in understanding and using health information can harm the patient and increase the cost of care provided. So, this study classified and mapped the characteristics and interventions that make health care professionals responsive to the patient's health literacy.</p><p><strong>Methods: </strong>Medline (PubMed), CINAHL (EBSCO), PsycInfo, ERIC (ProQuest), Lilacs (BVS) and EMBASE (Elsevier) were searched using a combination of controlled descriptors. The selected studies needed to address the concept or main focus of the study among health care professionals in the care or academic environment.</p><p><strong>Key results: </strong>After reviewing 34 articles, 14 definitions and 10 subcategories of responsiveness were identified, and a broad characterization of health professional responsiveness to health literacy was proposed. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy, classified as (A) expository (<i>n</i> = 18; 94.7%), (B) interactive (<i>n</i> = 9; 47.4%), (C) practice with educational materials (<i>n</i> = 2; 10.5%), (D) practice with standardized patient or simulation (<i>n</i> = 8; 42.1%), and (E) practice with actual patients (<i>n</i> = 4; 21.1%).</p><p><strong>Discussion: </strong>These characteristics and interventions provide a useful taxonomy for the development of curricula and professional education programs, and for the validation and use of measures to evaluate the health workforce. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2022;6(2):e96-e103.</b>] Plain Language Summary: We found 14 definitions and 10 categories of professional responsiveness to health literacy. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 1","pages":"e96-e103"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9126054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82516311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.3928/24748307-20220418-01
Hua Ou
Background: Health literacy describes an individuals' ability to maximize their potential in health care, including one's ability to understand information needed to make informed health decisions. A variety of general and condition-specific health literacy assessment tools have been created to help health professionals assess patients' health literacy skills and tailor the need for health care communication or education; however, there are no such tools available for the audiology field. Objective: The purpose of the study was to develop an objective reading recognition audiology-related health literacy assessment tool, the Rapid Estimate of Adult Literacy in Audiology (REALA). Methods: This was a cross-sectional study (N = 200). The initial version of the REALA contained 99 words specifically related to audiology. The final version, revised to have improved clinical utility, contained a total of 48 words that were selected based on item difficulty, item discrimination score, and point-biserial index using classical item analysis. Key Results: The total pass rate for the final version of the 48-word REALA was 0.72 (standard deviation = 0.45) and the Cronbach coefficient alpha was 0.93. Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. Conclusion: Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. [HLRP: Health Literacy Research and Practice. 2022;6(2):e88–e95.] Plain Language Summary: A health literacy assessment tool, the REALA, was developed in the study. The final version of REALA contained 48 words relative to hearing healthcare. The results suggested that REALA can help health professionals assess patients' hearing related health literacy and tailor the need for hearing health care communication or education.
{"title":"A Pilot Study to Develop the Rapid Estimate of Adult Literacy in Audiology","authors":"Hua Ou","doi":"10.3928/24748307-20220418-01","DOIUrl":"https://doi.org/10.3928/24748307-20220418-01","url":null,"abstract":"Background: Health literacy describes an individuals' ability to maximize their potential in health care, including one's ability to understand information needed to make informed health decisions. A variety of general and condition-specific health literacy assessment tools have been created to help health professionals assess patients' health literacy skills and tailor the need for health care communication or education; however, there are no such tools available for the audiology field. Objective: The purpose of the study was to develop an objective reading recognition audiology-related health literacy assessment tool, the Rapid Estimate of Adult Literacy in Audiology (REALA). Methods: This was a cross-sectional study (N = 200). The initial version of the REALA contained 99 words specifically related to audiology. The final version, revised to have improved clinical utility, contained a total of 48 words that were selected based on item difficulty, item discrimination score, and point-biserial index using classical item analysis. Key Results: The total pass rate for the final version of the 48-word REALA was 0.72 (standard deviation = 0.45) and the Cronbach coefficient alpha was 0.93. Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. Conclusion: Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. [HLRP: Health Literacy Research and Practice. 2022;6(2):e88–e95.] Plain Language Summary: A health literacy assessment tool, the REALA, was developed in the study. The final version of REALA contained 48 words relative to hearing healthcare. The results suggested that REALA can help health professionals assess patients' hearing related health literacy and tailor the need for hearing health care communication or education.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"5 1","pages":"e88 - e95"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84160610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-04DOI: 10.3928/24748307-20220309-01
Rishtya M. Kakar, R. Combs, Malea Hoepf Young, Nida M. Ali, Baraka Muvuka
