Yoxas/statistical_literacy huggingface dataset:
Health literacy (HL) has been put forward as a potential mediator through which socioeconomic status (SES) affects health. This study explores whether HL mediates the relation between SES and a selection of health or health-related outcomes. Data from the participants of the Belgian health interview survey 2018 aged 18 years or older were individually linked with data from the Belgian compulsory health insurance (n = 8080). HL was assessed with the HLS-EU-Q6. Mediation analyses were performed with health behaviour (physical activity, diet, alcohol and tobacco consumption), health status (perceived health status, mental health status), use of medicine (purchase of antibiotics), and use of preventive care (preventive dental care, influenza vaccination, breast cancer screening) as dependent outcome variables, educational attainment and income as independent variables of interest, age and sex as potential confounders and HL as mediating variable. The study showed that unhealthy behaviours (except alcohol consumption), poorer health status, higher use of medicine and lower use of preventive care (except flu vaccination) were associated with low SES (i.e., low education and low income) and with insufficient HL. HL partially mediated the relationship between education and health behaviour, perceived health status and mental health status, accounting for 3.8-16.0% of the total effect. HL also constituted a pathway by which income influences health behaviour, perceived health status, mental health status and preventive dental care, with the mediation effects accounting for 2.1-10.8% of the total effect. Although the influence of HL in the pathway is limited, our findings suggest that strategies for improving various health-related outcomes among low SES groups should include initiatives to enhance HL in these population groups. Further research is needed to confirm our results and to better explore the mediating effects of HL.
Health literacy (HL) in children is essential for healthy decision-making from early on. At six Austrian elementary schools, all children (aged 6-11 years) received 3 years of health education (HE). The participating schools were equipped with teaching materials to convey lessons in a child-oriented way. The teachers were professionally accompanied during the implementation process and received specific training. HL and its subprocesses (obtain, understand, comprehend and apply) in children >8 years were measured with a standardized test (QUIGK-K) after 1, 2 and 3 years of education and compared with values from two comparison schools without such lessons. t-Tests showed a significant increase in HL at the end of the second year of HE. After this period, the children showed above-average values on all subprocesses of HL and performed better than children without HE. The third year did not lead to a further increase. Hence, child-oriented HE is suitable to promote HL in elementary school students within 2 years. It is therefore recommended to start HE as early as possible in order to lay the foundation for a long and healthy life.
Health literacy (HL) in patients with type 2 diabetes mellitus (DM) can help control disease and prevent complications. However, most patients with type 2 DM have inadequate HL; therefore, their HL must be further improved. This study aimed to determine the effects of online infographics on improving HL among patients with type 2 DM. This randomized controlled trial was conducted from July 2022 to September 2022, at the primary care unit of Songklanagarind Hospital, Thailand; 30 patients with type 2 DM were randomly assigned to the experimental (n = 15; three types of infographics) and control (n = 15; three types of pamphlets) groups. Infographics and pamphlets were distributed weekly via social media platforms. The S-TOFHLA Thai version and Thai-FCCHL were used to evaluate HL. Chi-square, Fisher's exact, Wilcoxon rank-sum, t-test, paired t-test, and McNemar's chi-square tests were used. The median age of 30 participants was 56 years. The mean duration of DM was 9.6 years, with a median HbA1c level of 7.5 mg%. Most participants (80%) had adequate HL in S-TOFHLA, whereas 63.3% had adequate HL in FCCHL. All participants in the infographic group who had inadequate HL in the S-TOFHLA pre-test achieved adequate HL. Meanwhile, only 50% of patients in the pamphlet group achieved adequate HL. Regarding FCCHL, 50% of patients in the infographic group and 60% in the pamphlet group who had inadequate HL in the pretest achieved adequate HL. However, no statistical significance in achieving adequate HL was found in either group. The mean differences (SD) in S-TOFHLA between before and after intervention were 12.53 (8.77; p = 0.0007) and 10.13 (9.88; p = 0.001) in the infographic and pamphlet groups, respectively. Regarding FCCHL, the mean differences (SD) were 3.47 (4.29) and 3.20 (2.91) in the infographic group (p = 0.003) and pamphlet (p = 0.002) groups, respectively. No statistical significance in the mean difference was found between both groups. Novel online infographics and pamphlets did not significantly differ in achieving adequate HL among patients with type 2 DM who should receive health education about disease control and complication prevention. However, both interventions can increase and maintain HL levels. Online educational media can be appropriate during the COVID-19 pandemic. Nevertheless, further larger-scale studies should be performed to examine the impact of other DM educational media on HL promotion. The Thai Clinical Trials Registry (TCTR) with registry ID TCTR20230425001 (date of registration 25/04/2023).
