Health literacy research and practice最新文献

This study aimed to explore the barriers to cardiac rehabilitation (CR) participation across individuals with different levels of health literacy. A cross-sectional study was conducted among individuals referred to a CR program. Participants completed online surveys assessing CR barriers using the Cardiac Rehabilitation Barriers Scale and health literacy using the Brief Health Literacy Screening Tool. Descriptive statistics and comparisons were performed. Among 881 individuals invited, 400 responded, with varying levels of health literacy: 22(6%) limited, 305(76%) marginal, and 72(18%) adequate. The greatest barriers included family responsibilities, lack of energy, and a preference for managing health alone. However, distinct patterns emerged based on health literacy levels, with individuals citing different barriers. Although no significant differences were observed in CR barriers based on health literacy, understanding individual-specific challenges is crucial for intervention development. Addressing common barriers such as family responsibilities and logistical challenges could enhance CR engagement and adherence. [HLRP: Health Literacy Research and Practice. 2025;9(2):e72-e77.].

Background: From 2021 to 2023, the City of Albuquerque, the University of New Mexico (UNM) Office for Community Health, the UNM Hospital Health Literacy Office (UNMH HLO), and partners in Albuquerque, New Mexico, implemented the Albuquerque COVID-19 Health Literacy Project (AHLP). The goal of the program was to develop a network of Community Health Workers (CHWs) and community agency partners able to use health literacy (HL) best practices to reduce coronavirus disease 2019 (COVID-19)-related health disparities in Albuquerque, New Mexico.

Brief description of activity: AHLP created a training and support infrastructure to provide CHWs with the knowledge, skills and tools for using HL strategies and approaches for COVID-19 health promotion. The UNMH HLO guided integration of HL practices into the work. We collected and visualized data to identify geographies of need, map project outreach activities, and monitor population health indicators of the project's coordinated service efforts.

Implementation: Trainings, a core feature of the AHLP, were primarily conducted via video conference and included a project launch training, weekly check-ins, monthly workshops, and a series of on-site open house events at the facilities of agency partners. We conducted 10 trainings at which Teach Back and plain language strategies were taught and practiced with CHWs for this project. CHWs conducted outreach through events, phone calls, individual in-person meetings, group meetings, spur-of the moment conversations, and shorter and less structured CHW conversations.

Results: The AHLP reached 44,690 people-2.5 times our goal. Seventy two percent of clients indicated they were likely to get the COVID-19 vaccine. The COVID-19 booster gap closed for those living in high versus low Social Vulnerability Index geographies, reducing this disparity nearly 3-fold in 6 months. CHWs implemented this work using HL best practices that have primarily been developed for use in clinical settings and in the process, they innovated ways to adapt these practices to be appropriate for community contexts.

Lessons learned: HL practices were seen as valuable by AHLP CHWs. They reframed plain language as a path to empowerment. But for Teach Back to be used by CHWs in nonclinical settings, there needed to be changes to the way that Teach Back is taught, conceptualized, and implemented. CHWs in the AHLP refocused these tools and brought them into the CHW work they are already doing. [HLRP: Health Literacy Research and Practice. 2025;9(2):e56-e63.].

Objective: Using health literacy informed communication strategies can mitigate health inequities. Despite the high prevalence of limited health literacy among parents and children, pediatricians infrequently use clear communication techniques and further education is imperative. There is minimal literature exploring health literacy curricula in pediatric residencies. We sought to evaluate health literacy education across pediatric residency programs.

Methods: The Academic Pediatric Association's Health Literacy Special Interest Group performed a national, cross-sectional survey of pediatric associate program directors from July 2022 to September 2022. We asked about the presence of health literacy curricula, teaching strategies used, content highlighted, outcomes assessed, and barriers encountered.

Results: Among 55 associate program directors from programs diverse in setting, size, and geographic region who participated, most (84%) reported their residents would benefit from more health literacy training. Only 44% reported the presence of health literacy education, with minimal teaching of evidence-based principles, such as the universal precautions approach to clear communication.

Conclusion: Health literacy is infrequently taught in pediatric residency programs and there is appreciable variability among existing curricula. There is need for greater dissemination of existing resources, as well as standardization of curricula and assessment tools to ensure pediatricians are well-versed in use of health literacy-informed communication techniques. [HLRP: Health Literacy Research and Practice. 2025;9(1):e3-e7.].

