Health literacy research and practice最新文献

Background: Approximately 8% of elementary school-aged children in the United States have food allergies, a complicated health management situation that requires parents to use many types of health literacy, empowerment, and advocacy skills to work with school staff to protect their children.

Objective: This cross-sectional study examined (a) whether the highest versus lowest levels of functional, communicative, and critical health literacy are associated with higher perceived effectiveness of parental advocacy behaviors for safe food allergy management in schools [parental advocacy]; and (b) whether communicative and critical health literacy are more strongly associated with parental advocacy than functional health literacy.

Methods: A sample of parents of elementary school-aged children was recruited through 26 food allergy organizations and a research patient registry. Participants completed an anonymous online survey. Self-reported measurements of parental health literacy, empowerment, and advocacy were adapted and refined through pre-testing and pilot-testing. General linear model analyses were conducted to predict parental advocacy.

Key results: Participants (N = 313) were predominantly White, college-educated mothers with moderately high levels of food allergy knowledge, health literacy, empowerment, and parental advocacy skills. Parents who scored at the highest levels in the three dimensions of health literacy reported they engaged in more effective advocacy behaviors than parents who scored at the lowest levels. Parental advocacy was predicted largely by parental empowerment and the quality of the relationship with the school (B = .41 and B = .40, respectively). Functional health literacy and the child's diagnosis of asthma were smaller predictors. While accounting for covariates, functional health literacy was significantly associated with parental advocacy whereas communicative and critical health literacy were not.

Conclusions: Interventions to impact parental empowerment and parent-school relationships, including a health-literate universal precautions approach of communicating food allergy school policies, may influence parental advocacy for food allergy safety in schools. Further research could use a performance-based multidimensional measure of health literacy. [HLRP: Health Literacy Research and Practice. 2023;7(3):e165-e175.].

Background: Black women experience greater maternal mortality and morbidity than White women. Although there are many causes of this disparity, providing more and better maternal health information to this population may be beneficial. Social media offers a way to easily and quickly disseminate information to empower and educate Black women about health during pregnancy.

Objective: This study sought to identify social media use patterns to determine what sources Black women used to obtain information about pregnancy and to explore whether health literacy/eHealth literacy influence those patterns.

Methods: This cross-sectional, nationally representative survey panel included 404 Black women. Health literacy was measured by the Single Item Literacy Screener, and eHEALS was used to measure eHealth literacy. We examined participants' social media activity, social media use, social media use for support, and sharing of pregnancy-related health information. Relationships between health literacy, eHealth literacy, and social media use were assessed.

Key results: Overall, 67.5% of participants had high health literacy, and the average eHealth literacy score was high (34.5). Most women (71.6%) reported using more than three social media accounts as a source for pregnancy information. Women with low health literacy searched social media for general and specific pregnancy health information, reported more social media use during pregnancy in general (p < .001), and more use of social media for giving and getting support (p = .003). Women with higher eHealth literacy were more likely to report more social media use (r = 0.107, p = .039) and often used social media to give and get support (r = 0.197, p = .0001). Women with high health literacy more often reported sharing the pregnancy information they found on social media with their nurse (χ² = 7.068, p = .029), doula (χ² = 6.878, p = .032), and childbirth educator (χ² = 10.289, p = .006). Women who reported higher eHealth literacy also reported more often sharing the pregnancy information they found on social media with their doctor (r = 0.115, p = .030), nurse (r = 0.139, p = .001), coworkers (r = 0.160, p = .004), and family or friends (r = 0.201, p = .0001).

Conclusion: Substantial numbers of Black women use social media to find pregnancy health information. Future studies should elicit more detailed information on why and how Black women use social media to obtain pregnancy information and support as well as what role health literacy and eHealth literacy may have on birth outcomes. [HLRP: Health Literacy Research and Practice. 2023;7(3):e119-e129.].

Background: The definition of health literacy has recently expanded beyond the idea of individual skills to include the system and environment the individual interacts with to receive care, known as organizational health literacy (OHL). However, neither the prevalence of OHL nor the impact of OHL on individuals' perceptions of their health and healthcare have been examined in New York's Medicaid managed care population.

Objective: This study aimed to estimate the prevalence of organizational health literacy in the New York State (NYS) Medicaid Managed Care (MMC) program.

Methods: A brief measure to assess organizational health literacy was developed from responses to two questions in the 2018 NYS Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Generalized Estimating Equation models were developed to analyze the association between organizational health literacy and three aspects of perceptions of health and health care, controlling for demographic differences and clustering effects from health insurance plans. Missing data were handled using multiple imputation.

Key results: Among 3,598 members included in the study, 20% of the MMC members reported inadequate organizational health literacy. These members were more likely to be older, less educated, from racial and ethnic minority groups, and less fluent with English. They are more likely to have poorer self-reported health (odds ratio [OR] 1.49), lower perceived access to health care (OR 6.97), and lower satisfaction with their health care (OR 6.49) than members who did not report inadequate organizational health literacy.

