Health literacy research and practice最新文献

Background: Low income and low health literacy are associated with poorer health knowledge, health behaviors and poor health outcomes. The effectiveness of health literacy-directed weight loss treatment interventions in primary care clinics is lacking.

Objective: The aim of this study was to conduct a pragmatic cluster-randomized trial (PROmoting Successful Weight Loss in Primary CarE in Louisiana ([PROPEL]) to test the effectiveness of a 24-month, patient-centered, literacy-directed obesity treatment program delivered within primary care in an underserved population. This study reports the association between health literacy and program effectiveness, examining potential correlates of weight loss related to patient adherence to the program.

Methods: We randomly assigned 18 clinics to usual care (UC) or a health literacy-directed lifestyle intervention (HLI). The primary outcome was percent weight loss at 24 months.

Key results: Of 803 adult participants (84% women; 67% Black), 31% had limited health literacy. Patients in UC lost an average of 0.44%of their enrollment weight after 24 months. Those with adequate literacy lost 0.57% and those with limited literacy lost 0.30%, which was not significantly different. The HLI patient group lost an average of 4.9% of their enrollment weight. Those with adequate literacy lost 5.2% and those with limited literacy, 4.7%, which was not significantly different. The advantage of adequate health literacy was consistent across the 24-month study period, though not significant. Patients in the HLI group with adequate health literacy had greater percent weight loss by a margin of 0.50 ± 0.75 (p = .50), while the UC margin was 0.27 ± 0.84 (p = .74). The percent weight loss difference between HLI and UC groups was 4.6 ± 0.8 (p < .001) among patients with adequate health literacy and 4.4 ± 1.0 (p < .001) among patients with limited health literacy. The difference in percent weight loss between the HLI and UC groups was 0.2 ± 1.1 (p = .84) higher for adequate literacy patients.

Conclusions: A health literacy directed health coaching intervention in community clinics led to significant weight loss over 24 months but did not vary by level of patient health literacy. [HLRP: Health Literacy Research and Practice. 2024;8(4):e204-e211.].

Background: In Japan, the doctor-patient relationship has traditionally been characterized by a power imbalance that may contribute to communication gaps. To date, however, the link between patients' health literacy levels and their understanding of doctors' explanations of medical conditions and treatment has yet to be fully examined in Japan.

Objective: The purpose of this study was to investigate the association between patients' health literacy level and their understanding of doctors' explanations.

Methods: This was a cross-sectional study analyzing data derived from 11,217 questionnaires collected in July 2021 from participants of the Yamagata Study, a community-based cohort study implemented by Yamagata University since 2009.

Key results: The results showed lower health literacy was associated with poorer understanding of physicians' explanations, adjusting for potential confounding factors. In addition to low health literacy, factors associated with lower comprehension were being male, not having a regular family doctor, and having lower self-perceived levels of health and happiness.

Conclusions: The results suggest that health care professionals need to communicate with patients according to their health literacy level and ensure they fully understand their medical condition and treatment. Medical providers need to create a better health-literate environment to enable patients and families to make decisions by themselves. [HLRP: Health Literacy Research and Practice. 2024;8(3):e175-e183.].

To address current gaps in health literacy research and practice in low-resource settings, the 'Alfa-Health Program' was designed to improve health literacy in older adults who live in a community dwelling in a socioeconomically disadvantaged community in North-East Brazil. In this longitudinal qualitative study, participants were interviewed before and after participating in the group-based program that was delivered November 2017 to December 2017 in the Primary Care Health Unit. Semi-structured interviews were guided by a previously validated health literacy instrument, translated and adapted for use in Brazil. Data was analyzed using Framework analysis. Of the 21 participants, the majority were age 60 to 69 years with a median of 4-years of school education. Our analysis identified self-reported improvements in health knowledge, behaviors, and skills that matched program content and indicated that participants were supported to manage their health conditions more autonomously. Other themes reflect the distributed nature of health literacy and the potential for group-based health literacy programs to facilitate feelings of social support and cohesion through co-learning. However, age-related deficits in memory and external and structural factors remained important barriers to program participation. This study provides insight into developing health literacy in low-resource settings with older adults, where health literacy is compounded by social determinants and cognitive and sensory changes that contribute to health disparities. Although the targeted Alfa Health Program addresses calls to ensure that priority is proportionate to need by reaching and engaging population groups who are disproportionately affected by low health literacy, further work is needed to adapt the program for people who are unable to read or write. [HLRP: Health Literacy Research and Practice. 2024;8(3):e140-e150.].

Paulo Freire, Brazilian philosopher and educator, proposed an educational method for adults based on what he called "the problem posing method." This method was based on dialogue that he deemed necessary for education and was not oppressive and controlling. Freire argued that traditional educational methods were inherently oppressive because they served the interest of the elite, instituted what he called "the banking method" in hopes to turn people into better workers. In contrast to this, Freire advocated for an education that was liberating and required dialogue. Dialogue, however, could only take place with profound love. This article reflects on Freire's call for profound love and dialogue within his pedagogical framework, and its necessity for social and political change. Further, this article explores what Freire meant by profound love and dialogue, and explores how love and dialogue are applicable to current and future health literacy and health education efforts. [HLRP: Health Literacy Research and Practice. 2024;8(3):e118-e120.].