Health literacy (HL) is a crucial indicator for health promotion and diabetes care improvement, but the available measurements are mostly in English. This study aimed to translate and validate the 14-item Health Literacy Scale (HLS-14) questionnaire from English to Vietnamese for patients with diabetes in Vietnam. We translated HLS-14 into Vietnamese in accordance with the World Health Organization guidelines and conducted a cross-sectional survey among 571 outpatients with type 2 diabetes using the HLS-14 Vietnamese version (HLS-14 VN). The reliability and validity of the tool were assessed using Cronbach's alpha, composite reliability (CR), average variance extracted (AVE), and maximum shared variance (MSV), and confirmatory analysis was conducted. Cronbach's alpha coefficients for the three subscales as in the original version were 0.931, 0.810, and 0.928 for functional HL, communicative HL, and critical HL, respectively. However, AVE for critical HL was 0.488, which improved to 0.516 after the removal of one item in the communicative HL. For all subscales in the revised 13-item version (HLS-13 VN), CR was above 0.8, AVE was above 0.5, and MSV was less than AVE. Confirmatory analysis of HLS-13 VN revealed an acceptable fit with comparative fit index of 0.983, goodness-of-fit index of 0.963, and root mean squared error of approximation of 0.058. The reliability and validity of HLS-13 VN were confirmed. The tool is suitable for use in clinical settings in Vietnam to assess multidimensional HL in patients with type 2 diabetes.
Health literacy (HL) is a set of knowledge and skills that enables individuals to interpret and act upon health information, which is essential for health equity. There is a growing body of evidence in the field of HL in cancer care but there is, to our knowledge, no systematic review that explores the association between sociodemographic factors and HL among patients with cancer. The aim of this study was therefore to conduct a systematic review of the existing literature that assesses HL levels and the relationship between HL and sociodemographic factors in an adult cancer population. This is a systematic review and its protocol was registered in PROSPERO (ID: CRD42021164071). The study was conducted in accordance with the PRISMA statement. The literature search, from December 2009 to September 2023, was made in six databases, AMED, CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science Core Collection. Fifteen studies were included in the review. The included studies used nine different measurement tools for assessing HL. In the included studies between 11.9 % and 86 % had limited HL. We identified a relationship between limited HL and annual income, education level, ethnicity, living in rural areas and multiple comorbidities. The results indicate that limited HL is prevalent in the cancer population and should be acknowledge in everyday practice to meet health equity. Our awareness about sociodemographic factors and its association with HL, may enhance adherence to cancer treatment and quality of life, and lower physical and emotional distress.
