Keeping Current
There is a tremendous body of literature and news written on health literacy and patient engagement best practices. To make it easier for you to stay informed on current and emerging trends in the field, we regularly update this page to help you keep current on the latest news and publications.
For publications on health literacy by UNC-afiliated scholars only, see our section on Articles by UNC Scholars on Health Literacy.
Journal Articles
The following journal articles on health literacy are listed in chronological order. Skip to News Features
Sharing Health Literacy Research
2021 (CDC)
Advances in prevention, public health, and health care are, in part, limited by a failure to translate health literacy research findings into practice. Original research may take decades to become routine practice or habits for public health professionals, clinicians, communicators, and the public, especially if the research is not used to create evidence-based interventions that are widely disseminated. The strategies and resources below will help achieve the goal of translating research to practice more effectively and sharing it more quickly.
Access Sharing Health Literacy Research
Empathy: The Foundation of Health Literacy
August 6, 2021 (Pharmaceutical Executive)
The stakes in healthcare communication are incredibly high because health literacy is directly correlated to better outcomes. What’s more, the health literacy problem impacts 9 out of 10 adults. Research shows that people with low health literacy have more emergency room visits and hospital stays, are less likely to follow their provider’s recommendations, and have higher mortality rates. We also know that these issues most adversely impact underserved communities.
Fortunately, this is an area we as healthcare communicators can impact. We can adjust the way we convey complex information so that it is understood by the many, not the few. But to make the biggest difference, we must understand who the audience is and how they are feeling when they are accessing healthcare information. Simply, we must practice empathy.
Access Empathy: The Foundation of Health Literacy
Leveraging the Electronic Medical Record to Increase Distribution of Low Literacy Asthma Education in the Emergency Department
July, 2021 (PubMed)
This study aimed to assess university students’ levels of psychological distress and mental health literacy.
Though low literacy asthma education is effective at reducing emergency department (ED) use, few interventions are administered in the ED. The aim was to increase the number of parents of children with asthma receiving education in the ED to 50% receiving written and 30% receiving video education over 12 months.
Implementation of workflow improvement, education, and the addition of a functional education order in an existing order set led to a meaningful improvement in distribution of a low literacy asthma education intervention.
The health literacy disparity in adolescents with sickle cell disease
July 29, 2021 (Pediatric Nursing)
There are over 100,000 individuals with sickle cell disease (SCD) in the United States, most of whom are Black, poor, and publically insured. In combination with a chronic illness, these demographics lead to significant barriers to healthcare for patients with SCD, leaving them exceptionally vulnerable within the healthcare system. This unique vulnerability is especially notable when transitioning adolescents with SCD from pediatric to adult care, as this is a significant time of morbidity and mortality for these patients. It is postulated that health literacy influences transition from pediatric to adult care in adolescents with SCD. To better understand this relationship, more adolescent health literacy research must be conducted with both adolescents with and without SCD. Therefore, the purpose of this study is to systematically compare health literacy in adolescents with and without SCD.
Access The health literacy disparity in adolescents with sickle cell disease
Neurocognitive performance differences between black and white individuals with HIV disease are mediated by health literacy
July 26, 2021 (PubMed)
Health disparities are evident for Black Americans with HIV disease, who are disproportionally affected by the epidemic in the United States. The current study investigated whether the higher rates of neurocognitive impairment in Black Americans with HIV disease may be at least partly attributable to health literacy, which is a potentially modifiable factor.
Low health literacy may contribute to the higher rates of neurocognitive impairment for Black Americans with HIV disease. Future studies might examine the possible mechanism of this mediating relationship (e.g., access to health information, health behaviors, socioeconomics) and determine whether culturally tailored interventions that improve health literacy also confer broader brain health benefits for Black Americans with HIV disease.
Psychological distress and mental health literacy in university students
July 26, 2021 (PubMed)
This study aimed to assess university students’ levels of psychological distress and mental health literacy.
More than half of the participants had diagnosable psychological distress in terms of mental illness. The participants had a low level of mental health literacy, females and people with a mental illness had higher mental health literacy scores.
The results indicated that the scales could be used to develop interventions to assist Turkish students’ transition to healthy adulthood. Determining individuals’ psychological distress allows early detection of mental problems.
Access Psychological distress and mental health literacy in university students
“The system has to be health literate, too” – perspectives among healthcare professionals on health literacy in transcultural treatment settings
July 21, 2021 (PubMed)
This qualitative study aimed to examine the health literacy-related challenges, needs, and applied solutions of healthcare professionals when engaging with persons with a migrant background. Based on the integrated model of health literacy (Sørensen et al., BMC Public Health 12:80, 2012), we focused on environmental, personal, and situational factors that shape health literacy in transcultural treatment settings.
Known issues observed in the delivery of healthcare for the majority population (i.e., systemic lack of time, economic pressure) appear to be intensified in the context of migration. An increasingly diverse patient clientele indicates a growing need for culture-sensitive, health-literate healthcare organizations. A corresponding diversity of the health workforce is desirable and should be strengthened by national finance and educational programs. Healthcare professionals who interpret for colleagues should be given the necessary time. Further studies are needed to develop appropriate interventions for improving health literacy at individual and organizational levels. Funding for interpreting services should be expanded.
Musculoskeletal Health Literacy is Associated With Outcome and Satisfaction of Total Knee Arthroplasty
July, 2021 (PubMed)
The purpose of this study was to investigate if there is an association between musculoskeletal health literacy with outcome and satisfaction after total knee arthroplasty (TKA).
This study shows that patients with low musculoskeletal health literacy have worse outcome scores and are less likely to be satisfied with their TKA. By identifying these patients preoperatively, emphasis can be placed on enhancing procedure expectations and understanding to improve outcome measures and overall satisfaction.
Developing and Testing Automatic Models of Patient Communicative Health Literacy Using Linguistic Features: Findings from the ECLIPPSE study
July, 2021 (PubMed)
The goal of the study is to better understand HL from a linguistic perspective and to open new research areas to enhance population management and individualized care. Specifically, this study examines HL as a function of patients’ demonstrated ability to communicate health-related information to their providers via secure messages. The study develops an NLP-based HL model and validates the model by predicting patient-related events such as medical outcomes and hospitalizations. Results indicate that the developed model predicts human ratings of HL with ~80% accuracy. Validation indicates that lower HL patients are more likely to be nonwhite and have lower educational attainment. In addition, patients with lower HL suffered more negative health outcomes and had higher healthcare service utilization.
Mental health, compliance with measures and health prospects during the COVID-19 epidemic: the role of health literacy
July 10, 2021 (PubMed)
The importance of health literacy in dealing with the COVID-19 epidemic has been emphasized but scarcely addressed empirically. In this study, the association of health literacy with mental health, compliance with COVID-19 preventive measures and health prospects was assessed in a Belgian context.
These results suggest that health literacy is a crucial factor in managing the COVID-19 epidemic and offer a perspective for future studies that target health literacy in the context of virus outbreaks.
Health literacy among pregnant women in a lifestyle intervention trial: protocol for an explorative study on the role of health literacy in the perinatal health service setting
July, 2021 (PubMed)
Pregnancy is a vulnerable period that affects long-term health of pregnant women and their unborn infants. Health literacy plays a crucial role in promoting healthy behaviour and thereby maintaining good health. This study explores the role of health literacy in the GeMuKi (acronym for ‘Gemeinsam Gesund: Vorsorge plus für Mutter und Kind’-Strengthening health promotion: enhanced check-up visits for mother and child) Project. It will assess the ability of the GeMuKi lifestyle intervention to positively affect health literacy levels through active participation in preventive counselling. The study also explores associations between health literacy, health outcomes, health service use and effectiveness of the intervention.
Health literacy of patients on oral anticoagulation treatment- individual and social determinants and effect on health and treatment outcomes
July 9, 2021 (BMC Public Health)
Assessment health literacy in people with cardiovascular health problems would facilitate the development of appropriate health strategies for the care and reduction of complications associated with oral anticoagulation therapy. Aim: To evaluate the relationship between health literacy and health and treatment outcomes (concordance with oral anticoagulants, Normalized Ratio control and occurrence of complications) in patients with cardiovascular pathology.
Which criteria characterize a health literate health care organization? – a scoping review on organizational health literacy
July 6, 2021 (PubMed)
Organizational health literacy (OHL) aims to respond to the health literacy needs of patients by improving health information and services and making them easier to understand, access, and apply. This scoping review primarily maps criteria characterizing health literate health care organizations. Secondary outcomes are the concepts and terminologies underlying these criteria as well as instruments to measure them.
Organizational health literacy includes a significant number of distinct organizational criteria. The terminologies used in the OHL literature are heterogeneous based on a variety of concepts. A comprehensive, consensus-based conceptual framework on OHL is missing.
Effect of Physician-Delivered COVID-19 Public Health Messages and Messages Acknowledging Racial Inequity on Black and White Adults’ Knowledge, Beliefs, and Practices Related to COVID-19: A Randomized Clinical Trial
July 1, 2021 (PubMed)
Objectives: To determine whether messages delivered by physicians improve COVID-19 knowledge and preventive behaviors and to assess the differential effectiveness of messages tailored to the Black community.
Conclusions and relevance: In this study, a physician messaging campaign was effective in increasing COVID-19 knowledge, information-seeking, and self-reported protective behaviors among diverse groups. Studies implemented at scale are needed to confirm clinical importance.
How to L.I.F.T Your Spirits During COVID-19 and Other Hard Times
Summer, 2021 (Center for Health Literacy)
This module helps adults and teens recognize ways the pandemic might be impacting their emotional wellness and offers practical tips to address those challenges.
This project was funded under cooperative agreement number UG4LM012345 with the University of North Texas Health Science Center – Gibson D. Lewis Library and awarded by the DHHS, NIH, National Library of Medicine.
Access How to L.I.F.T Your Spirits During COVID-19 and Other Hard Times
Changes in Health Literacy during the first year following a kidney transplantation: Using the Health Literacy Questionnaire
July, 2021 (PubMed)
The study aimed to identify changes in health literacy (HL) and associated variables during the first year following a kidney transplantation.
Two main patterns of change were identified: a) HL increased during the first 8 weeks of close follow-up and b) in several domains, the positive increase from 5 days to 8 weeks flattened out from 5 days to 6 and 12 months. Self-efficacy, transplant-related knowledge, and general health were core variables associated with HL.
Overall, HL increased during the 8 weeks of close follow-up following the kidney transplantation, while 6 months seem to be a more vulnerable phase. Furthermore, low self-efficacy, less knowledge, and low self-perceived health may represent vulnerable characteristics in patients.
Rural use of health service and telemedicine during COVID-19: The role of access and eHealth literacy
Apr-Jun, 2021 (PubMed)
The COVID-19 pandemic has driven a greater reliance on telemedicine, yet rural access, use, and satisfaction with telemedicine and the role of eHealth literacy are unknown. Using a cross-sectional design, 279 (70.6% female) western rural Canadians completed an online survey. The majority of participants reported access to telemedicine, but nearly 1/5 lacked access to online or virtual mental health services. The majority of participants had used health care services following the declared COVID-19 pandemic in North America, and just under half had used telemedicine. Telemedicine satisfaction scores were higher among participants who had used video (M = 4.18) compared to those who used phone alone (M = 3.79) (p = 0.031). Telemedicine satisfaction and eHealth literacy were correlated (r = 0.26, p = 0.005). Participants did not want telemedicine to replace in-person consultations. Telemedicine practice requires that rural residents have the resources, ability and willingness to engage with remote care.
A structural equation model of relationships of health literacy, illness and medication beliefs with medication adherence among patients with chronic obstructive pulmonary disease
June, 2021 (PubMed)
Objective: To determine the relative contributions of health literacy (HL) and illness and medication beliefs to medication adherence among older COPD patients and determine the pathways through which they operate.
Results: Out of 393 older adults with COPD, 123 (31%) had limited HL and 208 (53%) reported low adherence to daily COPD medications. Those with limited HL were more likely to have low medication adherence (p < 0.0001). Medications concerns (p = 0.001) and medication necessity (p = 0.003) demonstrated a mediational role between HL and adherence. However, in the final multivariate model, HL did not have direct effect on medication adherence (p = 0.12) and illness beliefs (p = 0.16) did not demonstrate a mediational role between HL and adherence.
Conclusion: Our findings suggest that low HL is not a direct predictor of poor medication adherence among COPD patients.
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States
June, 2021 (PubMed)
Background: SARS-CoV-2 has spread rapidly resulted in a global pandemic and public health crisis. The internet is a frequently used resource for providing patient education materials (PEMs). The aim of this study was to evaluate the readability, content, and quality of web-based PEMs on COVID-19 from US academic medical centers.
Results: A total of 141 (97%) PEMs met inclusion criteria and were analyzed for readability, content, and quality. The mean readability was above the recommended sixth grade reading level (P < .001). Content was variable across PEMs. The PEMAT-P scores reflected good understandability with a median score of 83% (IQR 75%-87%), while actionability was poor with a median score of 41% (IQR 40%-60%).
Conclusions: Despite availability of web-based PEMs for COVID-19, the readability was significantly higher than the National Institute of Health and US Department of Health and Human Services recommended sixth grade reading level and actionability of PEMs was low. It is critical to provide readable PEMs on COVID-19 to effectively disseminate accurate information and facilitate patients’ understanding of the virus, how it spreads, and how to protect themselves.
Strengthening Critical Health Literacy for Health Information Appraisal: An Approach from Argumentation Theory
June 23, 2021 (PubMed)
The overload of health information has been a major challenge during the COVID-19 pandemic. Public health authorities play a primary role in managing this information. However, individuals have to apply critical health literacy to evaluate it. The objective of this paper is to identify targets for strengthening critical health literacy by focusing on the field of argumentation theory. This study operationalizes the main aspects of critical health literacy. It calls for specific educational and training initiatives in the field. Moreover, it argues in favor of broadening the current educational curricula to empower individuals to engage in informed and quality decision making. Strengthening individuals’ critical health literacy involves interventions to empower in argument evaluation. For this purpose, argumentation theory has analytical and normative frameworks that can be adapted within a lay-audience education concept.
Testing the reliability of the Health Literacy Questionnaire with carers of older adults receiving hospital care
June, 2021 (PubMed)
To determine the re-test reliability of the Health Literacy Questionnaire (HLQ) with carers of older adults discharged from hospital or attending the outpatient clinic.
Fifty-one carers of older patients participated. The HLQ showed good reliability (ICC = 0.75-0.90) for seven of the nine scales and moderate reliability (0.50-0.74) for the other two scales. Median completion time was 16.5 minutes (range 9-50), and acceptability was rated as 9.5/10.
The HLQ is a reliable tool for use with carers of older adults attending hospital. However, the length of time for completion of the HLQ may limit its feasibility for use by hospital staff and carers, given the high stress and time pressures of acute care.
Overcoming data barriers to unlock the full potential of SDoH in Healthcare
June 18, 2021 (PCQuest)
A person’s health and physical wellbeing is often attributed to factors like quality of food, levels of activity and genetics. However, studies have established that health and overall quality of life are affected by several other factors such as place of residence, education level, income status etc. which often go unnoticed during clinical evaluations.
Social determinants data can enable smarter investments and operational decisions for population health management programs. The insights generated through SDoH can help in designing effective interventions that reflect the needs and assets of the local community.
Access Overcoming data barriers to unlock the full potential of SDoH in Healthcare
Health Literacy during Pandemic and Education
June 18, 2021 (Cambridge University Press)
The COVID-19 pandemic has highlighted the importance of health literacy. This commentary discusses the consequences of poor health literacy and argues that we need to improve health literacy. Better health literacy has the potential to improve community trust, alleviate the health disparities and improve the results of the immediate response required in the early stages of a pandemic. The commentary argues that health literacy has to be addressed as part of mandatory school curriculum. Methods on how to improve and provide equitable access to education are also discussed.
Access Health Literacy during Pandemic and Education
COVID-19 Public Education Campaign [Resource in Spanish: Campaña de educación pública contra el COVID-19]
Summer, 2021 (US DHHS)
The HHS COVID-19 public education campaign is a national initiative to increase public confidence in and uptake of COVID-19 vaccines while reinforcing basic prevention measures such as mask wearing and social distancing.
Through a nationwide network of trusted messengers and consistent, fact-based public health messaging, the campaign helps the public make informed decisions about their health and COVID-19, including steps to protect themselves and their communities.
Access COVID-19 Public Education Campaign (Campaña de educación pública contra el COVID-19)
COVID-19 Is Connected with Lower Health Literacy in Rural Areas
May 27, 2021 (PubMed)
The relationship between social determinants of health (SDoH) and health outcomes is established and extends to a higher risk of contracting COVID-19. Given the factors included in SDoH, such as education level, race, rurality, and socioeconomic status are interconnected, it is unclear how individual SDoH factors may uniquely impact risk. Lower socioeconomic status often occurs in concert with lower educational attainment, for example. Because literacy provides access to information needed to avoid infection and content can be made more accessible, it is essential to determine to what extent health literacy contributes to successful containment of a pandemic. By incorporating this information into clinical data, we have isolated literacy and geographic location as SDoH factors uniquely related to the risk of COVID-19 infection. For patients with comorbidities linked to higher illness severity, residents of rural areas associated with lower health literacy at the zip code level had a greater likelihood of positive COVID-19 results unrelated to their economic status.
Access COVID-19 Is Connected with Lower Health Literacy in Rural Areas
How Medical Jargon Can Make COVID Health Disparities Even Worse
May 24, 2021 (NPR)
When cases of COVID-19 began rising in Boston last spring, Pooja Chandrashekar, then a first year student at Harvard Medical School, worried that easy-to-understand information about the pandemic might not be available in the many languages spoken by clients of the Family Van, the health services and health literacy program where she was working at the time.