Background: Despite increases in the number of insured Americans, consumers continue to face barriers in accessing care. Low levels of health insurance literacy (HIL) are associated with suboptimal use of health insurance coverage. There remains a need to further contextualize the relationship between HIL and access to care, especially among insured working-class people. Objective This study was conducted to understand the pathways through which HIL affects health care decision-making and access to care in an urban working-class population. Methods: Using a qualitative descriptive approach, we conducted five focus groups with 45 adult residents of South Louisville, Kentucky. The questions explored participants' experiences of insurance enrollment, use, and health care system navigation, as well as their perceptions and needs regarding accessing health insurance information. Using inductive thematic analysis, transcripts were open coded independently by team members, a focused coding framework was agreed upon, and emergent themes were identified through constant comparison techniques. Key Results: Most participants placed high value on their insurance, considering it the most important benefit employers offer. Despite having adequate HIL, most participants expressed frustration with the amount of time and effort they spent to determine the best insurance plan, obtain covered health services, and settle claims, often with ineffective results. Despite having insurance, cost considerations influenced many participants' decisions to accept certain tests or treatments, in some cases resulting in delayed or foregone care. Conclusions: The findings of this qualitative study indicate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system. Interventions to improve HIL should include practical examples and real-life scenarios, because HIL gained from experiential narratives was the most useful in navigating the health care system.[HLRP: Health Literacy Research and Practice. 2022;6(2):e61–e69.] Plain Language Summary: By conducting focus groups with a working-class population, this study contextualizes the pathways through which HIL affects consumers' health care decision-making and access to care. Findings demonstrate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system.
{"title":"Health Insurance Literacy Perceptions and the Needs of a Working-Class Community","authors":"Rishtya M. Kakar, R. Combs, Malea Hoepf Young, Nida M. Ali, Baraka Muvuka","doi":"10.3928/24748307-20220309-01","DOIUrl":"https://doi.org/10.3928/24748307-20220309-01","url":null,"abstract":"Background: Despite increases in the number of insured Americans, consumers continue to face barriers in accessing care. Low levels of health insurance literacy (HIL) are associated with suboptimal use of health insurance coverage. There remains a need to further contextualize the relationship between HIL and access to care, especially among insured working-class people. Objective This study was conducted to understand the pathways through which HIL affects health care decision-making and access to care in an urban working-class population. Methods: Using a qualitative descriptive approach, we conducted five focus groups with 45 adult residents of South Louisville, Kentucky. The questions explored participants' experiences of insurance enrollment, use, and health care system navigation, as well as their perceptions and needs regarding accessing health insurance information. Using inductive thematic analysis, transcripts were open coded independently by team members, a focused coding framework was agreed upon, and emergent themes were identified through constant comparison techniques. Key Results: Most participants placed high value on their insurance, considering it the most important benefit employers offer. Despite having adequate HIL, most participants expressed frustration with the amount of time and effort they spent to determine the best insurance plan, obtain covered health services, and settle claims, often with ineffective results. Despite having insurance, cost considerations influenced many participants' decisions to accept certain tests or treatments, in some cases resulting in delayed or foregone care. Conclusions: The findings of this qualitative study indicate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system. Interventions to improve HIL should include practical examples and real-life scenarios, because HIL gained from experiential narratives was the most useful in navigating the health care system.[HLRP: Health Literacy Research and Practice. 2022;6(2):e61–e69.] Plain Language Summary: By conducting focus groups with a working-class population, this study contextualizes the pathways through which HIL affects consumers' health care decision-making and access to care. Findings demonstrate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"36 1","pages":"e62 - e69"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81386874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Medication literacy encompasses the cognitive and social skills necessary for individuals to obtain, comprehend, communicate, calculate, and process medication-related information necessary to make informed decisions. Personal and contextual factors are widely recognized to influence the way that individuals acquire and maintain medication literacy skills. Despite a growing number of studies on medication literacy, current definitions remain general, lacking consideration for the specificities of older adults and hospitalization. Objective: The project was conducted to identify, compare, and summarize the attributes, antecedents, and consequences of medication literacy in hospitalized older adults and to propose a refined definition. Methods: A three-phase hybrid model of concept development was performed that included a literature review and focus groups with hospital nurses. In the final analytic phase, findings from the literature and focus groups were compared, and a refined definition of the concept was elaborated. Key Results: From the synthesis of 24 publications and the narrative data of 14 hospital nurses, 19 themes were described: 4 related to attributes, 8 to antecedents, and 7 to consequences. Medication literacy of hospitalized older adults has been further defined as the degree to which older adults and/or their natural caregivers can develop and maintain multidimensional skills, namely functional, interactive, and critical medication literacy skills. Adjustment of these skills is characterized by a dynamic and potentially complex process. In practice, optimal medication literacy might be achieved through control of and involvement in the medication regimen and the decisions related to it, and/or by using practical means to facilitate medication self-management (e.g., using lists, notes, reminders). Conclusions: The proposed refined definition might enhance professionals' common understanding of the concept and its application in practice, policy, and research. Managing a medication regimen is a complex activity that requires a high level of integration and coordination of cognitive and social skills. [HLRP: Health Literacy Research and Practice. 2022;6(2):e70–e83.] Plain Language Summary: Based on the literature on medication literacy and the experiences of nurses working in hospitals, this article defines medication literacy in hospitalized older adults. This definition will help professionals to better understand challenges related to medication literacy in older patients and to propose adequate support (i.e., provide education, simplify medication prescriptions, propose practical aids such as a pillbox).