Health literacy (HL) is an essential determinant of health in children. Inadequate HL causes problems for individuals and society, such as more hospitalizations, medication errors, poor health, and higher mortality and health care costs. A valid and reliable scale is needed to measure this population's HL. This study evaluated the cross-cultural adaptation and validation of the Persian version of the HL for School-Aged Children (HLSAC) Scale. In this methodological research, the HL scale of school-aged children was translated from English to Persian using the Backward-Forward translation protocol. The content validity, face validity, construct validity (Exploratory Factor Analysis [EFA] and Confirmatory factor analysis [CFA]), plus reliability, were evaluated by Internal consistency and stability methods. Two hundred forty samples from south of Tehran were selected by multi-stage sampling method to assess the construct validity. Data analysis was performed using SPSS v24 and Jamovi v2.2. A qualitative evaluation of face and content validity showed that experts and the target group approved all items on the scale. The results of EFA indicated the existence of one factor, explaining 47.17% of the total variance of the scale. The CFA results showed that the one-factor model of the Persian version of the HL scale for children is almost acceptable. (χ2/df = 2.94, Root Mean Square Error of Approximation = 0.09, Normed-Fit Index = 0.89, Tucker-Lewis Index = 0.89, Comparative Fit Index = 0.92). Cronbach's alpha coefficient for the whole scale was 0.80, and the Intraclass Correlation Coefficient value for the whole scale was calculated as 0.78 using the single-rating, absolute-agreement, 2-way mixed-effects method. The study validates the HLSAC Scale, affirming its suitability for assessing HL in Persian-speaking child populations.
Health literacy (HL) is an urgent public health challenge facing the U.S. HL is a critical factor in health inequities and exacerbates underlying social determinants of health. This study assesses the association between low HL (LHL) and adverse health behaviors, which contribute to poor health. Researchers used North Carolina's 2016 Behavioral Risk Factor Surveillance System data, namely, the Health Literacy optional module which asks respondents to rate how difficult it is for them to get health-related advice or to understand medical information (verbal or written). Health behaviors analyzed were excessive alcohol consumption, lack of adequate exercise and sleep, and irregular medical and dental check-ups. The sample was divided into four age categories (18-49, 50-64, and 65-75, and 76 and older) for statistical comparisons. Stata 15 and a user-written Stata command, - psacalc-, were used to examine the relationships by addressing omitted variable bias in OLS regressions. Findings indicate that LHL has a direct robust relationship with not exercising, inadequate sleep, irregular health and dental checkup, and health screenings across different age groups. Among women, LHL is associated with getting a Pap test in 3 years as opposed to more than 3 years. The adverse behaviors can explain the mechanisms underlying the link between LHL and adverse health outcomes. Further research on the causal relationship between LHL and adverse health behaviors using longitudinal data on a broader geographic region is warranted.
Health literacy (HL) is considered a cancer-preventive strategy. In addition, success in early diagnosis of cancer largely depends on individuals' knowledge, attitude, and performance regarding cancer warning signs. The aim of the present study was to investigate the potential relationship between HL and Knowledge, Attitude, and Performance (KAP) regarding cancer warning signs. This descriptive-correlational study was conducted on 280 adults who were referred to 3 health centers in Tehran, Iran, from January to March 2020. Data were collected using the Health Literacy Instrument for Adults (HELIA) and the researcher-made KAP regarding cancer warning signs questionnaire. Data were analyzed using the Pearson correlation test and linear regression in an adjusted model in the statistical package for social sciences software. Total HL score was positively and significantly correlated with knowledge (r = 0.35; p < 0.001), attitude (r = 0.17, p = 0.003), and performance (r = 0.46, p < 0.001). Moreover, after controlling for potential confounders, a significant and positive relationship was found between HL and knowledge (β = 0.48; t275= 4.45; p < 0.001), attitude (β =0.17; t265= 4.64; p < 0.001), and performance (β = 0.62; t265= 8.23; p < 0.001). It seems that adults' KAP regarding cancer warning signs can be promoted by increasing their HL. Therefore, greater attention should be paid to individuals' HL at community health centers when designing and performing programs to improve their KAP regarding cancer warning signs.