Access How Medical Jargon Can Make COVID Health Disparities Even Worse
If hospitals want to cut readmission rates, do a better job teaching patients about self-care
May 24, 2021 (Medical Economics)
A fundamental reason why hospitals consistently fall short on readmissions is a failure to empower and educate patients.
An older man is rushed to the emergency room suffering from a rapid pulse, severe thirst, and drowsiness — classic symptoms of a diabetic crisis.
After a few days of treatment, he’s discharged by an overworked nurse with some written instructions and a hasty explanation of how to care for himself and avoid a relapse. A few weeks later, the patient is back in an acute-care hospital bed.
It’s a cycle that’s repeated day-in and day-out across the United States, and one that is imposing a heavy financial burden on the nation’s hospitals and health systems.
Access If hospitals want to cut readmission rates, do a better job teaching patients about self-care
Digital Health Literacy Considerations for RPM in Senior Care
May 21, 2021 (Patient Engagement)
Boosting remote patient monitoring (RPM) use in senior care is going to require a strategy for addressing digital health literacy and patient navigation.
As remote patient monitoring (RPM) gains a toehold in the healthcare industry, it will be essential for medical professionals to address the digital health literacy issues that could come with it, especially when using RPM for senior care.
Access Digital Health Literacy Considerations for RPM in Senior Care
The Impact of Health Literacy on Knowledge and Attitudes towards Preventive Strategies against COVID-19: A Cross-Sectional Study
May 19, 2021 (PubMed)
The coronavirus disease 2019 (COVID-19) pandemic introduced a set of mitigation measures based on personal behavior and attitudes. In the absence of vaccination or specific treatment, it became essential to comply with these measures to reduce infection transmission. Health literacy is the basis for changing behaviors.
Better health literacy is associated with better attitudes towards preventive strategies against COVID-19. We should invest in ways to improve health literacy, so we can improve people’s attitudes and consequently reduce coronavirus’ transmission.
Cognitive Neuroscience Methods in Enhancing Health Literacy
May 17, 2021 (PubMed)
The aim of the article is to identify the usefulness of cognitive neuroscience methods in assessing the effectiveness of social advertising and constructing messages referring to the generally understood health promotion, which is to contribute to the development of health awareness, and hence to health literacy. The purpose of the study was to test cognitive responses as expressed by neural indices (memorization, interest) to the reception of an advertisement for the construction of a hospice for adults. The obtained results contribute to a better understanding of how to design advertising messages concerning health, so that they increase the awareness of the recipients’ responsibility for their own health and induce specific behavior patterns aimed at supporting health-related initiatives, e.g., donating funds for building hospices or performing preventive tests. In this respect, the study findings help improve the organizations’ communication with their environment, thus enhancing their performance. The study has also confirmed the potential and innovativeness of cognitive neuroscience methods as well as their considerable possibilities for application in this field.
Access Cognitive Neuroscience Methods in Enhancing Health Literacy
Do Uncontrolled Hypertension, Diabetes, Dyslipidemia, and Obesity Mediate the Relationship Between Health Literacy and Chronic Kidney Disease Complications?
May 14, 2021 (PubMed)
Health literacy is the ability to deal with information related to one’s health. Patients with low health literacy and chronic diseases, such as chronic kidney disease (CKD), have poor disease-management skills, which could lead to complications. We used logistic regressions and structural equational modeling to assess whether low health literacy is associated with the development of cardiovascular disease and mortality in patients with CKD, and whether this association is mediated by the presence of uncontrolled hypertension, diabetes, dyslipidemia, obesity, or albuminuria. Low health literacy is associated with the development of cardiovascular disease after adjustment for age and sex, and this association is mediated by uncontrolled diabetes and obesity.
Law and Policy as Tools in Healthy People 2030
May 13, 2021 (JPHMP)
Laws and policies are critical determinants of health and well-being. They can encourage positive behaviors and discourage harmful behaviors, and they can enhance or worsen health, health equity, health disparities, and health literacy. Recognizing their contribution to conditions in the environments in which people are born, live, learn, work, play, worship, and age, and people’s experiences of these conditions, the US Department of Health and Human Services considered the roles of law and policy throughout its development of Healthy People 2030. Laws and policies often interrelate, but they have different purposes. Healthy People 2030 offers an opportunity for stakeholders in diverse sectors and at all levels to use laws and policies to support or inform the initiative’s implementation, address health disparities and health inequities, and improve health and well-being in this decade. Introducing new laws and policies or rescinding existing ones to achieve Healthy People 2030 goals offers a chance to rigorously assess outcomes and weigh the balance of good outcomes against unintended consequences.
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Relationship between eHealth literacy and psychological status during COVID-19 pandemic: A survey of Chinese residents
May, 2021 (PubMed)
To investigate the eHealth literacy and the psychological status of Chinese residents during the COVID-19 pandemic and explore their interrelationship.
The score of eHealth literacy was 48.88 ± 8.46, and 11.4%, 6.8% and 20.1% of respondents experienced moderate to severe depression, insomnia and post-traumatic stress disorder. eHealth literacy negatively correlated with depression (r = -0.331), insomnia (r = -0.366) and post-traumatic stress disorder (r = -0.320).
eHealth literacy is closely related to psychological status. Improving eHealth literacy may contribute to maintaining good psychological well-being.
Dissociation, Cognitive Reflection and Health Literacy Have a Modest Effect on Belief in Conspiracy Theories about COVID-19
May 11, 2021 (PubMed)
Understanding the predictors of belief in COVID-related conspiracy theories and willingness to get vaccinated against COVID-19 may aid the resolution of current and future pandemics. We investigate how psychological and cognitive characteristics influence general conspiracy mentality and COVID-related conspiracy theories. A cross-sectional study was conducted based on data from an online survey of a sample of Czech university students (n = 866) collected in January 2021, using multivariate linear regression and mediation analysis. Sixteen percent of respondents believed that COVID-19 is a hoax, and 17% believed that COVID-19 was intentionally created by humans. Seven percent of the variance of the hoax theory and 10% of the variance of the creation theory was explained by (in descending order of relevance) low cognitive reflection, low digital health literacy, high experience with dissociation and, to some extent, high bullshit receptivity. Belief in COVID-related conspiracy theories depended less on psychological and cognitive variables compared to conspiracy mentality (16% of the variance explained). The effect of digital health literacy on belief in COVID-related theories was moderated by cognitive reflection. Belief in conspiracy theories related to COVID-19 was influenced by experience with dissociation, cognitive reflection, digital health literacy and bullshit receptivity.
Health literacy in people with venous leg ulcers: a protocol for scoping review
May 11, 2021 (PubMed)
Chronic venous leg ulcer (VLU) healing is a complex clinical problem. It requires intervention from skilled, costly, multidisciplinary wound-care teams, working with patients to manage their care. Compression therapy has been shown to help heal venous ulcers and to reduce recurrence, with some evidence suggesting the value of exercise as well. These activities require health education and health literacy (HL) as patients must process, understand and consistently apply health information for successful self-management. Research suggests that those most vulnerable to VLUs also tend to have limited HL, but there have been no reviews examining the state of HL in patients with previous or active VLUs. This scoping review aims to examine the level of HL in VLU patients and how HL may link to self-management behaviours (particularly exercise and compression adherence), and their VLU healing generally.
Access Health literacy in people with venous leg ulcers: a protocol for scoping review
The association between Internet use and health-related outcomes in older adults and the elderly: a cross-sectional study
May 6, 2021 (PubMed)
Older adults and elderly persons can experience a significant digital divide. However, there are many studies reporting that the use of the Internet has benefits related to a person’s health status and social inclusion. It is not fully clear if Internet use and health-related outcomes share common antecedents or if using the Internet may have a favourable effect on the determinants responsible for good health. The main aim of this study was to assess the relationship between the use of the Internet and health-related outcomes in older adults and elderly people in Poland.
In conclusion, in contrast to earlier findings, Internet use is not associated with favourable patterns of lifestyle or higher self-rated health in older Polish adults. However, persons with chronic conditions or disabilities less frequently declare the use of the Internet. It was also revealed that older adults and the elderly who make use of the Internet are less likely to utilise health services.
Impact of Social Determinants of Health, Health Literacy, Self-perceived Risk, and Trust in the Emergency Physician on Compliance with Follow-up
May 5, 2021 (PubMed)
Patients presenting to the emergency department (ED) with “low-risk” acute coronary syndrome (ACS) symptoms can be discharged with outpatient follow-up. However, follow-up compliance is low for unknown nonclinical reasons. We hypothesized that a patient’s social factors, health literacy, self-perceived risk, and trust in the emergency physician may impact follow-up compliance.
In an urban county ED, in patients who were deemed low risk for ACS and discharged, only self-perception of risk was associated with compliance with a follow-up appointment.
Assessment of Factors Associated With Parental Perceptions of Voluntary Decisions About Child Participation in Leukemia Clinical Trials
May 4, 2021 (JAMA Network)
This cross-sectional study prospectively enrolled 97 parents of children diagnosed as having leukemia at Rady Children’s Hospital San Diego, a large tertiary academic center in California, from 2014 to 2017. Health literacy, contextual factors (acculturation, decisional regret, and satisfaction with informed consent), sociodemographic characteristics, and perception of voluntariness after consenting for a therapeutic clinical trial were measured. Univariable and multivariable regression were used to determine significant associations. The analyses for the present study were conducted from May 2019 to May 2020.
Health Literacy Regarding Infectious Disease Predicts COVID-19 Preventive Behaviors: A Pathway Analysis
May 3, 2021 (PubMed)
Health literacy has been identified as one vital determinant of public health and healthy behaviors, but very few studies regarding infectious disease prevention have been found. This descriptive cross-sectional study aimed to validate the pathway of infectious disease-specific health literacy (IDSHL), COVID-19 (coronavirus disease 2019) preventive behaviors, and their determinants. A sample of 1459 casino workers in Macao was eligible for analysis. The concept model was verified with a comparative fit index of 0.937 and goodness-of-fit index of 0.971. Government responses was a significant determinant of situational factors (helpfulness of health information, resource accessibility, and organizational training adequacy), while situational factors showed a direct effect on COVID-19 preventive behaviors. Education and organization training adequacy was the strongest influencing factor of IDSHL, which should be a key target of intervention programs for COVID-19.
Health Literacy and Hearing Healthcare Use
May, 2021 (PubMed)
Objective: To assess whether health literacy is associated with: 1) degree of hearing loss at initial presentation for audiogram and 2) hearing aid adoption for hearing aid candidates.
Conclusions: In our population, patients with low health literacy are more likely to present with higher degrees of hearing loss, but no less likely to obtain hearing aids compared with patients with adequate health literacy. Hearing loss severity and hearing aid coverage by insurance appear to be the main drivers of hearing aid adoption.
Access Health Literacy and Hearing Healthcare Use
A Health-Literacy Intervention for Early Childhood Obesity Prevention: A Cluster-Randomized Controlled Trial
May, 2021 (PubMed)
Children who become overweight by age 2 have greater risk of long-term obesity and health problems. The study aim was to assess the effectiveness of a primary care–based intervention on the prevalence of overweight at age 24 months.
A total of 459 intervention and 406 control dyads were enrolled. In total, 49% of all children were overweight at 24 months. Adjusted odds for overweight at 24 months (treatment versus control) was 1.02.
Serving Culturally and Linguistically Diverse Patients in Audiology-Part 2: Promoting Health Literacy
May, 2021 (The Hearing Journal)
A growing body of evidence indicates poorer outcomes in health care are associated with lower health literacy.1 Patients need to understand their personal health care information so they can make informed decisions as to how they should act upon it. However, the 2003 National Assessment of Adult Literacy, which surveyed over 19,000 individuals 16 years or older, found that 36% of respondents had health literacy skills rated as “basic” or “below basic.” Additionally, more than 80% of adults with health literacy skills in the “below basic” category were unlikely to seek out information from a printed source or the internet.2 Health care professionals should view these findings as significant problems, as low health literacy leads to poor treatment compliance, poor management of chronic conditions, and poor use of preventative health services. Moreover, providers are not likely to know whether a patient has poor health literacy skills. In the latter half of this two-part culturally and linguistically diverse (CLD) patient feature, we present considerations and recommendations for addressing health literacy for practicing audiologists.
Effects of mHealth-based interventions on health literacy and related factors: A systematic review
April, 2021 (PubMed)
Aims: To evaluate the effects of mobile health (mHealth)-based interventions on health literacy and related factors.
Conclusion: mHealth can enhance health literacy; furthermore, mobile applications effectively improve patient health literacy. However, measurement tools used for evaluating health literacy indicators are inconsistent, with the concept and components of these tools being not specifically designed for evaluating health literacy indicators.
Access Effects of mHealth-based interventions on health literacy and related factors: A systematic review
Prevalence of low health literacy levels in decompensated heart failure compared with acute myocardial infarction patients
April, 2021 (PubMed)
Health literacy (HL) is a health determinant in cardiovascular diseases as the active participation of patients is essential for optimizing self-management of these conditions. We aimed to estimate the prevalence of low HL level in patients hospitalized for acute myocardial infarction (AMI) or acute decompensated heart failure (ADHF) and explore low HL determinants.
Prevalence of low HL was higher among ADHF patients than among AMI patients. Low HL ADHF patients needed more support when accessing healthcare services, and these would require more adaptation to respond to low HL patients’ needs.
Lessons Learned: A Process Evaluation of the Rural Elder Awareness of Medication Safety (REAMS) Program
April, 2021 (PubMed)
This process evaluation of the Rural Elder Awareness of Medication Safety (REAMS) program provided identification of successful and unsuccessful elements along with barriers to and facilitators of this home-based pilot program. The REAMS program was developed to assist rural older adults aged >65 years and community health care organizations with strategies to improve health literacy related to medications. Recruitment of older adults, rurality of the program’s setting, time constraints, and the onset of the COVID-19 pandemic were the greatest barriers. The collaborative relationship developed with community health care partners was the greatest facilitator. This relationship promoted shared ideas and adjustments in program design to achieve the outcome goals. The lessons learned from process evaluation may benefit future researchers or community health promotion planners with designing community-based programs for older adults in rural areas. Future research should focus on expanding recruitment opportunities in acute care, primary care, and home health with the inclusion of all established health care providers in the community.
Change in Health Literacy over a Decade in a Prospective Cohort of Community-Dwelling Older Adults
April, 2021 (PubMed)
Health literacy is often viewed as a static trait in longitudinal studies, which may over or underestimate an individual’s ability to manage one’s health.
We sought to examine health literacy over time among older adults using three widely used measures.
We found a negative relationship between age and health literacy over time as measured by the TOFHLA and NVS. Health literacy barriers appear to be more prevalent among individuals in later life, when self-care demands are similarly increasing. Clinicians might consider strategies to assess and respond to limited health literacy, particularly among patients 70 and older. REALM performance remained stable over 10 years of follow-up. This questions whether health literacy tools measure the same attribute. Prospective health literacy studies should carefully consider what measures to use, depending on their objective.
Access Change in Health Literacy over a Decade in a Prospective Cohort of Community-Dwelling Older Adults
Relationships between health literacy and quality of life among survivors with breast cancer
April, 2021 (PubMed)
During the survival period of breast cancer patients, an understanding of and ability to implement health knowledge may be important for survivors’ physical and mental quality of life (QOL). This study aims to investigate the health literacy and predictors of QOL for survivors of breast cancer.
The average health literacy score was 3.28. Education level and breast cancer stage were significant factors for the health literacy of survivors with breast cancer. Age, body mass index and health literacy were predictors of physical health-related QOL. Health literacy also was a predictor of mental health-related QOL.
The results provide the factors associated health literacy as well as health-related QOL. Nurses should understand the health literacy among survivors with breast cancer and improve health literacy to optimize their quality of life.
Access Relationships between health literacy and quality of life among survivors with breast cancer
Assessment of the Readability of Online Patient Education Material from Major Geriatric Associations
April, 2021 (PubMed)
An increasing number of patients are using the internet to supplement information provided by medical professionals. Online geriatric patient education materials (PEMs) should be written at or below a 6th grade reading level (GRL) that takes into account barriers unique to the geriatric population. The objectives of the study are to assess PEMs of geriatric associations’ websites and determine whether they are above the GRL recommended by the Centers for Disease Control and National Institutes of Health.
The mean of all PEMs using the numerical scales was 11.1 ± 2.4. Ninety-nine percent of PEMs are above the 6th GRL. PEMs ranged from a grade 3.0 to 19.0 reading level. Analysis of variance demonstrated a significant difference between associations (P < .0001), and multiple comparison analysis identified the National Institute on Aging as the content easiest to read (9.5 ± 1.6).
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Understanding and Responding to Health Literacy as a Social Determinant of Health
Spring, 2021 (Annu. Rev. Public
Evidence of a social gradient in health literacy has been found in all reported national population surveys. Health literacy is a midstream determinant of health but not a panacea for addressing health inequities created by the maldistribution of opportunity and resources. It is possible to optimize the contribution health literacy makes in mediating the causes and effects of established social determinants of health. Existing interventions demonstrate the feasibility of improving health literacy among higher-risk populations, but research remains underdeveloped and effects on health inequity are largely untested. Future health literacy intervention research should focus on a) improving the quality of health communication that reaches a diversity of populations, especially by improving frontline professional skills and support; b) enabling people to develop transferable skills in accessing, understanding, analyzing, and applying health information; and c) ensuring that priority is proportionate to need by reaching and engaging the population groups who are disproportionately affected by low health literacy
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Association of health literacy and medication adherence with health-related quality of life (HRQoL) in patients with ischemic heart disease
April 13, 2021 (PubMed)
Medication Adherence (MA) and Health Related Quality of Life (HRQoL) are two inter-connected concepts, co-influenced by Health Literacy (HL), with significant impact on patient management and care. Thus, we aimed to estimate the association of HL and MA with HRQoL in IHD patients.