{"title":"Medication Literacy in Hospitalized Older Adults: Concept Development","authors":"Jenny Gentizon, Emilie Bovet, Elise Rapp, Cédric Mabire","doi":"10.3928/24748307-20220309-02","DOIUrl":"https://doi.org/10.3928/24748307-20220309-02","url":null,"abstract":"Background: Medication literacy encompasses the cognitive and social skills necessary for individuals to obtain, comprehend, communicate, calculate, and process medication-related information necessary to make informed decisions. Personal and contextual factors are widely recognized to influence the way that individuals acquire and maintain medication literacy skills. Despite a growing number of studies on medication literacy, current definitions remain general, lacking consideration for the specificities of older adults and hospitalization. Objective: The project was conducted to identify, compare, and summarize the attributes, antecedents, and consequences of medication literacy in hospitalized older adults and to propose a refined definition. Methods: A three-phase hybrid model of concept development was performed that included a literature review and focus groups with hospital nurses. In the final analytic phase, findings from the literature and focus groups were compared, and a refined definition of the concept was elaborated. Key Results: From the synthesis of 24 publications and the narrative data of 14 hospital nurses, 19 themes were described: 4 related to attributes, 8 to antecedents, and 7 to consequences. Medication literacy of hospitalized older adults has been further defined as the degree to which older adults and/or their natural caregivers can develop and maintain multidimensional skills, namely functional, interactive, and critical medication literacy skills. Adjustment of these skills is characterized by a dynamic and potentially complex process. In practice, optimal medication literacy might be achieved through control of and involvement in the medication regimen and the decisions related to it, and/or by using practical means to facilitate medication self-management (e.g., using lists, notes, reminders). Conclusions: The proposed refined definition might enhance professionals' common understanding of the concept and its application in practice, policy, and research. Managing a medication regimen is a complex activity that requires a high level of integration and coordination of cognitive and social skills. [HLRP: Health Literacy Research and Practice. 2022;6(2):e70–e83.] Plain Language Summary: Based on the literature on medication literacy and the experiences of nurses working in hospitals, this article defines medication literacy in hospitalized older adults. This definition will help professionals to better understand challenges related to medication literacy in older patients and to propose adequate support (i.e., provide education, simplify medication prescriptions, propose practical aids such as a pillbox).","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"15 1","pages":"e70 - e83"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78723614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-04DOI: 10.3928/24748307-20220315-01
Angélica Maria Cupertino Lopes Marinho, C. Baur, Lucas Emanuel Oliveira Costa, J. Mambrini, F. Ferreira, A. Borges-Oliveira, M. D. de Abreu
The Centers for Disease Control and Prevention (CDC) Clear Communication Index (CCI) was cross-culturally adapted to Brazilian Portuguese (BR). It was necessary to analyze the reliability and validity of the BR-CDC-CCI for its use in Brazil. This study aimed to evaluate the psychometric properties of the instrument in its Brazilian version. Four specialists in health education used the BR-CDC-CCI to evaluate a population-level health education material. Primary health care professionals (n = 105) evaluated the same health material using the BRCDC-CCI, and 30 professionals performed the retest 15 to 20 days after the first assessment. Cohen Kappa and area under the receiver operating characteristic (ROC) curve analyses were developed. Inter-rater agreement ranged from moderate to almost perfect, with 90% of the items almost perfect. The percentage of agreement ranged from 8.6% to 98.1%. For the analyzed questions, the area on the ROC curve was 0.9412 (confidence interval [CI] 95%; [0.8259, 1.000]). The BR-CDC-CCI had sufficient validity and reliability for its use in the evaluation of educational/informational materials in health in the Brazilian context. In view of the good results from this psychometric assessment, we anticipated the BR-CDC-CCI could contribute to improvements in Brazilian professionals' skills in developing health communication materials, thereby improving the quality of education and, possibly health outcomes. [HLRP: Health Literacy Research and Practice. 2022;6(2):e84–e87.]