Conclusions: Our results suggest that a proportion of the NYS MMC population faces inadequate organizational health literacy, which can present a barrier to health care access and result in patients having a significantly poorer health care experience. Using an existing data source that is part of existing data collection allows for routine assessment of organizational health literacy, which can help inform health plans about areas for potential improvement. [HLRP: Health Literacy Research and Practice. 2023;7(3):e154-e164.].

Background: The coronavirus disease 2019 (COVID-19) pandemic has seen a rise in the spread of misleading and deceptive information, leading to a negative impact on the acceptance of the COVID-19 vaccine and public opinion. To address this issue, the importance of public e-Health literacy cannot be overstated. It empowers individuals to effectively utilize information technology and combat the dissemination of inaccurate narratives.

Objective: This study aimed to investigate the relationship between the ability to identify disingenuous news, electronic health literacy, and the inclination to receive the COVID-19 immunization.

Methods: In this descriptive-analytical cross-sectional study conducted during summer 2021 in Isfahan, Iran, 522 individuals older than age 18 years, seeking medical attention at health centers, were surveyed. The participants were selected through a meticulous multistage cluster sampling process from the pool of individuals referred to these health centers. Along with demographic information, data collection instruments included the standard e-Health literacy questionnaire and a researcher-developed questionnaire designed to identify misinformation. The collected questionnaires were entered into SPSS 24 for statistical analysis, which included the Kruskal-Wallis test, the Chi-square test, the Spearman test, and logistic regression models.

Key results: The study findings revealed a statistically significant relationship between acceptance of the COVID-19 vaccine and the ability to identify deceptive news. An increase of one unit in the score for recognizing misinformation led to a 24% and 32% reduction in vaccine hesitancy and the intention to remain unvaccinated, respectively. Furthermore, a significant correlation was found between the intention to receive the vaccine and e-Health literacy, where an increase of one unit in e-Health literacy score corresponded to a 6% decrease in the intention to remain unvaccinated. Additionally, the study found a notable association between the ability to detect false and misleading information and e-Health literacy. Each additional point in e-Health literacy was associated with a 0.33% increase in the capacity to identify fake news (Spearman's Rho = 0.333, p < .001).

Conclusion: The study outcomes demonstrate a positive correlation between the COVID-19 vaccine acceptance, the ability to identify counterfeit news, and proficiency in electronic health literacy. These findings provide a strong foundation for policymakers and health care practitioners to develop and implement strategies that counter the dissemination of spurious and deceitful information related to COVID-19 and COVID-19 immunization. [HLRP: Health Literacy Research and Practice. 2023;7(3):e130-e138.].

Inaccurate perceptions of COVID-19 (coronavirus disease 2019) risk may decrease compliance with public health mitigation practices, in turn increasing disease burden. The extent to which public perceptions of COVID-19 risk are inaccurate is not well studied. This study investigates the relationship between preferred information sources and inaccurate COVID-19 risk perception. A cross-sectional online survey of adults in the United States using online snowball techniques was administered between April 9, 2020 and July 12, 2020. Raking techniques were used to generate a representative U.S. sample from 10,650 respondents. Respondents who did not provide an answer to key questions were excluded. The remaining sample included 1,785 health care workers (HCW) and 4,843 non-HCW. Subjective risk was measured as the product of perceived likelihood of COVID-19 infection and perceived harm from infection. Objective risk was measured as a function of the presence of known COVID-19 risk factors. Discrepancies between subjective and objective risk were compared between respondents with different preferred information sources. Chi Square contingency tables and pair-wise correlation were used to evaluate differences to 95% confidence. For HCW and non-HCW, the greatest overestimation of personal COVID-19 risk assessment (p < .05 for all differences) were found in those whose preferred source of information was social media (HCW: 62.1%; non-HCW: 64.5%), followed by internet news sources (HCW: 59.6%, non-HCW%: 59.1%), government websites (HCW: 54%, non-HCW = 51.8%), other sources (HCW: 50.7%, non-HCW = 51.4%), and television news (HCW: 46.1%, non-HCW: 47.6%). Preferred information sources correlate with inaccuracies in personal COVID-19 risk assessment. Public health information campaigns should consider targeting groups whose preferred information sources correlate to higher inaccuracies in COVID-19 risk perceptions. [HLRP: Health Literacy Research and Practice. 2023;7(2):e105-e110.].

Background: Multimedia videos are important tools to inform uptake of the COVID-19 vaccine. Video design using health literacy guidelines may help optimize video usefulness. Many health organizations (HO) (provides information) and health care (HCO) (provides direct health care) organizations have used YouTube to deliver videos about COVID-19 vaccines.

Objective: We examined HO and HCO COVID-19 vaccine videos shown on YouTube for health literacy guidelines (quality, understandability and actionability).

Methods: The top 30 most viewed COVID-19 vaccine videos posted by HO and HCO were analyzed using the Global Quality Score (GQS) and the Patient Education Assessment Tool for evaluating audiovisual formats (PEMAT-AV).