Data suggested that adequate HL was significantly associated with adherence and both physical and mental dimensions of HRQoL were higher in IHD patients with adequate HL. Besides, HL and MA are independent predictors of HRQoL in IHD patients.
Impact of a Genomic Test on Treatment Decision in a Predominantly African American Population With Favorable-Risk Prostate Cancer: A Randomized Trial
April 9, 2021 (Journal of Clinical Oncology)
The Genomic Prostate Score (GPS), performed on biopsy tissue, predicts adverse outcome in prostate cancer (PCa) and has shown promise for improving patient selection for active surveillance (AS). However, its impact on treatment choice in high-risk populations of African Americans is largely unknown and, in general, the effect of the GPS on this difficult decision has not been evaluated in randomized trials.
Health literacy seen as an important tool in increasing COVID-19 vaccine uptake
April 8, 2021 (Healthcare Finance)
Healthcare professionals largely see vaccines as key tools in ending the COVID-19 pandemic, but they will only work to that end if enough Americans become inoculated in order to achieve herd immunity.
The vaccines themselves are largely effective. The challenge is in convincing the public to take them.
Skepticism about vaccines was high at first. Last fall, nearly half of older adults were on the fence about COVID-19 vaccination – or at least taking a wait-and-see attitude, according to a University of Michigan poll taken at the time.
Access Health literacy seen as an important tool in increasing COVID-19 vaccine uptake
Effective Cost Conversations: Addressing Financial Toxicity and Cost-Related Health Literacy
April 1, 2021 (PubMed)
Cancer survivors have greater risk of experiencing financial toxicity, or the undue financial burden and stress that patients face related to the costs of cancer care. Cost-related health literacy promotion should begin at the point of care with effective cost-of-care conversations that help to identify and manage patient financial needs. Nurses are uniquely positioned and often sought out as trusted sources of cost-of-care information and play a key role in engaging in effective cost conversations that help consumers to understand and manage their costs of care.
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Health literacy and the quality of pharmacist-patient communication among those prescribed anticoagulation therapy
March, 2021 (PubMed)
Adequate counseling from a pharmacist concerning anticoagulation therapy is crucial to the wellbeing of patients. No studies have fully examined the relationship between health literacy, patient-pharmacist communication, and anticoagulation control.
Patients receiving anticoagulation therapy and possessing inadequate health literacy appear more likely to percieve poorer communication with pharmacists. This seems especially true as it relates to the percieved time and attention pharmacist devote to the communication encounter, as well as the sense pharmacists provide patients concerning their ability to influence health outcomes.
Relationship Between Coronavirus-Related eHealth Literacy and COVID-19 Knowledge, Attitudes, and Practices among US Adults: Web-Based Survey Study
March 29, 2021 (PubMed)
During a global pandemic, it is critical that the public is able to rapidly acquire new and accurate health information. The internet is a major source of health information. eHealth literacy is the ability of individuals to find, assess, and use health information available on the internet. The goals of this study were to assess coronavirus-related eHealth literacy and examine the relationship between eHealth literacy and COVID-19-related knowledge, attitudes, and practices (KAPs).
This study provides an estimate of coronavirus-related eHealth literacy among US adults. Our findings suggest that a substantial proportion of US adults have low coronavirus-related eHealth literacy and are thus at a greater risk of lower and less-protective COVID-19 KAPs. These findings highlight the need to assess and address eHealth literacy as part of COVID-19 control efforts. Potential strategies include improving the quality of health information about COVID-19 available on the internet, assisting or simplifying web-based search for information about COVID-19, and training to improve general or coronavirus-specific search skills.
Health Literacy, Digital Health Literacy, and COVID-19 Pandemic Attitudes and Behaviors in U.S. College Students: Implications for Interventions
March 23, 2021 (PubMed)
The COVID-19 pandemic has been accompanied by rapidly emerging evidence, changing guidance, and misinformation, which present new challenges for health literacy (HL) and digital health literacy (DHL) skills. This study explored whether COVID-19-related information access, attitudes, and behaviors were associated with health literacy and digital health literacy among college students in the United States. In multivariable models, both HL and DHL were independently associated with overall compliance with basic preventive practices. Higher DHL, but not HL, was significantly associated with greater willingness to get a COVID-19 vaccine and the belief that acquiring the disease would negatively impact their life. On average, respondents discussed health with 4-5 people, which did not vary by HL or DHL measures. The usage of online information sources varied by HL and DHL. The study findings can inform future student-focused interventions, including identifying the distinct roles of HL and DHL in pandemic information access, attitudes, and behaviors.
Good things happening to support digital health literacy
March 22, 2021 (MirageNews)
A digital health literacy initiative funded by the Australian Digital Health Agency last year is reaping significant rewards and helping bridge the digital divide that precludes many Australians accessing improved health services.
Last year, 71 community organisations across Australia were selected by the Good Things Foundation to teach digital health literacy skills through the Health My Way program and improve digital inclusion.
Testing the Digital Health Literacy Instrument for Adolescents: Cognitive Interviews
March 15, 2021 (JMIR)
Despite the increasing number of youth seeking health information on the internet, few studies have been conducted to measure digital health literacy in this population. The digital health literacy instrument (DHLI) is defined as a scale that measures the ability to operate digital devices and read and write in web-based modes, and it assesses seven subconstructs: operational skills, navigation skills, information searching, evaluating reliability, determining relevance, adding self-generated content to a web-based app, and protecting privacy. Currently, there is no validation process of this instrument among adolescents.
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Biden Invests $250M for Community-Based COVID-19 Vaccination, Equity
March 12, 2021 (xtelligent Healthcare Media)
The Biden Administration recently announced a $250 million investment to encourage COVID-19 vaccination using community-based care to improve health literacy. The funding will be offered as a health literacy grant to localities to reach racial and ethnic minority, rural, and other vulnerable or underserved populations. The initiative, called Advancing Health Literacy to Enhance Equitable Community Responses to COVID-19, is expected to fund nearly 30 projects in urban communities and 43 projects in rural communities for two years.
Access Biden Invests $250M for Community-Based COVID-19 Vaccination, Equity
Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health
March 12, 2021 (PubMed)
Healthy People 2030…provides science-based national health objectives with targets to improve the health and well-being of Americans. For the first time since its 1979 establishment, the Healthy People framework aims to attain health literacy as an Overarching Goal and Foundational Principle to achieving health and well-being. Growing literature on health literacy describes it as a concept not solely reliant on individual capabilities but also on organizations’ ability to make health-related information and services equitably accessible and comprehensible.
The 2 separate analyses revealed plurality support for improving the definition to focus on both individual and organizational roles in health literacy. Results led HHS subject matter experts to update the definition to include definitions of personal health literacy and organizational health literacy. Healthy People 2030’s expanded health literacy definition reflects the most current science and input from the Secretary’s Advisory Committee, public comments, and HHS subject matter experts.
Approach to Improving Patient Safety: Communication
March 10, 2021 (Patient Safety Network)
Each one of the countless necessary communication points between providers and between providers and patients or family caregivers represents an unwelcome opportunity for a patient safety event. During a year when society has been focused on limiting the number of in-person interactions due to the risk of COVID-19, there is a need to acknowledge and prioritize the critical role communication still plays in the safe delivery of healthcare. In 2020, researchers explored current challenges to effective communication with patients, the impact of different techniques to improve communication between providers and with patients, and lessons learned from communication practices during the COVID-19 pandemic that may have applicability beyond the pandemic.
Access Approach to Improving Patient Safety: Communication
Federally Funded Research
March, 2021 (CDC)
The federal government supports and encourages health literacy research in several ways. On this page you can find funding opportunities, research findings, and training initiatives from several federal government agencies.
The Readability of Outpatient Plastic Surgery Clinic Letters: Are We Adhering to Plain English Writing Standards?
Jan-Mar, 2021 (PubMed)
This study aims to determine the quantity and quality of plastic surgery clinic letters sent to patients before and during the Covid-19 pandemic. Text was analyzed using a standardized set of commonly used readability formulae, including SMOG, Flesch Reading Ease, and the Coleman-Liao Index. A total of 100 pre-Covid and 58 peri-Covid letters were suitable for inclusion. Median results for formulae that output a U.S. grade score ranged between 9 and 12.9 for letters written prior to Covid-19 and 9 and 13.2 for those written during Covid-19. Eight percent of letters were sent to patients pre-Covid, increasing to 28% during the pandemic. Letters sent to patients had a median grade score of between 8 and 12 prior to Covid-19 and 8 and 10.6 during Covid-19. Letters sent to clinicians ranged between 9 and 13 and 9 and 13.3, respectively. Outpatient plastic surgery letters are written at a readability level too high to facilitate understanding among the general population. The increase in direct-to-patient contact during the Covid-19 outbreak has not led to a significant improvement in the readability of clinic letters. The authors suggest an increase in letter standardization and raising awareness of readability when writing clinic letters.
Examining the Relationship between Health Literacy and Hearing Health Care Use
March, 2021 (TheHearingJournal)
With 48.1 million (or 20.3%) of Americans and 466 million people worldwide estimated to have some degree of hearing loss, hearing impairment is one of the most prevalent medical conditions globally. However, despite evidence suggesting that hearing loss can impact a patient’s daily function, quality of life, and overall health, only 14 percent of Americans over the age of 50 who need hearing aids actually wear them. While several factors contribute to this low rate of hearing aid adoption, the financial and motivational barriers to accessing hearing tests and hearing aids are significant ones. Since hearing screenings for adults are not routinely conducted at the primary care level, the responsibility often falls on patients or their family to recognize and address the issue. This complexity in navigating the hearing health care system can make it particularly difficult for those with inadequate health literacy to access the care that they need.
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Health literacy supports active aging
February, 2021 (PubMed)
This study investigated the role of health literacy in active aging among persons differing in their number of chronic conditions. Data were collected from 948 individuals, 57% women, aged 75, 80 and 85 in 2017-2018 in the city of Jyväskylä in Central Finland. Health literacy was assessed with the 16-question version of the European Health Literacy Survey (HLS-EU-Q16), active aging with the University of Jyväskylä Active Aging Scale (UJACAS) and self-reported physician-diagnosed chronic conditions. Both health literacy (r = 0.40) and number of chronic conditions (r = -0.21) correlated with the active aging score. Linear regression models revealed that health literacy was a stronger predictor than chronic conditions of active aging (? 0.18, p < 0.001 vs. ? -0.06, p = 0.030) and that its predictive value remained statistically significant after adjustment for cognitive capacity, number of depressive symptoms, physical performance and length of education. Higher health literacy can enable older persons, including those with multiple chronic conditions, to maintain higher levels of active aging. As more people are projected to live with chronic conditions to older ages, health literacy may help them to cope with illnesses and functional limitations and lead a fulfilling life. These cross-sectional findings lay a foundation for future prospective and experimental studies on health literacy and active aging.
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Associated factors with treatment adherence of patients diagnosed with chronic disease: Relationship with health literacy
February, 2021 (PubMed)
This study aimed to examine the relationship between the health literacy level and treatment adherence in patients with chronic disease.
This study revealed that patients’ adherence to treatment increased as their health literacy increased. Thus, it is recommended that health literacy levels of the patients be raised through effective interventions to ensure better adherence to treatment.
The Influence of Health Literacy and Health Numeracy on Weight Loss Outcomes Following Bariatric Surgery
February, 2021 (PubMed)
Although cognitive functioning and health literacy are related to weight loss 1year following bariatric surgery, the influence of health numeracy (i.e., health-related mathematical abilities) is unknown. In addition, further research is needed to examine the impact of all these factors on longer-term weight loss outcomes to determine if they influence the ability to maintain weight loss.
Although health literacy and health numeracy did not predict weight loss outcomes for those in the initial weight loss period, they were related to weight outcomes for participants in the weight maintenance period. This suggests that health literacy and health numeracy may play a role in facilitating longer-term weight maintenance among patients who undergo bariatric surgery. Clinicians conducting presurgical psychosocial evaluations should consider routinely screening for health.
Disparities in Research Participation by Level of Health Literacy
February, 2021 (PubMed)
We examined the independent association of patients’ health literacy with two steps in their research participation decision-making process: (1) research interest – willingness to hear more about a research study; and (2) research participation – the decision to enroll after an informed consent discussion. Best practices for effective health communication were implemented in recruitment approaches and informed consent processes. Using logistic regression models, we determined patient characteristics independently associated with patients’ willingness to hear about and participate in the study.
In unadjusted analyses, participants with higher health literacy, and those who were younger, female, or had more education had higher levels of both research interest and research participation. Health literacy remained independently associated with both outcomes in multivariable models, after adjustment for sociodemographic factors.
Because identical variables predicted both research interest and eventual consent, efforts to recruit broad populations must include acceptable methods of approaching potential participants as well as explaining study materials.
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“People play it down and tell me it can’t kill people, but I know people are dying each day”. Children’s health literacy relating to a global pandemic (COVID-19); an international cross sectional study
February 10, 2021 (PubMed)
The aim of this study was to examine aspects of children’s health literacy; the information sources they were accessing, their information preferences, their perceived understanding of and their reported information needs in relation to COVID-19. An online survey for children aged 7-12 years of age and parent/caregivers from the UK, Sweden, Brazil, Spain, Canada and Australia was conducted between 6th of April and the 1st of June 2020. The findings show that parents are the main source of information for children during the pandemic in most countries, except in Sweden where school was the main source of information. However, in many cases parents chose to shield, filter or adapt their child’s access to information about COVID-19, especially in relation to the death rates within each country. Despite this, children in this study reported knowing that COVID-19 was deadly and spreads quickly. This paper argues for a community rather than individual approach to addressing children’s health literacy needs during a pandemic.
Patients With Poor Health Literacy Less Likely to Elect Hospice
February 2, 2021 (Hospice News)
Patients who have low levels of health literacy are more likely to seek intensive curative treatment at the end-of-life, as opposed to choosing hospice care. In addition to disparities in hospice utilization associated with race or ethnicity, a patient’s understanding of their condition and the available treatments may also be a contributing factor, according to a recent study in the American Journal of Hospice & Palliative Medicine.
Access Patients With Poor Health Literacy Less Likely to Elect Hospice
An Intervention for Mental Health Literacy and Resilience in Organized Sports
January, 2021 (PubMed)
Purpose: In this study, we tested the effectiveness of a multicomponent sports-based program aimed at promoting early intervention, help seeking, and resilience among a sample of adolescent male sport participants.
Results: Significant positive group-time interactions were found for the primary outcomes of depression and anxiety literacy, intentions to seek help from formal sources, confidence to seek mental health information, and resilience. We also found a significant positive group-time interaction for the secondary outcome of well-being. There were no group-time interactions for social distance (stigma), intentions to seek help from informal sources, implicit beliefs about adversity, perceived familial support, or psychological distress.
Conclusions: Given the high rates of sport participation worldwide and the increasing focus on mental health in this domain, translation and dissemination of the program may be warranted after replication.
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Addressing Health Literacy Needs in Rheumatology: Which Patient Health Literacy Profiles Need the Attention of Health Professionals?
January, 2021 (PubMed)
Objective: To identify and describe health literacy profiles of patients with rheumatic diseases and explore whether the identified health literacy profiles can be generalized to a broader rheumatology context.
Results: Among 895 participating patients, the lowest mean HLQ domain scores (indicating most difficulty) were found for “critical appraisal,” “navigating the health system,” and “finding good health information.” The 10 identified profiles revealed substantial diversity in combinations of strengths and weaknesses. While 42% of patients scored moderate to high on all 9 domains (profiles 1 and 3), another 42% of patients (profiles 2, 4, 5, and 6) clearly struggled with 1 or several aspects of health literacy. Notably, 16% (profiles 7-10) exhibited difficulty across a majority of health literacy domains. The probability of belonging to one of the profiles was independent of the hospital where the patient was treated or the type of rheumatic disease.
Conclusion: Ten distinct health literacy profiles were identified among patients with rheumatic diseases, independent of disease type and treating hospital. These profiles can be used to facilitate the development of health literacy interventions in rheumatology.
The Effect of Health Literacy on a Brief Intervention to Improve Advance Directive Completion: A Randomized Controlled Study
Jan-Dec, 2021 (PubMed)
Completion of an advance directive (AD) document is one component of advanced care planning. We evaluated a brief intervention to enhance AD completion and assess whether the intervention effect varied according to health literacy.
A brief intervention had no impact on AD completion for subjects of adequate or limited health literacy.
Our intervention was designed for easy implementation and to be accessible to patients of adequate or limited health literacy. This intervention was not more likely than the control (handing patients an AD form) to improve AD completion for patients of either limited or adequate health literacy. Future efforts and research to improve AD completion rates should focus on interventions that include: multiple inperson contacts with patients, contact with a trusted physician, documents at 5th grade reading level, and graphic/video decision aids.
Health literacy in persons at risk of and patients with coronary heart disease: A systematic review
January, 2021 (PubMed)
Health literacy (HL) plays a crucial role in the maintenance and improvement of individual health. Empirical findings highlight the relation between a person’s HL-level and clinical outcomes. However, the role of HL in persons at risk for coronary heart disease (CHD) and patients with CHD has not been researched conclusively. The concept of HL yields a promising potential to understand the process from obtaining information to actual health behavior change, and the results clearly indicate the need for more systematic research on HL in CHD patients and persons at risk.
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Considerations on Health Literacy and Hearing Aid Use
February, 2021 (The Hearing Journal)
Experts in many fields can find it challenging to communicate with non-experts; it requires effort to avoid field-specific terminology commonly used among peers but is impenetrable jargon to a layperson. Existing evidence for audiology suggests that hearing specialists are not immune to this difficulty, with clinicians and other experts communicating using a vocabulary that is at a much higher reading level than that of their patients. Moreover, it has been shown that the more complex the audiologists’ language, the lower the likelihood of hearing aid uptake by the patient. Missing from our understanding is the relationship between the patients’ ability to understand health-related information and their use of hearing health care.