{"title":"Some Psychometric Properties of the Brazilian CDC Clear Communication Index","authors":"Angélica Maria Cupertino Lopes Marinho, C. Baur, Lucas Emanuel Oliveira Costa, J. Mambrini, F. Ferreira, A. Borges-Oliveira, M. D. de Abreu","doi":"10.3928/24748307-20220315-01","DOIUrl":"https://doi.org/10.3928/24748307-20220315-01","url":null,"abstract":"The Centers for Disease Control and Prevention (CDC) Clear Communication Index (CCI) was cross-culturally adapted to Brazilian Portuguese (BR). It was necessary to analyze the reliability and validity of the BR-CDC-CCI for its use in Brazil. This study aimed to evaluate the psychometric properties of the instrument in its Brazilian version. Four specialists in health education used the BR-CDC-CCI to evaluate a population-level health education material. Primary health care professionals (n = 105) evaluated the same health material using the BRCDC-CCI, and 30 professionals performed the retest 15 to 20 days after the first assessment. Cohen Kappa and area under the receiver operating characteristic (ROC) curve analyses were developed. Inter-rater agreement ranged from moderate to almost perfect, with 90% of the items almost perfect. The percentage of agreement ranged from 8.6% to 98.1%. For the analyzed questions, the area on the ROC curve was 0.9412 (confidence interval [CI] 95%; [0.8259, 1.000]). The BR-CDC-CCI had sufficient validity and reliability for its use in the evaluation of educational/informational materials in health in the Brazilian context. In view of the good results from this psychometric assessment, we anticipated the BR-CDC-CCI could contribute to improvements in Brazilian professionals' skills in developing health communication materials, thereby improving the quality of education and, possibly health outcomes. [HLRP: Health Literacy Research and Practice. 2022;6(2):e84–e87.]","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"13 1","pages":"e84 - e87"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74303865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Improving health literacy has become one of the most important public health-related goals at the global level; however, there is no clear consensus on measurement of health literacy. Despite numerous health literacy scales available in Turkish, none of the existing scales was originally developed and validated at a national level.
Objective: This study aimed to develop and validate a culturally appropriate original health literacy scale (HLS) to be used as a reference for the Turkish-speaking literate adult population in Turkey and abroad.
Methods: Two multidisciplinary workshops with more than 20 experts were conducted and a large item pool was developed. The first and second draft of the scale were pre-tested with 20 and 150 adults, respectively, from different age groups and socioeconomic levels in Ankara. The validity and reliability study of the revised scale (110 items plus 20 self-efficacy statements) was carried out with a household survey of 2,411 adults in 12 randomly selected provinces from 12 Nomenclature of Territorial Units for Statistics Regions in Turkey. Explanatory and confirmatory factor analysis were performed. The fit indices were obtained. The item analysis was applied, and Cronbach's alpha statistics were obtained.
Key results: The scale was found to be both a valid and a reliable measurement tool to assess health literacy. Cronbach's alpha for two sub-dimensions ("disease prevention and health promotion" and "treatment and access to health services") were 0.79 and 0.91, respectively. Construction validity indices were Root Mean Square Error of Approximation (RMSEA) = 0.043, Goodness of Fit Index (GFI) = 0.96, Normed Fit Index (NFI) = 0.95, and Adjusted Goodness of Fit Index (AGFI) = 0.95. The scale includes "self-efficacy" as an additional dimension (Cronbach's alpha = 0.83, RMSEA = 0.68, GFI = 0.94, NFI = 0.94, and AGFI) = 0.91).
Conclusion: HLS is a valid and reliable measurement tool to assess health literacy of Turkish-speaking literate adults with a mixed (objective and subjective) assessment approach. [HLRP: Health Literacy Research and Practice. 2022;6(1):e2-e11.] Plain Language Summary: This study aimed to develop and validate a culturally sensitive original health literacy scale to be used as a reference scale for the Turkish-speaking literate adult population in Turkey and abroad. Study findings showed that HLS is both a valid and a reliable measurement tool to assess health literacy of Turkish-speaking literate adults.