Background: Formerly incarcerated individuals (FIIs) encounter difficulties with covering the cost of dental and medical care, adhering to medication regimens, and receiving fair treatment from health care providers. Yet, no published research has examined modifiable pathways to increase FIIs' health literacy (HL), which is essential for addressing the health needs of this vulnerable population.

Objective: The aim of this article is to examine neighborhood characteristics (neighborhood deprivation, racial and economic polarization, and residential segregation) and public assistance program enrollment as structural determinants of limited health literacy (LHL) among FIIs.

Methods: Using a socioecological framework, we analyzed a subsample of 578 FIIs from the 2023 Survey of Racism and Public Health, an online cross-sectional survey spanning U.S. Department of Health & Human Services Regions 1, 2, and 3. HL was assessed using the Brief Health Literacy Screen. Logistic regression models estimated unadjusted and adjusted associations of LHL with neighborhood characteristics and public assistance program enrollment. Adjusted models controlled for age, race and ethnicity, gender identity, educational attainment, marital and employment status, number of children, chronic health conditions, and incarceration length.

Key results: The 578 FIIs had an average age of 46, with 42% having LHL. We observed a statistically significant association between public assistance program enrollment and LHL (unadjusted odds ratio [OR] = 2.72, 95% confidence interval [CI]: 1.87, 4.01; adjusted OR = 2.50, 95% CI: 1.62, 3.88). We found no statistically significant associations of LHL with neighborhood deprivation, racial and economic polarization, and residential segregation.

Conclusions: Our findings suggest that there may be an opportunity to develop tailored interventions for increasing HL among FIIs through public assistance programs. Dissemination of HL resources among this marginalized group can improve their self-management of chronic diseases. This is of paramount importance because FIIs must simultaneously navigate other challenges after incarceration (e.g., unstable housing). [HLRP: Health Literacy Research and Practice. 2025;9(1):e8-e18.].

Background: While adolescents and young adults are increasingly expected to take more responsibility for their health and wellbeing, continuing digital transformation and increased implementation of digital health services (DHS) demand skills to utilize digital solutions offered to successfully undertake self-care and self-management. However, research is lacking regarding measurement of adolescents' and young adults' "ability to utilize DHS" (or "DHC").

Objective: This study aims to measure young people's DHC by (1) validating the Digital HealthCare Scale (DHC scale) in adolescents and in young adults and (2) exploring the extent to which DHC and digital health literacy (DHL) are associated with the number of general practitioner, emergency, or specialist visits.

Methods: A cross-sectional survey was conducted among 890 Norwegian adolescents and young adults age 16 to 25 years. Data were collected from April 2020 to October 2020 using computer-assisted telephone interviewing. Rasch modeling, independent samples t-test, chi-square test, and negative binomial regression models were used to analyze the data.

Key results: The DHC scale is considered valid for measuring DHC in adolescents and young adults, showing sufficient unidimensionality, good overall data-model fit, and no disordered response categories nor differential item functioning. Results showed that female participants and adolescents age 16 to 20 years self-reported significantly lower DHL and DHC than male participants and young adults age 21 to 25 years. Regression analyses displayed a statistically significant association between adolescents' and young adults' DHL (n = 371) and DHC (n = 389) and their utilization of specialist health services. For every unit (logit) increase in DHL and DHC, the number of specialist visits decreased by 25% and 28%, respectively.

Conclusions: Aligned with previous research calling for new up-to-date instruments to measure the new aspects of DHL, our study has introduced a new measurement scale (DHC scale) for use among adolescents and young adults. This scale may be useful for health authorities, public health workers, and health providers in evaluating and adapting DHC. [HLRP: Health Literacy Research and Practice. 2025;9(1):e19-e28.].

Background: The COVID-19 pandemic exacerbated long-standing disparities that many people in the United States experience due to their race and ethnicity and socioeconomic status.

Brief description of activity: An outcry from several relevant stakeholders ignited a federal response from the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (HHS), who, among other entities, decided to address low health literacy (HL) in underserved communities. Evidence suggests that HL impacts under-resourced communities' understanding of health issues and whether they adhere to health guidelines.

Implementation: This article aims to provide an ecological analysis of HL best practices, highlighting their role in community health during public health crises.

Results: Although a vast amount of literature applies Ecological Systems Theory (EST) to understanding and addressing a range of issues impacting the health of communities, scarce literature applies EST to understanding HL interventions.