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NATIONAL HEALTHCARE QUALITY AND DISPARITIES REPORT CHARTBOOK ON PATIENT SAFETY
February, 2021 (U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES)
This Patient Safety Chartbook is part of a family of documents and tools that support the National Healthcare Quality and Disparities Report (NHQDR). The NHQDR is an annual report to Congress mandated in the Healthcare Research and Quality Act of 1999… The NHQDR provides a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeconomic groups. The purpose of the reports is to assess the performance of our healthcare system and to identify areas of strengths and weaknesses in the healthcare system along three main axes: access to healthcare, quality of healthcare, and NHQDR priorities.
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Health literacy in persons at risk of and patients with coronary heart disease: A systematic review
February, 2021 (PubMed)
The aim of this rapid scoping review, for which only studies from the general population were considered, was to describe the extent of existing research on HL in the context of previous coronavirus outbreaks. 72 studies were included. Three investigated HL or explicitly referred to the concept of HL, 14 were guided by health behaviour theory. We did not find any study designed to develop or psychometrically evaluate pandemic/epidemic HL instruments, or relate pandemic/epidemic or general HL to a pandemic/epidemic outcome, or any controlled intervention study.
Access Health literacy in persons at risk of and patients with coronary heart disease: A systematic review
Developing Health Literacy Communication Practices for Medical Students
January 28, 2021 (PubMed)
Health literacy and its associated communication practices are critical to patient-centered care and have been endorsed by various associations as important for health professional training. Unfortunately, there is little published literature on how to teach health literacy to medical students and health professionals.
The workshop was implemented with approximately 100 second-year medical students as part of a course in their required curriculum. Results of a Wilcoxon rank sum test of pre/post survey responses showed a statistically significant move towards conviction of importance and confidence in ability to use three health literacy techniques.
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Role of Health Literacy in Health-Related Information-Seeking Behavior Online: Cross-sectional Study
January 27, 2021 (PubMed)
The internet has emerged as a main venue of health information delivery and health-related activities. However, few studies have examined how health literacy determines online health-related behavior.
Our findings indicate that access to online health-related information is not uniformly distributed throughout the population, which may exacerbate disparities in health and health care. Research, policy, and practice attention are needed to address the disparities in access to health information as well as to ensure the quality of the information and improve health literacy.
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Healthy People 2030 Health Literacy Definition Tells Organizations: Make Information and Services Easy to Find, Understand, and Use
January 22, 2021 (Springer)
This summer, the U.S. Department of Health and Human Services (HHS) released Healthy People 2030, the fifth iteration of the nation’s 10-year plan to improve the health of all Americans. For the first time, Healthy People features health literacy as part of its framework. Specifically, attaining health literacy for all is one of Healthy People 2030’s five overarching goals. Further, Healthy People 2030 has released an expanded definition of health literacy. Healthy People previously identified health literacy solely in terms of individuals’ capacities to understand health information. Now Healthy People’s definition includes a new organizational component that recognizes the essential role organizations that provide health-related information and services play in improving health literacy. Physicians, as both clinicians and organizational leaders, have key roles to play in helping their organizations become health literate.
You Can Teach Every Patient: A Health Literacy and Clear Communication Curriculum for Pediatric Clerkship Students
January 22, 2021 (PubMed)
Poor health literacy has a negative impact on various health care outcomes. Medical schools are not consistently providing health literacy training; when they do, they overly rely on didactics.
Compared to the didactic-only group, students in the didactic + workshop group more frequently used teach-back (53% vs. 27%, p < .01) and pictures (46% vs. 10%, p < .01). In addition, the didactic + workshop group had improved recall, self-reported use, and comfort with the skills. The didactic + workshop group solicited questions from the standardized patient less often, and there was no difference in use of clear language between the two groups.
Testing the reliability of the Health Literacy Questionnaire with carers of older adults receiving hospital care
January 19, 2021 (PubMed)
Objective: To determine the re-test reliability of the Health Literacy Questionnaire (HLQ) with carers of older adults discharged from hospital or attending the outpatient clinic.
Results: Fifty-one carers of older patients participated. The HLQ showed good reliability (ICC = 0.75-0.90) for seven of the nine scales and moderate reliability (0.50-0.74) for the other two scales. Median completion time was 16.5 minutes (range 9-50), and acceptability was rated as 9.5/10.
Conclusion: The HLQ is a reliable tool for use with carers of older adults attending hospital. However, the length of time for completion of the HLQ may limit its feasibility for use by hospital staff and carers, given the high stress and time pressures of acute care.
Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: results of the randomized trial AEQUALIS
January 7, 2021 (PubMed)
Evidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality.
The Relationship Between Attitudes about Research and Health Literacy among African American and White (Non-Hispanic) Community Dwelling Older Adults
January 7, 2021 (PubMed)
Ethnic minority representation lacks in research. Understanding factors that promote minorities in research helps address this participation gap. Minorities often face representation disparities, including health education, socioeconomic status, and race. Compared to other races in the USA, over 50% of African Americans (AA) over age 65 face obstacles towards achieving basic health literacy skills. This study aims to investigate differences in beliefs regarding research and health literacy between White and AA participants.
Organizational Health Literacy: Opportunities for Patient-Centered Care in the Wake of COVID-19
Jan/Mar, 2021 (PubMed)
The coronavirus disease-2019 (COVID-19) pandemic is transforming the health care sector. As health care organizations move from crisis mobilization to a new landscape of health and social needs, organizational health literacy offers practical building blocks to provide high-quality, efficient, and meaningful care to patients and their families. This article provides practical guidance for systems and informs decisions around resource allocation and organizational priorities to best meet the needs of patient populations even in the face of financial and workforce disruption.
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Level of Health Literacy Among Patients With Thrombotic Thrombocytopenic Purpura
October 8, 2020 (HematologyAdvisor)
A team of investigators evaluated knowledge gaps among patients with thrombotic thrombocytopenic purpura (TTP) in remission and found a range of levels of understanding of the condition. Findings were published in Hemasphere, a journal powered by the European Hematology Association.
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Why Health – and Pancreatic Cancer – Literacy Matter
October 8, 2020 (PancreaticCancerActionNewtwork)
Patient navigators may be a valuable resource and are available at many hospitals and cancer centers across the country. These healthcare professionals can provide one-on-one guidance for patients as they face medical, legal or financial challenges, including helping you understand treatment options. Ask your healthcare team for patient navigators available to you.
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Will the Effect of New Federal Breast Density Legislation Be Diminished by Currently Available Online Patient Educational Materials?
October, 2020 (PubMed)
To evaluate readability of commonly accessed online patient educational materials (OPEM) on breast density in setting of recently passed federal breast density legislation. Fouty-one websites met inclusion criteria representing patient-directed OPEM on breast density. Readability of currently available OPEM on breast density may be written at a level too difficult for the general public to comprehend, which may represent a barrier to educational goals of newly passed federal breast density legislation.
Instrumental and affective communication with patients with limited health literacy in the palliative phase of cancer or COPD
October 7, 2020 (PubMed)
Patients have a ‘need to know’ (instrumental need) and a ‘need to feel known’ (affective need). During consultations with patients with limited health literacy (LHL) in the palliative phase of their disease, both the instrumental and the affective communication skills of healthcare providers are important. The study aims to explore instrumental and affective communication between care providers and LHL patients in the palliative phase of COPD or cancer.
A Select Bibliography of Actions to Promote Vaccine Literacy: A Resource for Health Communication
October 2, 2020 (PubMed)
In this bibliography, the researchers provide an introduction to the available evidence base of actions to promote vaccine literacy. The research team organized interventions to create a tool that can inform health communicators and practitioners seeking a resource focused on strategy and implementation design for actions that support vaccine literacy. This scoping bibliography is honed specifically to respond to the urgency of the current pandemic, when supporting and increasing vaccine literacy offers promise for achieving the critically needed high levels of vaccination. Over the course of the coming months and year, this bibliography will be a dynamic and “living” document hosted and maintained on vaccineliteracy.com.
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4 Main Barriers Diminishing Patient Activation Efforts
October 2, 2020 (PatientEngagement)
Driving meaningful patient-provider communication and addressing patient social determinants of health needs are key to patient activation. As the medical field pushes value-based care efforts, the concept of patient activation has become more critical. After all, it’s an activated patient who is able to fend off or manage illness in between clinic visits.
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October is National Health Literacy Month!
October, 2020 (Health Literacy Month 2020)
Health Literacy Month is a time for organizations and individuals to promote the importance of understandable health information. This annual, worldwide, awareness-raising event has been going strong ever since Helen Osborne founded it in 1999. Learn more about the importance of making health information easy to understand and making the health care system easier to navigate by going to Health Literacy Month 2020.
Parental education, health literacy and children’s adult body height
Jun-Sep, 2020 (PubMed)
The objective of this study was to analyse the associations between parents’ education, their functional literacy and their children’s adult body height. The study used data for 39,240 individuals from the 2016 wave of the nationally representative Life in Transition Survey (LITS) conducted in 34 countries in Southern and Eastern Europe, the Middle East and Central Asia. Using linear and Poisson models, regression adjustment treatment estimators and multilevel mixed-effects linear regressions, the study analysed the links between mother’s and father’s educational attainment, parental functional literacy, measured by the number of books in the childhood home, and children’s adult height. The results demonstrated that mother’s educational attainment and parental functional literacy have independent associations with children’s adult body height. Sufficient literacy skills of the parent may have a positive effect on children’s growth even if parental education is low. The study also provides evidence of a widening of the height gap for men born in the period just before and after systemic transition in post-socialist societies, which may suggest an increase in social differences in early living standards.
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The paradox of the link between health literacy and health promotion: the case of COVID-19
Jun-Sep, 2020 (PubMed)
COVID-19 brought out the critical issues of public health messages and the relationship between health literacy, health promotion, and public health. The aim is to analyse these concepts to provide a framework in which mutual influences are ontologically analysed… There was a massive presence of COVID-19 misinformation, particularly on social media in terms of, among others, treatments, the utility of wearing mask, COVID-19 cases by age group, conspiracy theories, all added more confusion and uncertainty to the public. Public health must protect the public from misinfromation. While in practice actions have been put in place to improve patients’ compliance with respect to health promotion it is unclear the ontological relationship between health promotion and health literacy within the Public Health context.
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A cluster-randomized study on the Risk Assessment and Management Program for home blood pressure monitoring in an older population with inadequate health literacy
September, 2020 (PubMed)
The Risk Assessment and Management Program (RAMP) has successfully demonstrated a reduction of blood pressure (BP) and cardiovascular (CVD) risk of patients with hypertension. This study aimed to compare the blood pressure control rate of participants after attended RAMP group, with those attended RAMP individual from usual care. A prospective open cluster-randomized controlled trial was performed in five public primary care clinics. Patients with uncontrolled hypertension were recruited. RAMP group consisted of multi-disciplinary group education on knowledge of hypertension, lifestyle modification, and hands-on home blood pressure monitoring (HBPM) training. Each participant was given a branchial HBPM device. An individual face-to-face nurse follow-up was arranged 6 weeks later. Participants’ office BP and clinical parameters were assessed at 6, 12, and 18 months. Three RAMP group and two RAMP-individual clusters recruited 152 and 139 participants, respectively. The mean age was 67.0 (SD 9.9) year. After 18 months of treatment, there was a significantly higher BP control rate in the RAMP-group participants than the RAMP-individual participants (78.9% vs 36.5%, P < .001). The systolic BP was reduced by 19.7 mm Hg (95% CI -22.03, -17.40, P < .001) and diastolic BP by 8.1 mm Hg (95% CI -9.66, -6.61, P < .001) in RAMP group while the RAMP individual demonstrated 9.3 mm Hg (95% CI -12.1, -6.4, P < .001) reduction in systolic BP without any significant difference in diastolic BP. The RAMP-group participants’ body weight (BW) and body mass index(BMI) had no significant changes, while the RAMP-individual participants had a significant increase in BW and BMI. No adverse effect was reported.
Improving mental health literacy in adolescents: systematic review of supporting intervention studies
September, 2020 (PubMed)
The aim of this systematic review was to explore the effect of supporting interventions on improving MHL in adolescents. Supporting interventions for improving MHL in adolescents could be categorised into school-based and community-based. Both types used an education stand-alone strategy or an education plus contact-based group in their programmes. To provide knowledge of mental illness to adolescents, teaching methods should be interactive and use various media such as group discussion, videos and movies. School-based and community-based interventions were likely to improve MHL among adolescents. However, further research with objective tool measures is needed to confirm the findings.
Health literacy and COVID-19
September, 2020 (PubMed)
In early 2020, the world experienced an unprecedented health crisis. When the pandemic of coronavirus was declared by the World Health Organization, it brought with it sudden and dramatic changes to everyday life. In the UK, the key message from the Government was to ‘Stay at home, protect the NHS, save lives’, sending out a clear warning that failing to stay at home would put other lives and the ability of the NHS to cope at risk. This editorial discusses COVID-19, how society responded and the vital role that health literacy plays in saving lives during a global health emergency.
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An app for supporting older people receiving home care – usage, aspects of health and health literacy: a quasi-experimental study
September, 2020 (PubMed)
During the last decade, there has been an increase in studies describing use of mHealth, using smartphones with apps, in the healthcare system by a variety of populations. Despite this, few interventions including apps are targeting older people receiving home care. The current study is part of a larger project for identifying and managing health concerns via an app by using real-time data. The aim of the study was to describe older people’s usage of an app and to evaluate the impact of usage on aspects of health and health literacy over time. The results indicate that the usage of Interaktor can support older people by significantly improving their communicative and critical health literacy. Aspects of health were not shown to be affected by the usage of the app.
Association Between Public Knowledge About COVID-19, Trust in Information Sources, and Adherence to Social Distancing:Cross-Sectional Survey
July-September, 2020 (JMIR)
The aim of this study was to investigate associations between public knowledge about COVID-19, adherence tosocial distancing, and public trust in government information sources (eg, the US Centers for Disease Control and Prevention),private sources (eg, FOX and CNN), and social networks (eg, Facebook and Twitter) to inform future policies related to criticalinformation distribution. Government information sources were the most trusted among the public. However, we observed trends in the datathat suggested variations in trust by age and gender. White and older populations generally expressed higher trust in governmentsources, while non-White and younger populations expressed higher trust in private sources (eg, CNN) and social networks (eg,Twitter). Trust in government sources was positively associated with accurate knowledge about COVID-19 and adherence tosocial distancing. However, trust in private sources (eg, FOX and CNN) was negatively associated with knowledge aboutCOVID-19. Similarly, trust in social networks (eg, Facebook and Twitter) was negatively associated with both knowledge andadherence to social distancing.
Picture of a pandemic: visual aids in the COVID-19 crisis
September, 2020 (OxfordAcademic)
As a global crisis, COVID-19 has underscored the challenge of disseminating evidence-based public health recommendations amidst a rapidly evolving, often uncensored information ecosystem—one fueled in part by an unprecedented degree of connected afforded through social media. In this piece, we explore an underdiscussed intersection between the visual arts and public health, focusing on the use of validated infographics and other forms of visual communication to rapidly disseminate accurate public health information during the COVID-19 pandemic. We illustrate our arguments through our own experience in creating a validated infographic for patients, now disseminated through social media and other outlets across the world in nearly 20 translations. Visual communication offers a creative and practical medium to bridge critical health literacy gaps, empower diverse patient communities through evidence-based information and facilitate public health advocacy during this pandemic and the ‘new normal’ that lies ahead.
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The role of health literacy, depression, disease knowledge, and self-efficacy in self-care among adults with heart failure: An updated model
November-December 2020 (ScienceDirect)
Patients with inadequate health literacy and heart failure face high healthcare costs, more hospitalizations, and greater mortality. To address these negative consequences, patients need to improve heart failure self-care. Multiple factors may influence self-care, but the exact model by which they do so is not fully understood.
Answers to Coronavirus Questions
2020 (Georgia State University)
This online booklet provides answers to frequently asked Coronavirus questions in an easy-to-read format.
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CORONAVIRUS ADULT LITERACY RESOURCES
2020 (Georgia State University)
Here is a library of many high interest/low literacy Coronavirus materials. We have included materials up to a 9th-grade reading level.
The directory is categorized into easier to read materials and harder to read materials. We analyzed the materials using VisibleThread Readability software.
Access CORONAVIRUS ADULT LITERACY RESOURCES
History of Health Literacy Definitions
2020 (ODPHP)
In developing Healthy People 2030, the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 proposed expanding Healthy People’s view on health literacy.
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Combating Xenophobia in the Covid-19 Pandemic: The Importance of Health Literacy
2020 (Inquiries Journal)
The emergence of the novel coronavirus, SARS-CoV-2, has caused a global pandemic of the coronavirus disease, COVID-19. Delaying the spread of the virus quickly gained international prioritization; however, the growing cases of xenophobia –– the dislike, prejudice, or fear of people from other countries (Oxford Learner’s Dictionaries, n.d.) –– did not. The prevalence of the virus has been coupled with increased reports of xenophobia in the United States, targeting Asian and Asian-American communities due to the virus’ reported origins in Wuhan, China.
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Assessment of Disparities in COVID-19 Testing and Infection Across Language Groups in Seattle, Washington
September 24, 2020 (JAMA)
Clinicians from New York, New York, have raised the alarm that the coronavirus disease 2019 (COVID-19) pandemic has taken a disproportionate toll on their local immigrant communities. Limited English language proficiency (LEP) or low health literacy can present challenges to effective communication about disease transmission. Worries about stigma, deportation, or livelihood may supersede those of a health threat, however serious. It remains unclear whether these disparities have resulted in lower comparative access to testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a patient-initiated option in all but congregant settings, or in higher rates of infection among immigrants. To clarify this issue, we evaluated the proportion of patients who completed testing and the proportion of positive cases using language as a surrogate for immigrant status.