{"title":"Development and Validation of a Culture-Sensitive Generic Health Literacy Scale in Turkish-Speaking Adults.","authors":"Şevkat Bahar Özvarış, Bahar Güçiz Doğan, Hande Konşuk Ünlü, Ozge Karadag, Nuri Doğan, Selahattin Gelbal, Sibel Sakarya","doi":"10.3928/24748307-20211208-01","DOIUrl":"10.3928/24748307-20211208-01","url":null,"abstract":"<p><strong>Background: </strong>Improving health literacy has become one of the most important public health-related goals at the global level; however, there is no clear consensus on measurement of health literacy. Despite numerous health literacy scales available in Turkish, none of the existing scales was originally developed and validated at a national level.</p><p><strong>Objective: </strong>This study aimed to develop and validate a culturally appropriate original health literacy scale (HLS) to be used as a reference for the Turkish-speaking literate adult population in Turkey and abroad.</p><p><strong>Methods: </strong>Two multidisciplinary workshops with more than 20 experts were conducted and a large item pool was developed. The first and second draft of the scale were pre-tested with 20 and 150 adults, respectively, from different age groups and socioeconomic levels in Ankara. The validity and reliability study of the revised scale (110 items plus 20 self-efficacy statements) was carried out with a household survey of 2,411 adults in 12 randomly selected provinces from 12 Nomenclature of Territorial Units for Statistics Regions in Turkey. Explanatory and confirmatory factor analysis were performed. The fit indices were obtained. The item analysis was applied, and Cronbach's alpha statistics were obtained.</p><p><strong>Key results: </strong>The scale was found to be both a valid and a reliable measurement tool to assess health literacy. Cronbach's alpha for two sub-dimensions (\"disease prevention and health promotion\" and \"treatment and access to health services\") were 0.79 and 0.91, respectively. Construction validity indices were Root Mean Square Error of Approximation (RMSEA) = 0.043, Goodness of Fit Index (GFI) = 0.96, Normed Fit Index (NFI) = 0.95, and Adjusted Goodness of Fit Index (AGFI) = 0.95. The scale includes \"self-efficacy\" as an additional dimension (Cronbach's alpha = 0.83, RMSEA = 0.68, GFI = 0.94, NFI = 0.94, and AGFI) = 0.91).</p><p><strong>Conclusion: </strong>HLS is a valid and reliable measurement tool to assess health literacy of Turkish-speaking literate adults with a mixed (objective and subjective) assessment approach. <b>[<i>HLRP: Health Literacy Research and Practice</i>. 2022;6(1):e2-e11.]</b> Plain Language Summary: This study aimed to develop and validate a culturally sensitive original health literacy scale to be used as a reference scale for the Turkish-speaking literate adult population in Turkey and abroad. Study findings showed that HLS is both a valid and a reliable measurement tool to assess health literacy of Turkish-speaking literate adults.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":" ","pages":"e2-e11"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39907566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01Epub Date: 2022-01-13DOI: 10.3928/24748307-20211206-01
Cliff Coleman, Fernando Salcido-Torres, Rebecca E Cantone
Patients frequently do not understand health information received in clinical settings, yet rates of question-asking by patients are low, particularly for patients with lower health literacy skills. Experts recommend that health care professionals attempt to elicit patients' questions by using an open-ended phrase, such as "What questions do you have?" as opposed to a closed-ended phrase like, "Do you have any questions?" We compared question-eliciting techniques used during video-recorded observed structured clinical examinations among medical students who had completed a mostly didactic curriculum on health literacy and clear communication (n = 46) to students who completed a newer longitudinal problem-based communication curriculum (n = 32). Students were not aware that they were being observed for specific communication skills. Compared to controls, students in the intervention group were more likely to spontaneously attempt to elicit questions from a standardized patient (65.2% vs. 84.4%, p = .06), and were significantly more likely to use an open-ended phrase to do so (6.7% vs. 51.9%, p = .0002). The longitudinal communication skills curriculum was successful in creating long-term patient-centered question-eliciting habits. Further research is needed to determine whether eliciting questions with an open-ended technique result in patients asking more or different clarifying questions during the closing phase of clinical encounters. [HLRP: Health Literacy Research and Practice. 2022;6(1):e12-e16.].