Lessons learned: We discuss implications for public health efforts, concluding that Bronfenbrenner's Ecological Systems Theory is effective for grounding the development and implementation of best practices for promoting HL interventions. [HLRP: Health Literacy Research and Practice. 2025;9(1):e29-e36.].

Background: Organizations have a responsibility to reduce cognitive demands and strengthen health literacy support for patients and clients to improve understanding, access, and use of services. Most studies of organizational health literacy (OHL) are focused on traditional clinical settings and do not provide clear direction on how to make change. It is recognized that many people seek their everyday health information from trusted community-based organizations. The aim of this pilot study was to guide community-based health organizations performing an environmental health literacy assessment and operationalize the results to create actions plans for health literacy change.

Brief description of activity: A novel health literacy Pledge Program facilitated community-based health organizations in performing a self-assessment of their internal and external environments to identify OHL supporting factors and barriers. Findings informed this offering of best practice for the assessment process.

Implementation: Small teams from the 10 participating organizations, which included traditional health care settings like clinics and non-traditional settings like community centers and housing providers, performed the Health Literacy Environment of Hospitals and Health Centers (HLE2) self-assessment. Structured discussion groups were held with the teams to review the HLE2 results and create an action plan for OHL change. Thematic analysis of the findings revealed trends to inform actions to be considered in ongoing OHL research.

Results: All organizations were able to successfully complete the HLE2. Score ranges overall were low, indicating opportunities for improving OHL. There was overlap with the themes of the short-term and long-term actions. All themes aligned with OHL domains in which interventions can make services more understandable and accessible.

Lessons learned: This is the first known OHL study that includes non-clinical community based-health organizations. Findings demonstrate that OHL assessment and corresponding development of plans for actionable change is needed and accepted by community-based organizations. Further research into OHL best practices should continue to explore these trusted settings as a resource where people receive health information and services. [HLRP: Health Literacy Research and Practice. 2025;9(1):e37-e45.].

Background: Health literacy is becoming increasingly important in the field of public health as it contributes to individuals' social empowerment. During the coronavirus disease 2019 (COVID-19) pandemic, preventive measures (mask usage, physical distancing, hand washing) and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shaped the degree of infection of the population, and their acceptance was associated with a multitude of factors, health literacy included. The aim of this scoping review is to explore the impact of all health literacy dimensions (namely, understanding, access, evaluation and application of health information) on accepting preventive measures and vaccination against SARS-CoV-2 among adult European citizens.

Methods: A literature search on three different databases was conducted from July 2022 to December 2022.

Key results: A total of 154 articles were initially identified, which were rigorously assessed by two reviewers. Ten studies that met the inclusion criteria were analyzed. The results showed that health literacy played an important role in accepting preventive measures and vaccination as well as in rating health information related to the coronavirus.

Discussion: Health literacy is a positive predictor of coronavirus prophylaxis and could be incorporated into public health policies to appropriately control future health crises.

Background: Health literacy (HL) plays a crucial role in navigating the coronavirus disease 2019 (COVID-19) pandemic, especially with the abundance of conflicting information from unauthorized sources.

Objective: This study aims to measure COVID-19 vaccine acceptability, COVID-19 HL, and COVID-19 infodemic and their predictors in Iranians.

Methods: A cross-sectional study was conducted on the general population in Iran between August 20, 2021 to October 29, 2021. Data were collected using a valid questionnaire with four parts. Univariable and multivariable logistic regression models, generalized linear models, and ordinal regression with the Polytomous Universal Model were performed using SPSS version 26.

Key results: The study revealed that 68.6% of the participants were willing to accept the COVID-19 vaccine, 45% had sufficient knowledge about COVID-19, and 52.2% were confused by false information during the pandemic. The results showed that having sufficient COVID-19 HL was significantly associated with higher acceptance of the vaccine (adjusted odds ratio = 1.52, 95% confidence interval (CI): 1.02, 2.12). Additionally, higher COVID-19 HL scores were associated with a higher adjusted odds of confusion by false information with an odds ratio of 1.12 (95% CI: 1 .11, 1 .13).

Conclusion: This study exhibits low levels of COVID-19 HL in Iran, and the fact that higher COVID-19 HL is associated with higher vaccine acceptance. Because vaccination is an essential preventive measure to stop the COVID-19 pandemic, factors associated with low vaccine acceptance need to be addressed by public health strategies. [HLRP: Health Literacy Research and Practice. 2024;8(4):e184-e193.].