COVID-19 and health literacy: the yell of a silent epidemic amidst the pandemic
September 24, 2020 (NIH)
The emergence of a new form of Coronavirus (SARS-CoV-2) exposed weaknesses of health services in several countries, with overcrowding of hospitals, and lack of supplies and professionals in combating the disease, which sometimes contributed to the installation of social, political, and economic chaos. Health literacy is a broad and important topic in public health but still globally underestimated, thus considered a silent epidemic. The exponential increase in the number of confirmed cases shows the world population’s inadequacy and difficulty in understanding basic prevention guidelines. The COVID-19 pandemic warns of gaps in the health literacy levels of the world population and exposes the need for a comprehensive mapping to identify the overall health literacy status in more countries.
Access COVID-19 and health literacy: the yell of a silent epidemic amidst the pandemic
4 Pitfalls to Avoid in Nurse Communication
September 24, 2020 (PatientEngagement)
Strong nurse communication skills is arguably one of the most important factors leading to a good patient experience. After all, nurses spend more time with patients than many other clinicians, and the way they interact with the patient can make a big difference in how a patient perceives her medical care.
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Good Patient-Provider Relationship Proves to Boost Outcomes
September 16, 2020 (Patient Engagement)
A good patient-provider relationship has long been understood as the foundation of a high patient satisfaction score, but new evidence suggests these relationships can have greater impacts. A study in the Annals of Family Medicine has found that a better patient-provider relationship can mean better patient health outcomes.
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Measurements of Older Adults’ Physical Competence under the Concept of Physical Literacy: A Scoping Review
September 16, 2020 (PubMed)
In this scoping review, we reflected on previous empirical studies regarding the measurements of physical competence among older adults holistically and systematically to identify and analyze gaps in the topic of “physical literacy” among older adults as a precursor to a systematic review.
Through our review, we found that 73% of the mean age of the participants comprised older baby boomers who were from 65-74 years old as aging continues. Therefore, more effort should be made in developing physical literacy for older adults with the goal of health promotion. Our results showed that most studies adopted both self-reported and objective measures, in which objective measures were widely embraced by scholars in the measurement, while self-reported measures were encouraged to be included in the assessment as well.
Engaging Women with Limited Health Literacy in Mammography Decision-Making: Perspectives of Patients and Primary Care Providers
September 15, 2020 (PubMed)
Limited health literacy is a driver of cancer disparities and associated with less participation in medical decisions. Mammography screening decisions are an exemplar of where health literacy may impact decision-making and outcomes.
Women ages 40-54 with limited health literacy and no history of breast cancer or mammogram in the prior 9 months were approached before a primary care visit at a Boston academic, safety-net hospital. PCPs practicing at this site were eligible for PCP interviews.
Both patients and PCPs perceived a need for tools to relay technical and process knowledge about mammography prior to clinical encounters to address the scope of information that patients with limited health literacy desired.
Simple contents and good readability: Improving health literacy for LEP populations
September, 2020 (ScienceDirect)
Highlights:
- •Readability tests can be a useful tool for revising health information to increase readability.•Online health information should be simplified and tailored to the needs of those with LEP.•Basic health information should be written in simple English before being translated into other languages.
Access Simple contents and good readability: Improving health literacy for LEP populations
4 tips to enhance patient communication as a medical student
August 25, 2020 (AMA)
After months off the wards due to safety precautions put in place to curb potential exposure during the COVID-19 pandemic, many medical students are returning to patient-facing roles. While communication skills are an emphasis throughout your medical training, they take on a new meaning—and are vitally important—once you begin interacting with patients during clinical rotations.
Access 4 tips to enhance patient communication as a medical student
Recognize Misinformation on the Internet
August 24, 2020 (The New York Times)
Older people are vulnerable to misinformation online even under normal circumstances. But the coronavirus has made the problem especially urgent. Older people are more susceptible to the virus, making discerning reliable health information important now.
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Leveraging media and health communication strategies to overcome the COVID-19 infodemic
August 22, 2020 (Springer)
The COVID-19 pandemic has caused a complementary infodemic, whereby various outlets and digital media portals shared false information and unsourced recommendations on health. In addition, journals and authors published a mass of academic articles at a speed that suggests a non-existent or a non-rigorous peer review process. Such lapses can promote false information and adoption of health policies based on misleading data. Reliable information is vital for designing and implementing preventive measures and promoting health awareness in the fight against COVID-19. In the age of social media, information travels wide and fast, emphasizing a need for accurate data to be corroborated swiftly and for preventing misleading information from wide dissemination. Here, we discuss the implications of the COVID-19 infodemic and explore practical ways to leverage health communication strategies to overcome it. We propose the “Infodemic Response Checklist” as a comprehensive tool to overcome the challenges posed by the current and any future infodemics.
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The key to COVID-19 communication? Keep it simple
August 21, 2020 (NC Health News)
COVID-19 is complicated, and the world’s understanding of the virus has evolved over the last few months. We’ve gathered input from experts on how leaders can communicate clearly and why it’s so important to do so.
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The key to COVID-19 communication? Keep it simple
August 21, 2020 (NC Health News)
COVID-19 is complicated, and the world’s understanding of the virus has evolved over the last few months. We’ve gathered input from experts on how leaders can communicate clearly and why it’s so important to do so.
Access The key to COVID-19 communication? Keep it simple
Coronavirus websites usually go over people’s heads, study finds
August 20, 2020 (CNN)
Excuse me? What’s that mean?
When it comes to educating the world about coronavirus, public health organizations around the world uniformly exceed recommended reading levels, researchers reported Tuesday.
That includes guidance from the World Health Organization and the US Centers for Disease Control and Prevention.
While most public health guidelines are supposed to be written at between sixth- and eighth-grade reading levels, many websites for the public aim higher.
Access Coronavirus websites usually go over people’s heads, study finds
Comparison of Readability of Official Public Health Information About COVID-19 on Websites of International Agencies and the Governments of 15 Countries
August 18, 2020 (RheumatologyAdvisor)
Containment strategies for the coronavirus disease 2019 (COVID-19) pandemic have required broad public compliance, yet complex, contradictory, and false information proliferates. The American Medical Association (AMA), National Institutes of Health (NIH), and Centers for Disease Control and Prevention (CDC) recommend that medical information for the public be written at no higher than an eighth-grade reading level. We evaluated the readability of online information about COVID-19 provided by government and public health agencies and departments.
Every Picture Tells a Story: Health Literacy and COVID-19
August 18, 2020 (RheumatologyAdvisor)
Health literacy, or understanding the medical narrative, is a problem for a majority of Americans. When compounded with numeric literacy, understanding numbers, ratios and rates — the daily litany that has accompanied COVID-19 news conferences — it’s estimated that 8 out of 10 Americans just don’t get it.
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Radiation therapist health literacy training: Does learning alternate communication methods translate into improved confidence in patient interactions?
August, 2020 (PubMed)
Low health literacy can inhibit patients’ understanding of radiation therapy (RT) procedures. An objective of this research was to develop training to educate Australian radiation therapists (RTTs) about tools that support low health literacy patients, namely plain language and the Teach Back method (TBM). Perceptions, clinical use of these tools and confidence levels (pre and post training) in occupational scenarios were evaluated.
Radiation therapists’ confidence and use of alternative tools to improve patient understanding improved after attending training.
Challenges in Navigating the Health Care System: Development of an Instrument Measuring Navigation Health Literacy
August 8, 2020 (PubMed)
Due to their rapid expansion and complexity, it is increasingly difficult for patients to orient themselves in health care systems. Therefore, patients require a high degree of health literacy, or more precisely, navigation health literacy (HL-NAV). The actual extent of HL-NAV of patients and citizens is still largely unknown due to the lack of adequate measurement instruments. Thus, within the new international Health Literacy Population Survey 2019 (HLS19), one aim was to develop a suitable instrument for measuring HL-NAV in the HLS19 the HL-NAV-HLS19. The instrument will be used for the first time in the HLS19 survey and will provide first data on HL-NAV in general populations for the countries participating in HLS19. It is suited for cross-country comparisons and monitoring, as well as for intervention development. However, the instrument should be translated into and validated in further languages and countries for population samples.
Educational Tools for Improving Health Literacy Among Patients With Rheumatoid Arthritis
August 7, 2020 (ACSH)
Self-administration of an educational video and booklet was associated with improved health literacy and decreased decisional conflict among patients with rheumatoid arthritis (RA), according to findings reported in Arthritis Care & Research.
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Young Adults: Addressing the Health Needs of a Vulnerable Population
August 1, 2020 (AJMed)
Young adults ages 18-24 comprise 9% of the population of the United States and are a vulnerable group. They routinely disengage from the health care system starting in mid-adolescence and by the ages of 18-26, 15% do not have a usual source of care, and 40% have not seen a primary care physician in the previous year. As a result, 4.5 million young adults in this age group are currently without a usual source of care in the United States. We propose a framework to optimize the care of this age group that requires collaborative efforts among providers in combined internal medicine-pediatrics, family medicine, internal medicine, obstetrics-gynecology, and pediatric providers to maximize their health outcomes and reduce their costs to the health care system.
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Asthma and COPD patients’ perceived link between health literacy core domains and self-management of their condition
July, 2020 (PubMed)
Health literacy (HL) is a person’s ability to practically apply a wide range of cognitive and non-cognitive skills, to make health-related decisions. Currently, no tool applies all HL core domains to capture necessary data to measures HL in adult asthma and COPD patients. We endeavored to develop a comprehensive, function-based tool that adequately and accurately measures HL skills of this patient population. We explored the perspectives of patients related to each core HL domain, with an emphasis on self-management practices.
Thirteen subthemes were identified within five HL domains: (a) access: active access; passive access; lack of access; (b) understanding: how to improve understanding; (c) trustworthiness; relevancy and validity of information: pre- and post- application of information; (d) communication: barriers to proper communication; (e) application of information: making health decisions.
Low health literacy tied to worse heart failure outcomes
July 29, 2020 (Medical Xpress)
Poor health literacy is associated with worse heart failure outcomes, according to a review published in the June issue of JACC: Heart Failure…Matteo Fabbri, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues conducted a systematic literature review to evaluate associations between health literacy and health-related outcomes in patients with heart failure.
Access Low health literacy tied to worse heart failure outcomes
Health Equity Demands Health Literacy: Ethics in the Pediatric Emergency Department
July, 2020 (PubMed)
Health literacy has been shown to be of primary importance when determining a patient’s ability to achieve optimal health. As physicians, we often fail to recognize the enormous obstacles facing our patients. In the pediatric emergency department (PED), communication is complicated. Physicians must be able to effectively relay information to the patient’s caregiver while still not forgetting to provide developmentally appropriate instructions to the child. As providers, we need to always be questioning as to whether we properly conveyed the information to our patients. Teaching which results in good understanding is the ultimate goal when treating and releasing our patients in the pediatric emergency department. Matching the method of delivery of information and education to the family’s health literacy will help the care team deliver effective information so that it is applied at home hopefully preventing a rapid revisit.
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Health Literacy of Osteoporosis Risks among Caregivers Serving in Disability Care Facilities
July 7, 2020 (PubMed)
This study aims to present a general profile of health literacy related to osteoporosis risks and identify its associated factors among disability institutional caregivers. A cross-sectional study with a structured questionnaire was used to collect information on 465 caregivers from seven disability care institutions regarding their awareness of the health literacy related to osteoporosis risks. This study highlights risk factors related to a lower level of osteoporosis healthy literacy such as older age, less education, no experience of bone density test, and poor physical fitness that highlight the need to raise further awareness in order to improve caregivers’ bone health.
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Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties
July 3, 2020 (PubMed)
This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.
Effects of health literacy interventions on health-related outcomes in socioeconomically disadvantaged adults living in the community: a systematic review
July, 2020 (PubMed)
The objectives of this review were: i) to identify and synthesize the best available evidence on the effectiveness on health-related outcomes of health literacy interventions for enabling socioeconomically disadvantaged people living in the community to access, understand, appraise and apply health information; and ii) to identify components of health literacy interventions associated with improved health-related outcomes.
Parental health literacy and health knowledge, behaviours and outcomes in children: a cross-sectional survey
July 13, 2020 (PubMed)
Health literacy (HL) is closely associated with leading health indicators such as engaging in healthy behaviours and experiencing a healthy social environment. Parents represent a critical subgroup among the adult population since they are not only responsible for their own health but also for the health of their children. In preparation of an implementation study, a cross-sectional survey was conducted in 28 elementary and secondary schools in Germany. High parental HL was associated with positive health behaviours in children including healthier nutrition, regular tooth brushing and more physical activity.
The results confirm a relationship between low parental HL, SES and some child health behaviours likely to negatively impact their health and wellbeing including less healthy nutrition and less exercise. Strengthening the health knowledge and competencies of parents may contribute to improved child outcomes particularly in the areas of nutrition, exercise and dental health.
Special Supplement: Health Literacy and Adult Basic Education
July, 2020 (Health Literacy Research and Practice)
This supplement of HLRP: Health Literacy Research and Practice seeks to affirm the relevance of adult basic education (ABE) to advancements in the health literacy field. The worlds of health literacy and ABE have much in common, as both are preoccupied with promoting self-efficacy. Yet, they have largely remained unconnected in their research, policy, and practice. This supplement aims to highlight ways in which the health literacy and ABE fields have intersected and influenced each other to the benefit of adult populations with inadequate literacy skills, including those with limited print literacy and numeracy skills, and those with limited English proficiency.
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Learners’ experience and perceived impact of a health literacy program in adult basic education: a qualitative study
June 30, 2020 (PubMed)
Objectives and importance of the study: Adult literacy programs aim to empower learners to participate more effectively in everyday life. This includes programs with health content embedded in curricula to target health literacy. Adult learners who attend these programs represent a heterogeneous population, but include a high proportion of hard-to-reach or socially disadvantaged groups in terms of age, ethnicity, educational background, language and prevalence of learning disabilities. In 2014, we conducted a cluster-randomised controlled trial of a health literacy program in adult basic education classes across New South Wales, Australia. This paper reports findings from a qualitative study exploring learners’ experience of the course and its perceived impact on their lives, as well as their understanding and confidence about health.
Acceptance of illness mediate the effects of health literacy on self-management behaviour
June, 2020 (PubMed)
Self-management is crucial for blood pressure control and subsequent disease prevention. Health literacy and acceptance of illness may contribute to self-management behaviour; in addition, acceptance of illness may mediate the effects of health literacy on self-management behaviour among patients with hypertension.
Acceptance of illness mediated the relationships between three types of health literacy and self-management. Health literacy and acceptance of illness should be addressed when taking measures to improve patients’ self-management behaviour.
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Tele-rehabilitation and hospital-based cardiac rehabilitation are comparable in increasing patient activation and health literacy: A pilot study
June, 2020 (PubMed)
Cardiac tele-rehabilitation is defined as using information and communication technology to support rehabilitation services. However, it requires a high level of patient activation and health literacy; this has not yet been explored.
Tele-rehabilitation and hospital-based cardiac rehabilitation seemed to be equally successful in improving patient activation and health literacy. Tele-rehabilitation should be further tested in a randomised controlled trial, with a focus on whether patient levels of education and self-management at the initiation of rehabilitation are decisive factors for tele-rehabilitation participation.
Promoting Convergence Between Health Literacy and Health Communication
June, 2020 (PubMed)
Health communication and health literacy are complementary areas of study and application. However, the important connections between the work conducted in these two related areas of inquiry do not appear to have always been well understood, nor appreciated, leading to limited integration and coordination between health communication and health literacy inquiry. While there are many scholars who study both health communication and health literacy, some researchers are not well-versed in both areas, and do not understand how they can contribute to one another. In this chapter, the authors examine the parallel development of these two interdependent areas of study, trace their inter-connections, and propose strategies to enhance collaboration and integration within health literacy as well as health communication research and applications.
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The Role and Impact of Health Literacy on Peer-to-Peer Health Communication
June, 2020 (PubMed)
The chapter first discusses the rise of peer-to-peer sharing of health information and accompanying health literacy concerns. Next, a series of case studies are presented that illustrate the potential role of health literacy in three different online settings: clinical trial patient support networks, social media channels, and personal blogs. The chapter then explores common themes highlighted in these examples and discusses the range of health literacy benefits and pitfalls that accompany the use of these channels for health information. Finally, the chapter explores existing individual-level and system-level health literacy initiatives for peer-to-peer health communication and suggests opportunities for future work in this area. Such efforts to address and improve health literacy can help individuals and communities successfully navigate online platforms where peer-to-peer health information is exchanged.
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Health Literacy: An Essential Element of Health Care Professionalism and Resilience
June 25, 2020 (PubMed)
This chapter examines the evolution of the concept of health literacy and its practical implications for health literacy interventions. The chapter, then, provides an updated overview of reported interventions and existing strengths and weaknesses. It concludes with recommendations on interventional research that provides practical and implementable solutions which can inform future policy, strategy, and priorities.
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The Intersections Between Social Determinants of Health, Health Literacy, and Health Disparities
June 25, 2020 (PubMed)
his chapter synthesizes what is known about the relationship between social disadvantage and measures of low health literacy (LHL), and reviews the research examining whether LHL is an explanatory factor connecting social disadvantage, health outcomes, and health disparities. Written from a U.S. perspective, the chapter then offers a novel conceptual framework that presents how the social determinants of health might interact with LHL to result in health disparities. The framework articulates relationships that reflect public health pathways and healthcare pathways, which include their related health literacies. In addition, the chapter highlights as an exemplar one important potential causal mechanism in the healthcare pathway by exploring the communication model in outpatient care, as communication has been very well-studied with respect to both health disparities and HL. The chapter then, provides two examples of HL interventions aligned with the conceptual framework, one of which addresses the health care literacy pathway, and the other addresses the public health literacy pathway.