Health literacy (HL) is considered a key concept to positively address relevant decisions concerning physical and mental health. According to an integrated model of a European Consortium, the process to access, understand, appraise and apply health information is at the centre of practising HL. In this study, we examine HL in a population with an early onset of a mental disorder (MD). Results are based on a cross-sectional survey among people with MD (n = 310) who sought help at an early detection centre for MD in Cologne, Dresden or Munich. Help-seekers filled out the European Health Literacy Survey questionnaire (HLS-EU-Q) on perception-based HL, socio-demographic data and general health status. Psychopathology was assessed separately by trained specialists. Data are compared with a representative sample of the German population. Overall, HL was lower in a sample with MD compared with the general population. Disease-specific limitations were present in accessing, appraising and applying health information, whereas understanding was perceived fairly easy. Statistical analysis of limited HL revealed correlations with the diagnosis of affective disorders and anxiety disorders, an increase of depressive symptoms as well as the presence of more than one MD. In line with these findings, low levels of HL were associated with a worse general health status. In a population with MD, accessing, appraising and applying health information seemed to be particularly challenging. Therefore, educational programmes that mainly focus on increasing knowledge might not be sufficient for improving the HL in people with MD. Further research should concentrate on context-specific HL to foster behavioural change and improve overall health.
Health literacy (HL) is defined as the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make appropriate health decisions. Patients with limited HL are less likely to manage chronic diseases appropriately. We sought to assess the prevalence of limited HL in patients with atopic dermatitis (AD) and its association with other patient-reported outcomes. A cross-sectional questionnaire-based study was conducted at a tertiary referral center for AD. Patients diagnosed with AD by a dermatologist between 2019 and 2021 were identified from medical records. Perception-based HL was assessed by the European Health Literacy Survey Questionnaire 16 and performance-based HL by the Newest Vital Sign. Patients completed the Patient-Oriented Eczema Measure, Dermatology Life Quality Index, and Atopic Dermatitis Control Tool to measure AD severity, quality of life, and AD disease control, respectively. In total, 322 patients were included (response rate, 48.3%). On the basis of the European Health Literacy Survey Questionnaire 16, 32.4% had limited HL (8.4% inadequate and 24.0% problematic), which was associated with impaired quality of life. According to the Newest Vital Sign, 20.3% had inadequate HL, which was associated with older age. Up to one-third of the patients with AD showed signs of limited HL, which was associated with impaired health-related quality of life and older age. Further research should evaluate the influence of inadequate HL on health outcomes and focus on strategies to improve organizational HL to eventually enhance patient-centered care.
Health literacy (HL) is one of the effective factors in controlling the COVID-19 epidemic. Considering the high prevalence of COVID-19 disease, the present study aimed to determine the relationship between HL and the adoption of COVID-19 preventive behaviors. This was a descriptive-cross sectional study conducted on 214 students selected by simple random sampling method in Esfarayen Faculty of Medical Sciences, Iran, in 2022. The data included demographic and background characteristics, health literacy for Iranian Adults (HELIA), and a valid and reliable questionnaire to measure COVID-19 preventive behaviors. The data were analyzed using SPSS 23, descriptive statistics, and ordinal logistic regression tests. The mean and standard deviation of the scores of adoption of COVID-19 preventive behaviors and HL among students were 18.18) 4.02(out of 25 and 72.14) and 12.75 (out of 100, respectively. The results of the logistic regression test showed that the HL (P = 0.003), gender (P<0.001), mother's education (P = 0.039), educational level (P = 0.031), smoking (P = 0.032), and physical activity (P = 0.007) were effective factors in adopting preventive behaviors. Adopting preventive behaviors against COVID-19 was lower among students with lower levels of health literacy, male students, students with less physical activity, students with illiterate mothers, undergraduate students, and finally smokers. Therefore, it is necessary to pay more attention to these students in designing educational programs. It is suggested to carry out more extensive studies to clarify the effect of HL on the adoption of COVID-19 preventive behaviors.