{"title":"\"What Questions Do You Have?\": Teaching Medical Students to Use an Open-Ended Phrase for Eliciting Patients' Questions.","authors":"Cliff Coleman, Fernando Salcido-Torres, Rebecca E Cantone","doi":"10.3928/24748307-20211206-01","DOIUrl":"10.3928/24748307-20211206-01","url":null,"abstract":"<p><p>Patients frequently do not understand health information received in clinical settings, yet rates of question-asking by patients are low, particularly for patients with lower health literacy skills. Experts recommend that health care professionals attempt to elicit patients' questions by using an open-ended phrase, such as \"What questions do you have?\" as opposed to a closed-ended phrase like, \"Do you have any questions?\" We compared question-eliciting techniques used during video-recorded observed structured clinical examinations among medical students who had completed a mostly didactic curriculum on health literacy and clear communication (<i>n</i> = 46) to students who completed a newer longitudinal problem-based communication curriculum (<i>n</i> = 32). Students were not aware that they were being observed for specific communication skills. Compared to controls, students in the intervention group were more likely to spontaneously attempt to elicit questions from a standardized patient (65.2% vs. 84.4%, <i>p</i> = .06), and were significantly more likely to use an open-ended phrase to do so (6.7% vs. 51.9%, <i>p</i> = .0002). The longitudinal communication skills curriculum was successful in creating long-term patient-centered question-eliciting habits. Further research is needed to determine whether eliciting questions with an open-ended technique result in patients asking more or different clarifying questions during the closing phase of clinical encounters. <b>[<i>HLRP: Health Literacy Research and Practice</i>. 2022;6(1):e12-e16.]</b>.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":" ","pages":"e12-e16"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/e1/hlrp0122colemanbr-prt.PMC8758184.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39907565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01Epub Date: 2022-02-04DOI: 10.3928/24748307-20220106-01
Ane H Bonde, Nanna W Stjernqvist, Charlotte D Klinker, Helle T Maindal, Olli Paakkari, Peter Elsborg
Low health literacy (HL) is associated with adverse health behaviors and poor health, and brief, high-quality instruments for measuring HL in children are scarce. The Health Literacy for School-Aged Children (HLSAC) instrument is a 10-item theory-based and internationally validated tool for measuring HL. The purpose of this study was to translate and validate the HLSAC instrument among Danish school-aged children. The instrument was translated into Danish by a standardized forward-backward translation process, and then pre-tested for face validity with 61 pupils from four schools. Thereafter, the instrument was tested among 805 pupils in grades 6 to 7 (age 11-14 years) from 15 schools. When HL was modeled as one latent factor with all 10 items loading on this factor, the confirmative factor analysis showed standardized factor loadings from 0.52 to 0.75 (p < .001) and an excellent model fit. The association between HL and food intake as a health behavior example (p < .001, r2 = .027) indicates the predictive validity of the instrument. The internal consistency was high (Cronbach's alpha = 0.86). Thus, a valid and reliable version of the HLSAC instrument is available in Danish for future surveys to monitor HL and guide health promotion targeting children and adolescents. [HLRP: Health Literacy Research and Practice. 2022;6(1):e25-e29.].
{"title":"Translation and Validation of a Brief Health Literacy Instrument for School-Age Children in a Danish Context.","authors":"Ane H Bonde, Nanna W Stjernqvist, Charlotte D Klinker, Helle T Maindal, Olli Paakkari, Peter Elsborg","doi":"10.3928/24748307-20220106-01","DOIUrl":"https://doi.org/10.3928/24748307-20220106-01","url":null,"abstract":"<p><p>Low health literacy (HL) is associated with adverse health behaviors and poor health, and brief, high-quality instruments for measuring HL in children are scarce. The Health Literacy for School-Aged Children (HLSAC) instrument is a 10-item theory-based and internationally validated tool for measuring HL. The purpose of this study was to translate and validate the HLSAC instrument among Danish school-aged children. The instrument was translated into Danish by a standardized forward-backward translation process, and then pre-tested for face validity with 61 pupils from four schools. Thereafter, the instrument was tested among 805 pupils in grades 6 to 7 (age 11-14 years) from 15 schools. When HL was modeled as one latent factor with all 10 items loading on this factor, the confirmative factor analysis showed standardized factor loadings from 0.52 to 0.75 (<i>p</i> < .001) and an excellent model fit. The association between HL and food intake as a health behavior example (<i>p</i> < .001, r<sup>2</sup> = .027) indicates the predictive validity of the instrument. The internal consistency was high (Cronbach's alpha = 0.86). Thus, a valid and reliable version of the HLSAC instrument is available in Danish for future surveys to monitor HL and guide health promotion targeting children and adolescents. <b>[<i>HLRP: Health Literacy Research and Practice</i>. 2022;6(1):e25-e29.]</b>.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":" ","pages":"e26-e29"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39899265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.3928/24748307-20220208-01
E. Griffeth, I. Sharif, Alexandria Caldwell, M. Townsend Cooper, Hollyce Tyrrell, M. Dunlap