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The Evolving Role of Health Literacy in Improving Oral Health
June 25, 2020 (PubMed)
This chapter examines the evolution of the concept of health literacy and its practical implications for health literacy interventions. The chapter, then, provides an updated overview of reported interventions and existing strengths and weaknesses. It concludes with recommendations on interventional research that provides practical and implementable solutions which can inform future policy, strategy, and priorities.
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Health Literacy and Pediatric Health
June 25, 2020 (PubMed)
This chapter will review the epidemiology of health literacy in parents, adolescents, and children, and how this compares to the general adult population. It will highlight unique considerations regarding health literacy and pediatric health. The chapter will then focus on the impact of health literacy and relevant health literacy-informed interventions on pediatric health. Finally, the chapter will discuss gaps in the literature and future directions.
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Advancing Health Literacy Interventions
June 25, 2020 (PubMed)
This chapter provides a review of the evolution of oral health literacy including its impact on oral health outcomes, the current status of oral health literacy initiatives and future research needs. A major part of the chapter describes oral health literacy’s influence in the integration of dental and medical care. The chapter provides an extensive list of research needed to further our understanding of the impact of oral health literacy on health disparities and the health of the population.
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Improving Immunization and Health Literacy Through a Community-Based Approach
June 25, 2020 (PubMed)
This report illustrates the importance of capacity-building to advance immunization literacy through a community-based participatory research (CPBR) approach to decrease child health immunization disparities. The research project utilizes culturally-tailored immunization and technology literacy modalities for dissemination in targeted low-income neighborhoods. The results suggest successful outcomes are dependent upon contributions and engagement of community members in all project processes, ensuring community buy-in and cultural relevance. The latter approach is time-intensive due in part to the need to build broad-based community partnerships, which can result in a promising approach to foster broader population impact.
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Improving parent oral health literacy in Head Start programs
June, 2020 (PubMed)
We sought to determine whether an oral health literacy intervention aimed at parents of children attending Head Start programs improved oral health literacy and behaviors. Findings suggest that this intervention successfully improved oral health literacy for diverse parents of children at high risk for dental caries.
Access Improving parent oral health literacy in Head Start programs
Health Literacy’s Impact On Health Law & Policy
June, 2020 (PubMed)
Law and policy are an integral part of any health system, in the U.S. and abroad. This chapter discusses the trend towards incorporating health literacy or patient understanding requirements into the varied laws and policies that impact all parts of healthcare. After reading this chapter, healthcare providers, hospital executives, biomedical researchers, industry sponsors, and public health professionals will better understand the regulatory trend towards health literacy and how they can use these sources of authority to advocate for change in their respective fields.
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Reintegrate Empowerment and Health Literacy to Advance Public Health and Healthcare Delivery
June, 2020 (PubMed)
Empowerment has been described as a prerequisite for health and the ultimate goal of health literacy in both clinical practice and health promotion. Improving health literacy and empowerment is central to national and international public health and healthcare policies. Few studies have addressed both concepts. This chapter summarizes and interprets the significance of these fault lines for current and future research. Divergent clinical and health promotion perceptions of health empowerment, its expected outcomes, processes, interventions and measures are reviewed. The chapter reinforces recent calls for increased attention to empowerment in health literacy research and the reintegration of the critical health literacy concept to better reflect policy, achieve global public health goals, advance healthcare delivery, and foster multidisciplinary career opportunities for students, researchers, and practitioners.
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Programmatic Approaches to Increase the Health of Children and Senior Citizens Using Health Literacy Best Practices
June, 2020 (PubMed)
Effective communication is essential to improving individual health and wellbeing, especially for those with marginalized literacy levels. While there are many populations that benefit from effective communication, this report concentrates on child and senior populations. Three programs developed by the Institute for Healthcare Advancement (IHA) and partner agencies in the U.S. are explored as examples of practical techniques that can be included in programmatic initiatives. The authors also provide suggestions for sustainability. The discussed programs are intended to: reduce emergency department visits; prevent falls among senior citizens; and provide health education and outreach to isolated senior citizens in a Southern California (U.S.) community.
Beyond the Bench and Bedside: Health Literacy Is Fundamental to Sustainable Health and Development
June, 2020 (PubMed)
Thirty years after the Ottawa Charter for Health Promotion, the 2030 Agenda for Sustainable Development – predicated on seventeen Sustainable Development Goals (SDGs) – were unveiled to the global community. Health literacy is an essential precondition and indicator of achieving the SDGs. Efforts to define and describe health literacy within public health and medicine have identified that the skills and abilities of many populations are inadequate to navigate the demands and complexity of health and healthcare. The authors suggest health literacy must move beyond the bench and bedside in clinical practice to achieve the aspirations and objectives of the SDGs. This report synthesizes major developments in health literacy and draws from related disciplines to propose opportunities and future directions to improve health literacy across the lifespan.
Access Beyond the Bench and Bedside: Health Literacy Is Fundamental to Sustainable Health and Development
Integrated Measures of Health Literacy, Language Access, and Cultural Competency Would Improve Health Care Quality and Value
June, 2020 (PubMed)
Improving health care quality and value requires increased attention to patient and family-centeredness as well as care equity. Although health literacy, language access, and cultural competency have been perceived as separate constructs. each represents a dimension of patient and family-centeredness and care equity. Developing and using integrated measures of health literacy, language access, and cultural competency could provide a viable strategy to improve patient and family-centeredness and equity in health care. While there are challenges to the development and use of integrated measures, some responsive strategies include: using more patient, family and caregiver-reported information; utilizing patient demographic data from electronic health records; and incorporating the latter elements within measures of patient experience. Integrated quality measures also create opportunities for collaborative and interdisciplinary research, and for health care delivery innovation.
Health Literacy and Outcomes of a Community-Based Self-Help Intervention: A Case of Korean Americans With Type 2 Diabetes
May/June, 2020 (PubMed)
Higher literacy levels “can increase peoples’ ability to take action to manage their healthcare,” said Earnestine Willis, MD, MPH, a member of the Roundtable on Health literacy and a retired professor of pediatrics at the Medical College of Wisconsin in Milwaukee. Strategies to increase health literacy “can help promote trust between communities and providers,” she said.
Lack of Health Literacy a Barrier to Grasping COVID-19
June 10, 2020 (MedPage Today)
Higher literacy levels “can increase peoples’ ability to take action to manage their healthcare,” said Earnestine Willis, MD, MPH, a member of the Roundtable on Health literacy and a retired professor of pediatrics at the Medical College of Wisconsin in Milwaukee. Strategies to increase health literacy “can help promote trust between communities and providers,” she said.
Access Lack of Health Literacy a Barrier to Grasping COVID-19
SDOH Affect Patient Health Literacy, Knowledge About COVID-19
June 25, 2020 (PatientEngagementHIT)
Patient health literacy and knowledge about the COVID-19 pandemic falls along sociodemographic lines, further evidence of the fact that the social determinants of health (SDOH) dictate an individual’s ability to be and stay healthy, according to new research from the Harvard Kennedy School.
More specifically, individual knowledge about COVID-19 and health behaviors were dependent upon individual race, sex, and age.
Black people, males, and individuals younger than age 55 were less likely to know how the novel coronavirus spreads and the key symptoms of the disease.
Additionally, individuals in those populations were less likely to engage in key healthy behaviors known to prevent COVID-19 spread, including regular handwashing and adherence to stay-at-home or better-at-home orders, the researchers found.
Access SDOH Affect Patient Health Literacy, Knowledge About COVID-19
COVID-19 Misinformation Turns Attention to Public Health Messaging
June 9, 2020 (PatientEngagementHIT)
CDC data showed that misinformation about disinfectants and COVID-19 spread to nearly one-third of adults. This outlines a need to target public health messaging.
Access COVID-19 Misinformation Turns Attention to Public Health Messaging
Health Literacy and Outcomes Among Patients With Heart Failure
June, 2020 (JACC)
The purpose of this study was to determine if health literacy is associated with mortality, hospitalizations, or emergency department (ED) visits among patients living with heart failure (HF). Growing evidence suggests an association between health literacy and health-related outcomes in patients with HF.
Access Health Literacy and Outcomes Among Patients With Heart Failure.
Lack of Health Literacy Linked to Poor Outcomes Among Patients With Heart Failure
May 28, 2020 (AJMC)
Heart failure is a complicated disease to manage, requiring coordination of several outcomes-related measurements: weight, blood pressure, glycemic index, and medication and diet adherence, as well as exercise and weight loss on occasion. Does patient knowledge of these measures—their health literacy—affect their health outcomes, and if so, to what extent?
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Heart failure patients with limited health literacy may have higher risk of death
May 25, 2020 (AAAS)
Patients with heart failure who experience low health literacy are at an increased risk of hospitalization and mortality. This finding has significant clinical and public health implications and suggests that assessing and intervening upon an individual’s understanding of their own health could improve heart failure outcomes, according to research published in JACC: Heart Failure.
Access Heart failure patients with limited health literacy may have higher risk of death
Systematic Review of Health Literacy in Childhood Cancer Patients, Survivors, and Their Caregivers
May, 2020 (PubMed)
This systematic review examined the literature regarding health literacy among pediatric cancer patients, survivors, and their caregivers. Specific aims were to identify and summarize measures used, levels of and demographic correlates of health literacy, effects of health literacy interventions, and associations between health literacy and health outcomes.
Very few studies assessed health literacy in pediatric oncology. As treatment for childhood cancer becomes increasingly complex, and patients and caregivers are expected to have adequate understanding of health information, health literacy is a critical construct that should not be overlooked.
Access Systematic Review of Health Literacy in Childhood Cancer Patients, Survivors, and Their Caregivers
Public Health Communication in Time of Crisis: Readability of On-Line COVID-19 Information
May, 2020 (PubMed)
The purpose of this study was to assess the readability of information on the Internet posted about coronavirus disease 2019 (COVID-19) to determine how closely these materials are written to the recommended reading levels. The mean readability scores ranged between grade levels 6.2 and 17.8 (graduate school level). Four of the 5 measures (GFI, CLI, SMOG, FRE) found that readability exceeded the 10th grade reading level indicating that the text of these websites would be difficult for the average American to read.
Messages about COVID-19 must be readable at an “easy” level, and must contain clear guidelines for behavior. The degree to which individuals seek information in response to risk messages is positively related to the expectation that the information will resolve uncertainty. However, if the information is too complex to interpret and it fails to lead to disambiguation, this can contribute to feelings of panic.
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The impact of health literacy environment on patient stress: a systematic review
May 24, 2020 (PubMed)
The aim of this study was to assess the strength of the evidence on the relationship between health situations and patient stress, considered in the context of health professional perception, and determine what health situations act to influence patient stress. A systematic review of English articles using PubMed, PsycINFO, CINAHL and Embase databases was conducted. Overall, the findings of what patients find most stressful in Intensive Care Units can guide health care professionals practicing best practice care. However, the evidence on how patient stress is influenced by non-Intensive Care Unit health care settings is weak. Further research is needed to enhance current understanding of the interaction between patient stress and health care environments in both hospital and primary care settings.
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The Association of Health Literacy Domains With Hospitalizations and Mortality
May 13, 2020 (AJMC)
A total of 470 community-dwelling veterans underwent evaluations of health literacy, numeracy, and graph literacy with validated instruments in 2012 and were followed until 2018. At the end of follow-up, the associations with all-cause hospitalizations and mortality were determined with the Andersen-Gill model and Cox regression multivariate analysis, respectively.
There were no associations of health literacy, numeracy, or graph literacy with all-cause hospitalization or mortality after multivariate adjustment. In subgroup analysis, subjective numeracy was associated with hospitalizations in African Americans. Higher objective and subjective numeracy were associated with future hospitalizations only for those with a history of hospitalization. Higher graph literacy was associated with lower mortality in those with a history of hospitalization.
Access The Association of Health Literacy Domains With Hospitalizations and Mortality
Development and validation of a short and easy-to-use instrument for measuring health literacy: the Health Literacy Instrument for Adults (HELIA)
May 12, 2020 (PubMed)
Health literacy is the ability to access to, understand, evaluate and use of essential health information to make basic health decisions. This study aimed to develop and psychometrically evaluate an instrument for measuring health literacy among adults (the Health Literacy Instrument for Adults – HELIA).
When you break down barriers to care, you build trust
May 11, 2020 (Nurse.com)
Barriers to care can have a huge impact on patients’ trust in their healthcare teams and on their recovery.
But nurses help eliminate barriers to care by, for instance, assisting a patient who speaks a different language or helping patients gain a better understanding of their treatment plan.
In doing so, nurses are preventing re-hospitalizations and improving health outcomes.
So, what does it take to break down barriers to care?
Access When you break down barriers to care, you build trust.
Associations of eHealth Literacy with Obtaining Knowledge about Colorectal Cancer among Internet Users Accessing a Reputable Cancer Website: Internet-Based Survey Study
May 9, 2020 (PubMed)
Examining the associations of eHealth literacy (eHL) with obtaining health knowledge from websites would help to clarify the causal pathway between eHL and health knowledge. This study aimed to compare the results obtained from Internet users with high or low eHL in accessing a reputable cancer website to obtain colorectal cancer (CRC) knowledge. A total of 105 participants with high eHL and 103 participants with low eHL accessed a reputable CRC website managed by the National Cancer Center and responded to Internet-based surveys before and after accessing a website in 2012. Low eHL Internet users appeared less capable of obtaining knowledge of CRC by accessing information from a reputable cancer website than high eHL Internet users.
We Have A Health Literacy Problem, And It’s Time To Face It Head-On
May 6, 2020 (Forbes)
Nearly half of all Europeans have a “problematic” or worse level of health literacy. Only 12% of people in the U.S. have “proficient” health literacy, and 59% of adult Australians suffer from inadequate knowledge around their health.
Based on the populations of these three regions alone, a large swath of people are unable to make good decisions around their health. They don’t seek care when they need it, and they can’t live healthy lifestyles. Some will be susceptible to misinformation and fraud.
It’s long been a problem desperately in need of addressing. But the outbreak of COVID-19 has exposed what health illiteracy looks like at its worst.
Access We Have A Health Literacy Problem, And It’s Time To Face It Head-On.
A systematic literature review of existing conceptualisation and measurement of mental health literacy in adolescent research: current challenges and inconsistencies
May 1, 2020 (PubMed)
With an increased political interest in school-based mental health education, the dominant understanding and measurement of mental health literacy (MHL) in adolescent research should be critically appraised. This systematic literature review aimed to investigate the conceptualisation and measurement of MHL in adolescent research and the extent of methodological homogeneity in the field for meta-analyses. MHL research with adolescent samples is increasing. Results suggest that a better understanding of what MHL means for this population is needed in order to develop reliable, valid and feasible adolescent measures, and explore mechanisms for change in improving adolescent mental health.
Accuracy of the Spinal Pain Diagram Is Influenced by Patient Health Literacy in Completion of the Scoliosis Research Society30 Questionnaire
Spring, 2020 (PubMed)
The purpose of this research study was to investigate the health literacy demands of the Scoliosis Research Society Questionnaire (SRS30) and to determine if health literacy best practices mitigate errors for patients with low health literacy. Readability assessment, focus groups and structured interviews were used. Results indicated that patients with low health literacy perceived health literacy best practices as helpful in completing the SRS30 drawing. Additionally, patients with inadequate health literacy had a higher proportion of errors in pain location on the drawing (p = 0.0325) compared to patients with adequate health literacy. (Journal of Surgical Orthopaedic Advances 29(1):3942, 2020).
Health Literacy Environment of Breast and Cervical Cancer among Black African Women Globally: A Systematic Review Protocol of Mixed Methods
May 1, 2020 (PubMed)
Evidence exists indicating a low level of general health literacy among Black African women, especially those with a refugee background. The level of health literacy specific to breast and cervical cancer among Black African women, especially those with a refugee background, has not been reviewed systematically. The present study describes a protocol for a systematic review of the available evidence on the level of health literacy specific to breast and cervical cancer among Black African women globally. We will perform a systematic review of the available quantitative and qualitative studies. We will be guided by socioecological theory and Indigenous epistemology to synthesise the non-quantifiable information thematically, and pool the quantitative information using meta-analysis, based on the availability of information.
IHLA Statement to the WHO on health literacy as an essential life-saving strategy during the pandemic
May, 2020 (International Health Literacy Association)
Throughout the course of the COVID-19 pandemic, health literacy has manifested itself as an essentiallife-saving determinant of health and of healthy behavior. COVID-19has given rise to the COVID-19 infodemic spreading dangerousmisinformation. Inaccurate information underminesthe efforts of governments, WHO,and public health authorities to contain the spread of COVID-19. Citizens and governmentsand other official agenciesare dependent on health literacy to make the best use of availableinformation. The epidemiological curve flattenswhen people can find, understand, judge and useevidence-based information regarding the risk of contractingthe virus and of effective prevention, such as handwashing, social distancing, and wearing masks.
Are college students health literate?
April, 2020 (PubMed)
Most college students displayed adequate health literacy (99.2%). The ANOVA analyses revealed college classification was the most significant predictor, followed by ethnicity, sex, and primary language. Age was significantly related to health literacy, when holding college classification constant. Interestingly, college major, healthcare work experience, or having health care credentials were not predictors of health literacy. Conclusion: This group of college students had adequate health literacy skills. However, the results of this study revealed demographic disparities that suggest further study.
Access Are college students health literate?
Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study
April, 2020 (PubMed)
The effects of patient sustained self-care behaviors on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence self-care behaviors. To date, these factors have not been placed in a single model to clarify the critical path affecting self-care behaviors. The aims of this study were to explore the relationships of these factors and the differences in patient preference for medical decision-making. Significant direct pathways were identified from health literacy to self-efficacy, patient empowerment, and self-care behaviors; from self-efficacy to self-care behaviors; and from patient empowerment to self-care behaviors. Indirect pathways were from health literacy to self-care behaviors via self-efficacy or patient empowerment. The pathway from health literacy to self-efficacy was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making.