Key results: GQS scores averaged 3.12 (standard deviation [SD] .789), which is equivalent to 80%. Using PEMATAV, there was a relationship between actionability and quality (r(28) = .453, p < .05) for HO; for HCO, there was a relationship between usability and quality (r(28) = .455, p < .05). Odds ratio analysis showed quality in HO leading to higher odds of actionability (3.573, 95% confidence interval [CI] [1.480-14.569]) and quality in HCO videos leading to higher understandability (4.093, CI [1.203-17.865]).

Conclusion: Few organizations applied all health literacy principles to video design. Video creation for mass media health campaigns by HO and HCO should include consideration of evidence-based health literacy measures (quality, understandability, actionability) to ensure intended results across viewers with different health literacy levels including communities who have been disproportionately affected by COVID-19. [HLRP: Health Literacy Research and Practice. 2023;7(2):e111-e118.].

Health literacy is the ability to understand and use health information. More than one-third of adults living in the United States have limited health literacy, which is associated with adverse health outcomes. Physicians need education about how to communicate effectively across the range of health literacy levels, but residency programs often fail to provide it. We aimed to develop and evaluate a curriculum to establish evidence-based recommendations for training family medicine resident physicians to communicate effectively across the range of health literacy levels. We developed and implemented a 6-month curriculum about health literacy and best practices for communication and collected three pre-/post-measures: patient surveys, videos of residents' patient encounters, and resident self-surveys of knowledge, attitudes, and use of communication techniques. Training of 39 residents included conferences, videotape reviews, written feedback, targeted supervision, and environmental cues. All knowledge/attitude questions on the resident survey improved significantly, as did the use of 4 of 6 communication techniques. Video observation also showed significant improvement in the residents' use of three techniques and a decrease in jargon use and an increase in "plain language" explanations of terms. Multimodal interventions improved residents' knowledge and attitudes about health literacy and use of health literacy precautions. [HLRP: Health Literacy Research and Practice. 2023;7(2):e99-e104.].

Background: Although health literacy (HL) skills may change over time, most research treats HL as a constant, using baseline HL to predict other health-related constructs. Few studies have explored change in HL over time.

Objective: We examined person-level differences in HL trajectories. We identified subgroups (latent classes) based on longitudinal assessments of HL and examined the association of class membership with demographic and oral health variables.

Methods: We used four measurement waves of parental HL data, reflecting the risk of limited HL, collected as part of an intervention to reduce dental decay in American Indian children (N = 579 parent-child dyads at baseline). Repeated measures latent class analysis (RMLCA) models were estimated to identify subgroups of HL trajectories over time. We examined class membership in association with baseline demographics and with 36-month assessments of parental oral health knowledge, beliefs, and behaviors as well as pediatric oral health.

Key results: A four-class model best fit the data. The largest class (high HL; 49.7% of the sample) was characterized by high levels of HL at all waves. A second class (improving HL; 17.7%) improved over all waves. The remaining two classes were characterized as moderate HL (20%) and low HL (12.6%) and maintained relatively stable HL levels over time. Higher educational attainment was associated with membership in the high HL and improving HL classes. Older age among this young-adult sample and higher income also were associated with high HL class membership. Parents in the high HL and improving HL classes exhibited more favorable performance on measures of oral health knowledge, beliefs, and behavioral adherence than did those in the other classes. Class membership was not associated with pediatric oral health.

Conclusions: RMLCA demonstrated person-level variability in HL trajectories. Longitudinal patterns were associated with baseline demographics and prospectively with parental oral health knowledge, beliefs, and behaviors, but not with pediatric oral health. [HLRP: Health Literacy Research and Practice. 2023;7(2):e89-e98.].

Background: Acute coronary syndrome is a significant global health concern that can affect patients' health outcomes and quality of life. In addition, adherence to treatment and health literacy can affect health outcomes.

Objective: This study aimed to investigate the relationship between treatment adherence, health literacy, and quality of life among patients with acute coronary syndrome.

Methods: This cross-sectional study was conducted on 407 patients in Iran from April 2019 to November 2019. Patients were selected by convenience sampling method. Data were collected using demographic questionnaire, World Health Organization Quality of Life Brief Version, Adherence to Treatment Questionnaire, and Health Literacy for Iranian Adults questionnaire. SPSS 25 was used for statistical analysis.

Results: Based on descriptive statistics in this study, most of the participants had good treatment adherence level (56.5%); 28.7% of the participants had insufficient health literacy level. The mean score of quality of life was 51.41 ± 12.03, which was greater than the midpoint of the questionnaire. Furthermore, Pearson's correlation coefficient showed a negative association between health literacy, treatment adherence (r = -0.167, p < .01), and quality of life (r = -0.153, p < .01), and a positive association between treatment adherence and quality of life (r = 0.169, p < .01).

Conclusion: The results of the current study showed a negative relationship between health literacy, quality of life, and treatment adherence among patients with acute coronary syndrome. [HLRP: Health Literacy Research and Practice. 2023;7(2):e71-e79.].