Background: Low health literacy affects one-third of adults in the United States and can have a negative effect on health behavior and outcomes. Objective: The goal of this study was to examine attitudes and knowledge of health literacy among pediatric residents and faculty in pediatric resident continuity clinics across the country. Methods: An online mixed-methods survey was distributed to pediatric faculty and residents through the Academic Pediatric Association's Continuity Research Network. The 20-question survey included questions about the participants' health literacy knowledge and health literacy practices in continuity clinics, such as use of universal health literacy precautions. Categorical answer choices were dichotomized into positive and negative groupings and resident and faculty responses were compared using the Chi-squared test (significance p < .05). Qualitative data were analyzed using emergent coding and grounded theory to determine themes. Key Results: Responses were received from 402 individuals at 24 pediatric residency programs. Most participants agreed or strongly agreed that they could correctly identify participants with low health literacy (76% residents vs. 53% faculty). Only 19% of residents and 26% of faculty were familiar with universal health literacy precautions. Many residents and faculty had received no training in health literacy (37% residents vs. 38% faculty). Barriers and challenges around health literacy included time, language, limited training or resources, low literacy, disease mismanagement, and fixed misconceptions. Conclusion: Despite ample evidence in the literature to the contrary, most respondents believed they could correctly identify individuals with low health literacy. Additionally, most participants had not heard of universal health literacy precautions and were unaware of their usage in their practice setting. This is not consistent with current expert recommendations. These findings are troubling as they are from academic residency programs, indicating an educational deficit. These findings point toward a next step in health literacy education for pediatric residents. [HLRP: Health Literacy Research and Practice. 2022;6(1):e51–e60.] Plain Language Summary: Pediatric residents and faculty in continuity clinics were surveyed about their opinions, health literacy knowledge, ability, and practices in continuity clinics. Despite evidence to the contrary, most respondents believed they could correctly identify individuals with low health literacy and had not heard of universal health literacy precautions. These findings highlight the need for more health literacy education for pediatric residents.
{"title":"Health Literacy Perceptions and Knowledge in Pediatric Continuity Practices","authors":"E. Griffeth, I. Sharif, Alexandria Caldwell, M. Townsend Cooper, Hollyce Tyrrell, M. Dunlap","doi":"10.3928/24748307-20220208-01","DOIUrl":"https://doi.org/10.3928/24748307-20220208-01","url":null,"abstract":"Background: Low health literacy affects one-third of adults in the United States and can have a negative effect on health behavior and outcomes. Objective: The goal of this study was to examine attitudes and knowledge of health literacy among pediatric residents and faculty in pediatric resident continuity clinics across the country. Methods: An online mixed-methods survey was distributed to pediatric faculty and residents through the Academic Pediatric Association's Continuity Research Network. The 20-question survey included questions about the participants' health literacy knowledge and health literacy practices in continuity clinics, such as use of universal health literacy precautions. Categorical answer choices were dichotomized into positive and negative groupings and resident and faculty responses were compared using the Chi-squared test (significance p < .05). Qualitative data were analyzed using emergent coding and grounded theory to determine themes. Key Results: Responses were received from 402 individuals at 24 pediatric residency programs. Most participants agreed or strongly agreed that they could correctly identify participants with low health literacy (76% residents vs. 53% faculty). Only 19% of residents and 26% of faculty were familiar with universal health literacy precautions. Many residents and faculty had received no training in health literacy (37% residents vs. 38% faculty). Barriers and challenges around health literacy included time, language, limited training or resources, low literacy, disease mismanagement, and fixed misconceptions. Conclusion: Despite ample evidence in the literature to the contrary, most respondents believed they could correctly identify individuals with low health literacy. Additionally, most participants had not heard of universal health literacy precautions and were unaware of their usage in their practice setting. This is not consistent with current expert recommendations. These findings are troubling as they are from academic residency programs, indicating an educational deficit. These findings point toward a next step in health literacy education for pediatric residents. [HLRP: Health Literacy Research and Practice. 2022;6(1):e51–e60.] Plain Language Summary: Pediatric residents and faculty in continuity clinics were surveyed about their opinions, health literacy knowledge, ability, and practices in continuity clinics. Despite evidence to the contrary, most respondents believed they could correctly identify individuals with low health literacy and had not heard of universal health literacy precautions. These findings highlight the need for more health literacy education for pediatric residents.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"11 1","pages":"e51 - e60"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76132098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.3928/24748307-20220201-01