Development of a communication and health literacy curriculum: Optimizing the informal cancer caregiver role
April, 2020 (PubMed)
The aim of this study was to develop learning objectives and identify content for a core communication and health literacy curriculum designed to optimize the role of informal cancer caregivers (family or friends). This theoretically grounded study systematically identified seven curriculum topic areas and content unique to caregivers and included input from key stakeholders. The next step is to develop the program for dissemination and to test its impact on caregiver and patient outcomes.
A Path Analysis of Patient and Social-Level Factors on Health Literacy and Retention in Care Among African Americans Living with HIV
April, 2020 (PubMed)
Low health literacy and poor retention in care may contribute to HIV health disparities among African Americans, but causal pathways have not been examined. We utilized an adapted health literacy model to examine the role of health literacy on racial disparities in retention in care. Retention in care for 699 participants was assessed 24-months post survey and operationalized as 100% visit adherence versus less than 100% visit adherence. Most participants were African American (60%) and virally suppressed (93%). Results from a path analysis revealed that non-African American race was related to greater health literacy (p = .023) and to 100% visit adherence (p = .024). Greater health literacy was associated with 100% visit adherence (p = .008), which was in turn related to viral suppression (p < .001). Findings indicate that health literacy partially mediates the relationship between race and retention in care and are among the first to suggest these causal pathways.
Real-World Responses in Real Time : COVID-19 Information Needs to Consider Literacy Gaps
April 30, 2020 (Inside IES Research)
During the COVID-19 pandemic, when people have a heightened need for information, literacy barriers can be life threatening. In the United States, roughly 20 percent of adults read at the lowest level, with another 33 percent still below proficiency. Thus, many may be struggling to understand written guidance on COVID-19.
IES researchers at the Center for the Study of Adult Literacy (R305C120001 and R305H180061) and their associated Adult Literacy Research Center at Georgia State University are working to address the needs of adults with literacy skill gaps. Dr. Meredith Larson spoke to Dr. Daphne Greenberg and Dr. Iris Feinberg about their work in this area.
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Medication self-management support for people with diabetes and low health literacy: A needs assessment
April, 2020 (PubMed)
An adequate level of health literacy is regarded as a prerequisite for adequate medication self-management. Low health literacy skills are relatively more common in people with Diabetes Mellitus type 2. The aim of this study was to explore the needs regarding medication self-management of people with type 2 diabetes and low (functional, communicative and critical) health literacy, and their preferences for medication self-management support.
Testing the Preliminary Validity of a Multidimensional Framework for Studying the Effects of Cancer Health Literacy on Cancer Screening Behaviors among Diverse Populations
April 25, 2020 (PubMed)
The objective of this study was to evaluate the applicability of a multidimensional framework to explore factors associated with cancer literacy and its effects on receiving cancer screenings among diverse populations. Based on the conceptual framework, we developed and pilot-tested the Multidimensional Cancer Literacy Questionnaire (MCLQ) among 1500 individuals (African Americans, Latinos and Whites) in Louisiana. A multidimensional framework to study cancer literacy, including cultural attitudes, beliefs and practices, as well as facilitators and barriers, among diverse populations, will increase understanding of factors influencing individuals’ approach to cancer prevention and screening. Results will inform further testing of the multidimensional framework and questionnaire.
Development and Psychometric Properties of a Questionnaire Assessing Self-Reported Generic Health Literacy in Adolescence
April 21, 2020 (PubMed<)
Promoting health literacy in early stages of life could contribute to reducing health inequalities. However, it is difficult to identify concrete needs for action as there are few age-adjusted measures to assess generic health literacy in young people. Our aim was to develop a multidimensional measure of health literacy in German to assess generic health literacy among 14- to 17-year-old adolescents, namely, the “Measurement of Health Literacy Among Adolescents Questionnaire” (MOHLAA-Q). The internal consistency coefficients (Cronbach’s ?) of the scales varied from 0.54 to 0.77. The development of the MOHLAA-Q constitutes a significant step towards the comprehensive measurement of adolescents’ health literacy. However, further research is necessary to re-examine its structural validity and to improve the internal consistency of two scales.
Fostering Health Literacy Responsiveness in a Remote Primary Health Care Setting: A Pilot Study
April 16, 2020 (PubMed)
Primary healthcare organisations have an important role in addressing health literacy as this is a barrier to accessing and utilising health care. Until recently, no organisational development tool operationalising health literacy in an Australian context existed. This research evaluated the efficacy of the Organisational Health Literacy Responsiveness (Org-HLR) tool and associated assessment process in a primary healthcare organisation in the Pilbara region of Western Australia. External barriers to improving their internal organisational health literacy responsiveness were identified, with participants acknowledging the management style and culture of open communication within the organisation as enablers of change. Participants identified actionable changes to improve their organisational health literacy responsiveness using the process of organisational assessment and change.
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Coronavirus (COVID-19) Resources
April, 2020 (Center for Health Literacy Solutions)
Sorting through the tons of Coronavirus (COVID-19) resources can be time-consuming. To help, we have put together a collection of resources that explain things in plain language and that help to break down this complex topic. We update the collection frequently so please keep checking back.
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COVID-19: health literacy is an underestimated problem
April 14, 2020 (The Lancet Public Health)
Rapid development of coronavirus disease 2019 (COVID-19) into a pandemic has called for people to acquire and apply health information, and adapt their behaviour at a fast pace. Health communication intended to educate people about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and how to avoid getting or spreading the infection has become widely available. Most valuable information is created in an easy-to-understand manner that offers simple and practical solutions, such as washing hands, maintaining physical distance, and where to find information about the latest recommendations, and advice. Unfortunately, there is also complex, contradictory, and false information. Similarly, individuals are considered able to acquire, understand, and use this information in a sound and ethical manner—ie, to be health literate.
Access COVID-19: health literacy is an underestimated problem.
Using the Health Literacy Questionnaire (HLQ) with Providers in the Early Intervention Setting: A Qualitative Validity Testing Study
April 10, 2020 (PubMed)
Early intervention (EI) programs are optimally placed to build the health literacy capacity of caregivers, which could improve health equity. The health literacy of interdisciplinary EI providers has not previously been measured. This study used the Health Literacy Questionnaire (HLQ) with EI providers (n = 10) to investigate evidence based on response (cognitive) processes. Three themes reflecting discordance were identified: (1) Differences between Australian and USA culture/health systems; (2) Healthcare provider perspective; and (3) Participants with no health problems to manage. Results show strong concordance between EI providers’ narrative responses and item intents. Study results contribute validity evidence for the use of HLQ data to inform interventions that build health literacy capacity of EI providers to then empower and build the health literacy of EI parents.
Coronavirus Center – Lifeology
April, 2020 (Lifeology)
Lifeology is a platform that brings together scientists, artists, writers and broader audiences in the creation of educational content including mobile-friendly Lifeology mini-courses that can reach anyone.
Groundbreaking science is increasingly collaborative and interdisciplinary. The same is true for science communication (or scicomm, as we like to call it). By working with artists and writers here at Lifeology.io, scientists can better communicate their work with relevance to society and people’s daily lives.
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Potentials of School Nursing for Strengthening the Health Literacy of Children, Parents and Teachers
April 9, 2020 (PubMed)
Health literacy (HL) plays a key role in explaining health disparities. School nurses (SN) provide health related expertise within the school setting. A positive effect on the HL of children but also their teachers and parents has been suggested by some research, but gaps persist in the available information. Improvements were significant for children and parents but not for the teachers. Despite the relatively short intervention period and a relatively non-specific spectrum of interventions, there is some evidence that SN may contribute to strengthening HL within the school setting. The longer-term effects of SN on health literacy and child health should be further examined. For this, a clearer conceptualization of the scope of work of the SN in Germany including their educational interventions is imperative.
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AI Steps Up to Fight COVID-19 with New Digital Human Health Advisor
April 7, 2020 (Directions Magazine)
United States and New Zealand based digital human company UneeQ, has launched a free COVID-19 health advisor designed to educate and help prevent the spread of misinformation, particularly among those with limited healthcare and medical literacy. According to the Center for Health Care Strategies, roughly 90 million Americans have low health literacy, including the elderly population that is most vulnerable to the COVID-19 outbreak.
Access AI Steps Up to Fight COVID-19 with New Digital Human Health Advisor.
How Much Do Words Matter When We Talk to Our Patients?
April 3, 2020 (Haymarket Media, Inc.)
As a physician assistant (PA) who has been practicing for more than 20 years, a big part of my focus has been on health literacy, a subject that is completely different from literacy: Literacy is the ability to read and understand written/spoken language, whereas health literacy is the ability to understand what providers are talking about. Even with my strong commitment to making my communication meaningful and relevant to my patients, no matter their level of education, I often fail.
Access How Much Do Words Matter When We Talk to Our Patients?.
Patient Advocate Foundation Deploys a Range of Safety Net Services to Assist Patients and Families Impacted By COVID-19
April 1, 2020 (Patient Advocate Foundation)
Hampton, VA, April 01, 2020 (GLOBE NEWSWIRE) — Patient Advocate Foundation (PAF), a national nonprofit organization that provides case management services, education, and financial aid to patients with chronic, debilitating and life-threatening diseases, is poised to deliver committed, expert, and expeditious help to patients and families who are facing health and financial impacts as a result of the novel Coronavirus (COVID-19). As a leader in the delivery of one-on-one interventions to our nation’s most vulnerable patient populations, PAF is honored to join the fight against COVID-19, urgently applying our skills and resources to the service of those impacted by this pandemic.
COVID-19: where to find quality information
April, 2020 (IUHPE)
The dissemination of quality, timely and understandable information is key in slowing down transmission and avoiding overburdening the healthcare system. We have been supporting dissemination of evidence-based messaging on COVID-19 by trusted sources… To further IUHPE contribution to this collective effort, we are compiling a list of resources from key sources, IUHPE institutional members, Global Working Groups and Networks, academic publishers as well as collections of resources. We will be updating this page as new resources are created, or we learn about them.
Access COVID-19: where to find quality information.
Living with a Chronic, Life-Threatening or Disabling Disease OR Diagnosed with COVID During the Coronavirus Pandemic
April, 2020 (Patient Advocate Foundation)
As the coronavirus spreads across the country, PAF wants to make sure you have answers and resources to support you during this uncertain and stressful time. If you are experiencing challenges accessing care or have affordability concerns we are here to help.
Health Literacy and the Desire to Manage One’s Own Health
March, 2020 (PubMed)
With the ever-increasing market share of direct-to-consumer (DTC) testing, projected to surpass $350 million this year, health care professionals must address the health literacy gap that exists between what the clinician knows and what the general public understands about clinical laboratory testing. Health literacy is lowest among people with lower socioeconomic status and results in poorer outcomes. However, these individuals represent those that would benefit most from valuable DTC testing. There is a need for unbiased and universally accessible tools to help improve consumers’ understanding of test utility, limitations to the accuracy of results, and result interpretation.
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Adherence to Antiepileptic Drugs and the Health Literacy of Caregivers in Childhood Epilepsy
March, 2020 (PubMed)
Objective: To investigate the relationship between caregivers’ health literacy and adherence to treatment in children with epilepsy.
Conclusion: Age and caregivers’ health literacy knowledge were found to be significantly associated with adherence. To better define the factors associated with drug adherence in children with epilepsy, additional research (using objective, validated tools) aimed at determining caregivers’ health literacy is needed.
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Health literacy level and influencing factors in university students
March, 2020 (PubMed)
Health literacy (HL) competencies vary across different health domains, and so the youth HL level plays an important role in access to healthcare. The aim of this study was to determine HL levels, the factors that affect it and health-promoting lifestyle behaviours of university students. Logistic regression showed that gender and health education were significantly associated with the HL level. We recommend increasing awareness regarding health liability and integrating HL notions into the higher education curriculum.
Access Health literacy level and influencing factors in university students
Identifying Core Variables Associated With Health Literacy in Kidney Transplant Recipients
March, 2020 (PubMed)
A kidney transplantation requires complex self-care skills and adequate follow-up from health-care providers. Identifying strengths and limitations in different aspects of health literacy (HL) and associated variables are central to being able to improve health care. The objective of this study was to identify core variables associated with independent domains of HL 8 weeks following a kidney transplantation. The HLQ provides a more complex picture of strengths and limitations related to HL, as well as important knowledge about vulnerable groups following a kidney transplantation. The study offers an important supplement to the field of HL in kidney transplant care.
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COVID-19 Fact Sheets – Available in 34 Languages
March, 2020 (Harvard Health Publishing)
The COVID-19 Health Literacy Project has created and translated accessible COVID-19 information into different languages to help all patients know when, and how, to seek care. The materials are created in collaboration with Harvard Health Publishing. Find the language you need at COVID-19 Fact Sheets – Available in 34 Languages.
The Agreement between Patients’ and Healthcare Professionals’ Assessment of Patients’ Health Literacy-A Systematic Review
March 31, 2020 (PubMed)
Healthcare professionals (HCPs) can play a key role in promoting health literacy (HL) in patients to help them navigate the healthcare system effectively. HCPs should assess patients’ health literacy needs and check the patient´s understanding to communicate adequate health information. This review investigates the agreement between the patients’ and HCPs assessment of patients’ HL. The results demonstrated that HCPs had difficulty determining patients’ HL adequately. Differences between the HL estimation of HCPs and the actual HL skills of patients might lead to communication problems.
Coronavirus/COVID-19 – Frequently Asked Questions (Printable Resource)
March, 2020 (Centers for Disease Control and Prevention)
The CDC recently published this easy-to-read printable FAQ flyer on COVID-19. You can find more print resources by the CDC on the Coronavirus Coronavirus/COVID-19 – Frequently Asked Questions (Printable Resource).
For up-to-date information about COVID-19, visit https://coronavirus.gov
Relationship between Determinants of Health, Equity, and Dimensions of Health Literacy in Patients with Cardiovascular Disease
March 20, 2020 (PubMed)
Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity. Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease.
COVID-19: A Guide to Good Practice on Keeping People Well Informed
March 19, 2020 (SA People News)
The coronavirus disease (COVID-19) is spreading across the world. For those who catch it, the vast majority will experience mild symptoms, but for a few, it can cause severe disease and death. Some groups – like older people and those with pre-existing health conditions – are more vulnerable when exposed than others.
Access COVID-19: A Guide to Good Practice on Keeping People Well Informed.
The effects of health literacy in influenza vaccination competencies among community-dwelling older adults in Hong Kong
March 14, 2020 (PubMed)
Poor health literacy was found to be one of the key barriers in older adults’ disease prevention practice. However, it has still been unclear how different processes in health literacy play a role in older adult’s vaccination-related competencies. By adopting the European Health Literacy Survey (HLS-EU), the current study aimed to examine older adults’ competences in accessing, understanding, evaluating and applying health information, as well as how they are related to perceived difficulties in vaccination-related practices. The findings showed that the health literacy of Hong Kong older adults has been limited, particularly in information appraisal. Poorer competences in accessing and appraising health information were associated with greater difficulties in making vaccination decision.
Individual and Organizational Health Literacy: A Key to the Future of Health
March 17, 2020 (National Library of Medicine)
As the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 prepares its new statement for Healthy People 2030, NLM has been asked to review and comment on the definition of health literacy. This request has provided a good opportunity for me to consider how NLM facilitates health literacy — but more about that in a minute.
Access Individual and Organizational Health Literacy: A Key to the Future of Health.
The Mediating Role of the Patient Health Engagement Model on the Relationship Between Patient Perceived Autonomy Supportive Healthcare Climate and Health Literacy Skills
March 7, 2020 (PubMed)
Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL; hence, the improvement of HL is a key outcome in modern healthcare systems. Our main hypothesis is that the well-known relationship between patients’ perceived autonomy supportive healthcare climate and HL skills is mediated by the Patient Health Engagement Model (PHE-model). The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking an autonomy-supportive healthcare climate to PHE-model and HL. Results show that the theoretical model has a good fit indexes and that PHE-model fully mediates the relationship between autonomy-supportive healthcare climate and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.
Health Literacy as Communicative Action-A Qualitative Study among Persons at Risk in the Context of Predictive and Preventive Medicine
March 5, 2020 (PubMed)
Predictive and preventive medicine play an increasingly important role in public debates on health, providing cutting-edge technologies with the potential to measure and predict individual risks of getting ill. This leads to an ever-expanding definitional space between being “healthy” and being “ill”, challenging the individual’s everyday life, attitudes and perceptions towards the self and the process of health-related decision-making. “How do the condition of ‘being at risk’ and individual health literacy interrelate?” is the leading question of the current contribution. Drawing on empirical qualitative data, collected by means of narrative interviews with persons at risk in four clinical fields, a bottom-up ethnographic and health sciences perspective on health literacy (with an emphasis on critical health literacy) is employed. The findings will be embedded within theoretical approaches dealing with power relations and communication in healthcare encounters, particularly Habermas’ theory of communicative action. The core outcome of our study is a concept for an overarching model of health literacy in the context of health-related risk prediction across indications, based on empirical insights gained through interpretative analysis of the four clinical domains.
Health Literacy: From a Property of Individuals to One of Communities
March 2, 2020 (PubMed)
Health literacy (HL) is increasingly hailed as a strategy to improve the control individuals have over their health. A central critic of HL intervention is its overemphasis on individual level factors, something recognised in the 2008 report of the Commission of Social Determinants of Health (SDoH) that recommended expanding the scope of HL to cover the SDoH. The objective of our study was to assess the extent to which recent progress on HL captures the need for collective action on the SDoH. We found no instance of HL intervention regarding communities as complex systems of actors sharing a common space and dynamic. We conclude by suggesting a new definition of HL and by drawing attention to the research gap in addressing the upstream SDoH through HL actions.