Health literacy (HL) is pivotal for the successful self-management of chronic diseases. Little HL information is currently available in SSc patients; therefore, the present study aims at evaluating the HL levels in an Italian cohort of SSc patients. SSc patients were enrolled with the support of Italian patient associations, from September 2022 to March 2023. Health literacy characteristics were derived from the Health Literacy Scale European Questionnaire-16 (HLS-EU-Q16), consisting of 16 items designed on a four-point Likert scale ranging from "very difficult" to "very easy", and three HL levels were identified: inadequate HL (0-8 score); problematic HL (9-12 score); and sufficient HL (13-16 score). Enrolled patients (n = 57, mean age = 59 years, SD = 13.2) were mostly female (98.2%), partnered (73.7%), and unemployed or retired (67.9%). Almost half of SSc patients were diagnosed more than 10 years ago, with first symptoms appearing on average 19 years ago (SD 10.5). In 63% of the participants, the overall health literacy skills were inadequate, or problematic, especially in the health care and disease prevention domains. Indeed, 49.2% of the patients declared difficulty in finding information on treatments for illnesses and where to get professional help (42.1%), 47.6% found difficulty in retrieving information on how to manage mental health problems, and 40.4% declared difficulties in judging whether the information on health risks in the media was reliable. Our findings show that SSc patients have inadequate or problematic levels of HL, suggesting the need for periodic screenings to uncover poor health literacy skills and to provide tailored and understandable educational material. This study was not registered.
Health literacy (HL) is the ability of a person to acquire the process, understand the necessary health information, and make the health services needed for conscious health decisions. Besides, diabetes is the most common metabolic disorder that affects patients' quantity and quality of life. This study focused on determining the factors that affect the HL status of patients with type 2 diabetes (T2D) through the role of the demographic variables. This descriptive-analytical research survey recruited a sample based on 280 patients with T2D at the Diabetes Research Center of Ayatollah Taleghani Hospital in Kermanshah in 2020. This study selected patients with T2D using a simple random sampling technique. The study applied the demographic information questionnaire and the Functional, Communicative, and Critical HL Scale to collect data from patients with T2D. This study used the SPSS version 23 on the received data sets to perform statistical analysis, including t-test, analysis of the variance, and multiple regression, to predict the factors affecting HL among diabetes patients. The study results showed that the mean age of the participating patients with T2D was 55.80 ± 13.04. The results indicated the mean score and standard deviation of total HL score in patients with T2D 2.70 ± 0.44. The findings specified a statistically significant relationship between HL, gender, education, occupation, income, and place of residence. Results indicated that β-coefficients of the multiple regression analysis and the income variable (β = 0.170), age (β = 0.176), and employment variable (β = 0.157). These are the most predictive of the HL of patients with T2D. The results of this study specified that the HL rate of individuals with diabetes type 2 is average. The potential communicative and critical HL influence is essential for communication and education for diabetes patients in the primary health-care system settings. The findings indicate that communicative and critical HL related to patients' management and functional HL looks passable in this study.
Health literacy (HL) is the ability to make informed decisions using health information. As health data and information availability increase due to online clinic notes and patient portals, it is important to understand how HL relates to social determinants of health (SDoH) and the place of informatics in mitigating disparities. This systematic literature review aims to examine the role of HL in interactions with SDoH and to identify feasible HL-based interventions that address low patient understanding of health information to improve clinic note-sharing efficacy. The review examined 2 databases, Scopus and PubMed, for English-language articles relating to HL and SDoH. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine the roles of HL and interventions. The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, the role of HL, and interventions. Most articles (n=23) noted that HL was a result of SDoH, but other articles noted that it could also be a mediator for SdoH (n=6) or a modifiable SdoH (n=14) itself. The multivariable nature of HL indicates that it could form the basis for many interventions to combat low patient understandability, including 4 interventions using informatics-based solutions. HL is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving HL or addressing poor HL in patients can help increase comprehension of health information, including the information contained in clinic notes shared with patients.