J. Edward, R. Thompson, A. Wiggins
Background: With rising unemployment rates brought on by coronavirus disease 2019 pandemic, the rates of underinsured and uninsured consumers are likely to rise. Health information intermediaries play a critical role in assisting consumers with navigating the complexities of the United States health care system and the ever-changing health care policy landscape. Not much is known about the health insurance literacy (HIL) levels of information intermediaries and their ability to assist consumers with making informed decisions about their health insurance. Objective: This study aimed to examine the association between information intermediary levels of HIL, sociodemographic factors, and confidence and behaviors in assisting consumers with health insurance needs. Methods: We surveyed 118 information intermediaries from various roles to assess objective and subjective HIL, frequency, and confidence in assisting consumers, and confidence in understanding changes in federal health reform policies and state Medicaid waiver programs. Key Results: Less than one-half (39%) of information intermediaries had high subjective HIL and much fewer (13%) had high objective HIL. The average frequency of assisting consumers with health insurance scores were somewhat low, and confidence in assisting consumers with health insurance scores and confidence with understanding state and federal policies were modest. Results from our logistic regression model indicated that confidence in assisting consumers was found to be the only significant contributor to high subjective HIL. For every one-point increase on the confidence assisting subscale, there was a 35% increase in the information intermediaries having high subjective HIL. Conclusions: Findings from this study, coupled with rising uninsured rates, indicate the need for tailored training programs and resources to equip our information intermediaries to provide timely and appropriate health insurance support for consumers. [HLRP: Health Literacy Research and Practice. 2022;6(1):e30–e36.] Plain Language Summary: In a sample of 118 information intermediaries, representing community health workers, navigators, and other people in outreach roles, the majority had low subjective and objective HIL. We also found that as confidence with assisting consumers with health insurance needs increases, HIL increased as well. These findings indicate that tailored training programs and resources are needed to equip information intermediaries to provide health insurance support for consumers.
{"title":"Health Insurance Literacy Levels of Information Intermediaries: How Prepared Are They to Address the Growing Health Insurance Access Needs of Consumers?","authors":"J. Edward, R. Thompson, A. Wiggins","doi":"10.3928/24748307-20220201-01","DOIUrl":"https://doi.org/10.3928/24748307-20220201-01","url":null,"abstract":"Background: With rising unemployment rates brought on by coronavirus disease 2019 pandemic, the rates of underinsured and uninsured consumers are likely to rise. Health information intermediaries play a critical role in assisting consumers with navigating the complexities of the United States health care system and the ever-changing health care policy landscape. Not much is known about the health insurance literacy (HIL) levels of information intermediaries and their ability to assist consumers with making informed decisions about their health insurance. Objective: This study aimed to examine the association between information intermediary levels of HIL, sociodemographic factors, and confidence and behaviors in assisting consumers with health insurance needs. Methods: We surveyed 118 information intermediaries from various roles to assess objective and subjective HIL, frequency, and confidence in assisting consumers, and confidence in understanding changes in federal health reform policies and state Medicaid waiver programs. Key Results: Less than one-half (39%) of information intermediaries had high subjective HIL and much fewer (13%) had high objective HIL. The average frequency of assisting consumers with health insurance scores were somewhat low, and confidence in assisting consumers with health insurance scores and confidence with understanding state and federal policies were modest. Results from our logistic regression model indicated that confidence in assisting consumers was found to be the only significant contributor to high subjective HIL. For every one-point increase on the confidence assisting subscale, there was a 35% increase in the information intermediaries having high subjective HIL. Conclusions: Findings from this study, coupled with rising uninsured rates, indicate the need for tailored training programs and resources to equip our information intermediaries to provide timely and appropriate health insurance support for consumers. [HLRP: Health Literacy Research and Practice. 2022;6(1):e30–e36.] Plain Language Summary: In a sample of 118 information intermediaries, representing community health workers, navigators, and other people in outreach roles, the majority had low subjective and objective HIL. We also found that as confidence with assisting consumers with health insurance needs increases, HIL increased as well. These findings indicate that tailored training programs and resources are needed to equip information intermediaries to provide health insurance support for consumers.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"129 1","pages":"e30 - e36"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73462692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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