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COVID-19 Graphic Medicine
March, 2020 (Center for Disease Control and Prevention)
Using comics, or infographics, is an effective way to convey health information to the public in a way that is engaging and simple. The Center for Disease Control and Prevention (CDC) recently published 10 comics about COVID-19. Most are available in multiple languages and cover topics like basic COVID facts, proper handwashing, and what to do if you’re sick.
Access the free print resources.
Self-reported Health Literacy Among North Carolina Adults and Associations With Health Status and Chronic Health Conditions
Mar-Apr 2020 (PubMed)
Low health literacy is a recognized contributor to health disparities. Significant proportions of the adult population, especially the underserved, have low health literacy. The purpose of this study was to examine health literacy and its associations with health status and chronic health conditions among North Carolina adults
Organized dentistry supports oral health literacy
March 4, 2020 (American Dental Association)
In a Feb. 26 letter to Reps. Tony Ca?rdenas, D-Calif., and Gus Bilirakis, R-Fla., the coalition — led by the Academy of General Dentistry — thanked the lawmakers for introducing HR 4678, the Oral Health Literacy and Awareness Act. The bill authorizes the Health Resources and Services Administration to develop a 5-year evidence-based oral health literacy campaign across the agency’s relevant programs.
Access Organized dentistry supports oral health literacy.
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans
February, 2020 (PubMed)
Individuals with limited health literacy often experience suboptimal health outcomes. This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older Black Americans. Approximately 52% of participants had limited health literacy, the REALM-R score was 5.4 (SD = 2.7). Univariable correlates of limited health literacy were gender, employment, income, prior screening, cancer fatalism, CRC awareness, and PHM constructs (religious beliefs, salience/coherence, perceived susceptibility). Limited health literacy was associated with multiple complex factors. Interventions should incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial
February, 2020 (PubMed)
This randomized controlled trial was conducted in 2018 with 118 elderly people with uncontrolled primary hypertension and inadequate health literacy. Self-management education was developed on the basis of the health literacy index. Medication adherence and blood pressure were assessed using 8-items Morisky Medication Adherence Scale and a mercury sphygmomanometer, respectively.
Self-management education tailored to health literacy significantly promotes medication adherence but has no significant effects on control of blood pressure.
The Association Between Cancer Care Coordination and Quality of Life Is Stronger for Breast Cancer Patients With Lower Health Literacy: A Greater Plains Collaborative Study
February, 2020 (National Center for Biotechnology Information)
Health literacy (HL) and cancer care coordination (CCC) were examined for their relationship to quality of life (QOL) among breast cancer survivors. CCC was hypothesized to have a stronger relationship to QOL for women with lower HL.. The association between CCC and later QOL is strongest for people who have lower HL. Prioritizing care coordination for patients with lower health literacy may be an effective strategy in a setting of limited resources.
Improving Organizational Health Literacy Responsiveness in Cardiac Rehabilitation Using a Co-Design Methodology: Results from The Heart Skills Study
February, 2020 (PubMed)
For health services, improving organizational health literacy responsiveness is a promising approach to enhance health and counter health inequity. A number of frameworks and tools are available to help organizations boost their health literacy responsiveness.
Within a municipal cardiac rehabilitation (CR) setting, the Heart Skills Study aimed to: (1) Develop and test an organizational health literacy intervention using an extended version of the Ophelia approach, and (2) evaluate the organizational impact of the application of the Ophelia approach. The findings can be used to inform the development and evaluation of sustainable co-designed health literacy initiatives in other settings.
Making a Case for “Education for Health Literacy”: An International Perspective
February 24, 2020 (PubMed)
This Perspective Article describes the importance and utility of the education for health literacy perspective, which, follows a view that health literacy is a key outcome of health education from which improved population health, health promotion and disease prevention could be achieved across diverse contexts. We first describe different educational paradigms to address health literacy and clarify the education for health literacy perspective as a supportive, instructional and capacity-building global resource across the life-course. Then, using specific examples from Canada, America, and Germany, we provide a snapshot of the diverse ways in which the education for health literacy perspective can be found in national policies. We next consider the tensions and gaps that can arise in the translation and implementation of these policies relative to the ideal education for health literacy perspective, especially related to equity. Finally, we highlight strategic opportunities to achieve education for health literacy and equity especially offering examples from innovative practice in Canada across the lifespan.
Access Making a Case for “Education for Health Literacy”: An International Perspective
Health Literacy in Surgery
February 13, 2020 (PubMed)
Low health literacy is common among surgical patients. Important opportunities exist to better understand the role of health literacy in determining surgical outcomes and to develop more health literacy-sensitive models of surgical care. [HLRP: Health Literacy Research and Practice. 2020;4(1):e45-e65.] PLAIN LANGUAGE SUMMARY: Health literacy has not been well-studied in surgery but likely plays an important role. In this article, we reviewed all current research on health literacy in surgery to help us understand where we are at and where we need to go. We found that low health literacy is common and we need more ways to address it in surgery.
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Empirically Tested Health Literacy Frameworks
February 11, 2020 (Healio)
Health literacy is a significant determinant of health behaviors, but the pathways through which health literacy influences health behaviors are not completely clear nor consistent. The purpose of this systematic review is to critically appraise studies that have empirically tested the potential pathways linking health literacy to health behavior.
Access Empirically Tested Health Literacy Frameworks.
Study: Health literacy leads to better outcomes for baby and mom
February 8, 2020 (Augusta Chronicle)
Women who understand the health information they are provided and who give birth in a hospital, have better outcomes, new research shows.
Access Study: Health literacy leads to better outcomes for baby and mom.
Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?
February, 2020 (PubMed)
Health insurance access and health literacy are critical components of “enabling resources” to encourage uptake of services. We sought to test whether health literacy boosts health services utilization in the context of expanded access to health insurance stemming from the Affordable Care Act. We used individual-level data from 11 states included in the Behavioral Risk Factor Surveillance System 2016.
We found that improving health insurance access increased the likelihood of reporting a personal doctor while reducing the likelihood of reporting cost as a barrier to care. We also found an interaction effect between health insurance and health literacy on dental visits. However, there was no significant interaction effect between insurance access and health literacy for preventive services utilization. Conclusion. Health literacy did not explain why people fail to access preventive services even when they obtain access to insurance, with the sole possible exception of dental visits among individuals with high literacy.
A Scoping Review on How to Make Hospitals health Literate Healthcare Organizations
February 6, 2020 (PubMed)
The aim of this study is to identify and describe, through a scoping review approach, the characteristics and the interventions that make a hospital a health literate health care organisation (HLHO), in order to develop an integrated conceptual model. Of the 1532 titles and abstracts screened, 106 were included. Few studies have explored the effect of environmental support on health professionals, and few outcomes related to staff satisfaction/perception of helpfulness have been reported. The logical framework developed can be an effective tool to define and understand priorities and related consequences, thereby helping researchers and policymakers to have a wider vision and a more homogeneous approach to health literacy and its use and promotion in healthcare organizations.
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Health Literacy in Adult Oncology: An Integrative Review
January/February, 2020(PubMed)
Patients with cancer face high expectations for performing health literacy activities necessary for self-management and decision making, but only 12% of adults in the United States are proficient in health literacy. This review explores evidence regarding what is known about functional, interactive, and critical health literacy in adult oncology populations.
Implications for research: Additional research is needed to clarify the role of health literacy in cancer care to develop effective interventions that facilitate self-management and decision making.
Access Health Literacy in Adult Oncology: An Integrative Review
Effectiveness of Tailored Rehabilitation Education in Improving the Health Literacy and Health Status of Postoperative Patients With Breast Cancer: A Randomized Controlled Trial
January/February, 2020(PubMed)
The improvement of breast cancer treatment and the extension of survivorship have led to the development of postoperative complications among cancer survivors. Health literacy (HL), defined as patients’ capability of using health information to maintain their health status, can enable breast cancer patients to manage postoperative complications.
Our results showed that the TRE program produced significant improvements in HL and health status in the components of the International Classification of Functioning, Disability and Health. However, no significant difference was observed in the activity scores obtained using the Barthel Index between the 2 groups.
Our finding supports the effectiveness of 1-month TRE in improving HL and all components of the International Classification of Functioning, Disability and Health status, except the activity component among breast cancer in Taiwan.
Helping patients become health literate
January 29, 2020 (Medical Economics)
Due to the biology of aging, the potential presence of a life-limiting chronic illness and individuals who have completed a high school education or less, there is ample opportunity for widespread patient misunderstanding of their disease, their medication, how to self-manage their condition and how to appropriately access medical services.
Access Helping patients become health literate.
To see articles published prior to 2021, click on the “PubMed Search Results” widget below.
Health Literacy Articles prior to 2021
- Self-Regulation Strategies Among Community-Dwelling People Aging With Arthritis and Multimorbidity December 30, 2020Self-regulation strategies of selection, optimization, and compensation (SR-SOC) have been found to predict arthritis self-efficacy and quality of life among community-dwelling people aging with arthritis and multimorbidity. The current study aimed to describe the health resources and chronic disabling symptom characteristics of community-dwelling people aging with arthritis and multimorbidity and investigate how these characteristics influence […]Wenhui Zhang
- Persons with dementia as internet users: what are their needs? A qualitative study December 30, 2020CONCLUSIONS: Information should be adapted to the course of disease. Opportunities and positive aspects should also be mentioned. The presentation should be well-structured. Health professionals might support persons with dementia in searching and interpreting internet-based information.Angela Schnelli
- The relationship between general health behaviors and general health literacy levels in the Turkish population December 30, 2020The purpose of our study was to determine the health literacy level of the study participants and examine the relationship between health literacy levels and sociodemographic characteristics, health self-assessment levels and health protective behaviors. We recruited 826 individuals into the study, selecting the participants by using a systematic random sampling method. Data were collected with […]Ozcan Aygun
- Why you should Mini-Med School: Mini-Med School as an intervention to increase health literacy December 22, 2020BACKGROUND: Health literacy is an increasingly important topic in healthcare given that low health literacy is widely prevalent and linked to poorer health outcomes and higher healthcare costs. We sought to determine if a Mini-Med School delivered by medical students could prove to be an effective intervention to improve health literacy in the elderly.Sergiy Shatenko
- Literature review of medication administration problems in paediatrics by parent/caregiver and the role of health literacy December 11, 2020CONCLUSION: The findings suggest that in order to optimise medication use by parents, further work is needed to address the nature of these issues at home. Counselling, medication administration instructions and measurement tools are some of the areas in addition to the sociodemographic characteristics of parents and young people that need to be considered when […]Dania Talaat Dahmash
Health Literacy in the News
The following news items are listed in chronological order. Return to Journal Articles.
Impact of health literacy on shared decision making for prostate‐specific antigen screening in the United State
November 9, 2020 (American Cancer Society)
Current guidelines endorse shared decision making (SDM) for prostate‐specific antigen (PSA) screening. The relationship between a patient’s health literacy (HL) and SDM remains unclear. In the current study, the authors sought to identify the impact of HL on the rates of PSA screening and on the relationship between HL and SDM following the 2012 US Preventive Services Task Force recommendations against PSA screening.
Access Impact of health literacy on shared decision making for prostate‐specific antigen screening in the United State
Improving health literacy: Lessons from clinical ethics
November 6, 2020 (Baylor College of Medicine)
“If you were in my position, what would you do?”
I still remember the first time I witnessed a patient ask this question. I was working with a physician at a local primary care clinic. We had given the patient a new diagnosis of a heart condition, and followed the diagnosis with a series of options for medications, referrals, imaging, and further diagnostics.
For me, this experience was only the first of many to follow that highlighted the importance of promoting health literacy… More than 80 million people in the U.S. general population demonstrate low health literacy. To these individuals, new medical diagnoses and treatments represent new languages that must be learned – terminology, regimens, statistics, and specialists.
Access Improving health literacy: Lessons from clinical ethics
Research brief: Improving Health Literacy Could Prevent Nearly 1 Million Hospital Visits and Save of $25 Billion a Year
October 26, 2020 (Pew)
Findings from new UnitedHealth Group research illustrate the importance of increasing health literacy as a key component in driving better health outcomes and improving health care affordability. Seniors — who use more health care services, have more chronic conditions, and take more medications compared to other age groups — benefit from increased health literacy levels because it helps them make informed decisions and enhances their health care experience.
Access Health Literacy Key to Better Health Outcomes
ODPHP’s Health Literacy Custom List
October, 2020 (HealthyPeople2030)
Build a custom list of Healthy People 2030 objectives to use in your work. This custom list is publicly available to anyone with the link. If you add or remove an objective from the list, we’ll generate a new link.
Access ODPHP’s Health Literacy Custom List
How Health Literate Are You? Put your knowledge to the test with our latest quiz
October 14, 2020 (DHHS)
Scholars and fellows across Pew’s three biomedical research programs are working to tackle some of the biggest challenges in human health by bolstering scientific knowledge. They’re focusing on issues that affect all Americans—from infectious diseases and cancer to gut health and beyond. Take this quiz to test your health literacy skills and learn more about scientists’ promising research.
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Organizational Health Literacy More Essential than Ever for Preventing and Managing Chronic Disease
October 14, 2020 (DHHS)
When healthcare consumers are unable find, understand, and use information to inform decisions about their care, the consequences can be dire. Because many healthcare interactions are happening remotely due to the COVID-19 pandemic, there is even greater risk for avoidable adverse outcomes due to misunderstanding.
Access Organizational Health Literacy More Essential than Ever for Preventing and Managing Chronic Disease
2020 Federal Plain Language Report Card
October 13, 2020 (CenterForPlainLanguage)
A decade ago, Congress passed the Plain Writing Act to ensure that people can understand the information they receive from federal agencies. Since 2012, the Center for Plain Language has issued a yearly report card evaluating how well agencies follow this law.
This year we evaluated 20 Executive Branch agencies, including all 15 cabinet-level departments. Agencies earned grades between A and F for both organizational compliance, covering the staffing, training, and annual reporting required by law, and writing, focusing on how easy it is to find, understand, and use information the public needs. For this year’s writing grade, we looked at two online pages from each agency.
Access 2020 Federal Plain Language Report Card
Center for Health Literacy Celebrates Health Literacy Month
October 13, 2020 (CenterForHealthLiteracy)
The UAMS Center for Health Literacy celebrates health literacy month with the Plain Pledge. The #PlainPledge is a social media campaign designed to engage health care professionals and students to pledge to use words that are easy to understand the first time someone hears or reads them. To take the pledge all you have to do is write a health-related word that you pledged to stop using in a word buster and take a selfie with it, and then share it on social media. A toolkit is available on our website.
With nearly 1 billion health-related Google searches each day, it is safe to say that many people use the internet to find health information. Unfortunately, due to the amount of misinformation on the internet some people don’t have the information they need to make appropriate health decisions for themselves. This is of significant importance given the current public health crisis with nearly 7 in 10 adults saying that searched for COVID-related information at the beginning of the pandemic. To address this need, we have created a new campaign with tips on finding health information online. Follow us on Facebook, Twitter, LinkedIn, or Instagram to learn more and share with your staff and the people you serve.
Access Center for Health Literacy
Happy 10th Anniversary Plain Writing Act (Video)
October 12, 2020 (CenterForPlainLanguage)
The Plain Writing Act is turning 10 years old on October 13, 2020. The Act gave U.S. federal employees the legal oomph to turn the stereotype that government writing is overly complicated, stilted, and obtuse on its head. No longer was plain language just a good idea that could easily be tossed aside for lack of time or tacked on the end of a project as if it were synonymous with proofreading. Plain language was the law. Government now had the responsibility to ensure a reader could find, understand, and use the information it provided.
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Level of Health Literacy Among Patients With Thrombotic Thrombocytopenic Purpura
October 8, 2020 (HematologyAdvisor)
A team of investigators evaluated knowledge gaps among patients with thrombotic thrombocytopenic purpura (TTP) in remission and found a range of levels of understanding of the condition. Findings were published in Hemasphere, a journal powered by the European Hematology Association.
Access Level of Health Literacy Among Patients With Thrombotic Thrombocytopenic Purpura
Why Health – and Pancreatic Cancer – Literacy Matter
October 8, 2020 (PancreaticCancerActionNewtwork)
Patient navigators may be a valuable resource and are available at many hospitals and cancer centers across the country. These healthcare professionals can provide one-on-one guidance for patients as they face medical, legal or financial challenges, including helping you understand treatment options. Ask your healthcare team for patient navigators available to you.
Access Why Health – and Pancreatic Cancer – Literacy Matter
4 Main Barriers Diminishing Patient Activation Efforts
October 2, 2020 (PatientEngagement)
Driving meaningful patient-provider communication and addressing patient social determinants of health needs are key to patient activation. As the medical field pushes value-based care efforts, the concept of patient activation has become more critical. After all, it’s an activated patient who is able to fend off or manage illness in between clinic visits.
Access 4 Main Barriers Diminishing Patient Activation Efforts
October is National Health Literacy Month!
October, 2020 (Health Literacy Month 2020)
Health Literacy Month is a time for organizations and individuals to promote the importance of understandable health information. This annual, worldwide, awareness-raising event has been going strong ever since Helen Osborne founded it in 1999. Learn more about the importance of making health information easy to understand and making the health care system easier to navigate by going to Health Literacy Month 2020.
Answers to Coronavirus Questions
2020 (Georgia State University)
This online booklet provides answers to frequently asked Coronavirus questions in an easy-to-read format.
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CORONAVIRUS ADULT LITERACY RESOURCES
2020 (Georgia State University)
Here is a library of many high interest/low literacy Coronavirus materials. We have included materials up to a 9th-grade reading level.
The directory is categorized into easier to read materials and harder to read materials. We analyzed the materials using VisibleThread Readability software.
Access CORONAVIRUS ADULT LITERACY RESOURCES
History of Health Literacy Definitions
2020 (ODPHP)
In developing Healthy People 2030, the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 proposed expanding Healthy People’s view on health literacy.
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