Defining and identifying laboratory literacy as a component of health literacy: An assessment of existing health literacy tools
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ABSTRACT:
SUBMITTER: Franco J
PROVIDER: S-EPMC10641569 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:"Environmental Health Literacy" (EHL) is embraced as important for improving public health by preventing disability and disease from our environment. This study aimed to determine knowledge and skill items identified by Environmental Health (EH) professionals as being associated with EHL and to understand how these items rank by importance. Such a coordinated effort to tease out skills and knowledge needed for EHL had not previously been made. We utilized a mixed-methods approach of semi-structured interviews of 24 EH professionals and a quantitative survey with 275 EH professionals across the United States. Interviews identified 37 skill and 69 knowledge items, which were used to create the survey questions. Survey results indicate 32 knowledge items and six skill items considered essential by >50% of respondents where consensus was reached between professional groups (chi square test: p > 0.05). We further identified six knowledge items, which >70% of EH professionals agreed were essential for EHL. The identification of these knowledge and skill items sets the stage for further research that includes exploring agreement with more diverse stakeholders, developing comprehensive measures of EHL and evaluation of methods and materials designed to improve EHL.
| S-EPMC8583686 | biostudies-literature
Project description:BackgroundHealth literacy (HL) is seen as an increasingly relevant issue for global public health and requires a reliable and comprehensive operationalization. By now, there is limited evidence on how the development of tools measuring HL proceeded in recent years and if scholars considered existing methodological guidance when developing an instrument.MethodsWe performed a systematic review of generic measurement tools developed to assess HL by searching PubMed, ERIC, CINAHL and Web of Knowledge (2009 forward). Two reviewers independently reviewed abstracts/ full text articles for inclusion according to predefined criteria. Additionally we conducted a reporting quality appraisal according to the survey reporting guideline SURGE.ResultsWe identified 17 articles reporting on the development and validation of 17 instruments measuring health literacy. More than two thirds of all instruments are based on a multidimensional construct of health literacy. Moreover, there is a trend towards a mixed measurement (self-report and direct test) of health literacy with 41% of instruments applying it, though results strongly indicate a weakness of coherence between the underlying constructs measured. Overall, almost every third instrument is based on assessment formats modeled on already existing functional literacy screeners such as the REALM or the TOFHLA and 30% of the included articles do not report on significant reporting features specified in the SURGE guideline.ConclusionsScholars recently developing instruments that measure health literacy mainly comply with recommendations of the academic circle by applying multidimensional constructs and mixing up measurement approaches to capture health literacy comprehensively. Nonetheless, there is still a dependence on assessment formats, rooted in functional literacy measurement contradicting the widespread call for new instruments. All things considered, there is no clear "consensus" on HL measurement but a convergence to more comprehensive tools. Giving attention to this finding can help to offer direction towards the development of comparable and reliable health literacy assessment tools that effectively respond to the informational needs of populations.
| S-EPMC4289240 | biostudies-literature
Project description:Health literacy is an important determinant of health, and is one of the key indicators of a healthy city. Developing and improving methods to measure health literacy is prudent and necessary. This review summarizes the findings of published tools for assessing health literacy among the general population to provide a reference for establishing health literacy assessment tools in the future. In this systematic review, PubMed, Embase, and Web of Science were used to search articles regarding tools for assessing health literacy among the general population published up to 10 January 2018. Two researchers independently conducted literature screening, quality assessment of methodology, and data extraction according to preset inclusion and exclusion criteria. The quality assessment of the research was examined with the use of the specifications of the reporting guidelines for survey research (SURGE). Eleven articles met the inclusion criteria. All included instruments in monitoring the health literacy of the general population were presented through the form of questionnaires. The multistage process of making all the scales generally involved the following steps: item development, pre-testing, and evaluation of readability. However, the specific methods were different. Internal consistency for all the instruments was acceptable but with weak consistency among the subscales for some instruments. Most of the identified instruments derived from the definition of health literacy or were based on existing health literacy theory. Approximately 30% of the performed studies provided no description of the important features specified in the SURGE. This review indicates a trend in the increasing tools for assessing the health literacy of the general population by using multidimensional structures and comprehensive measurement approaches. However, no clear "consensus" was observed in the dimensions of health literacy tools.
| S-EPMC6122038 | biostudies-literature
Project description:BackgroundMeasurement of patients' healthcare experiences is increasingly used as an indicator of quality of care, but there are concerns that existing measures omit information that is meaningful to patients and that results may not be used systematically to inform service improvement. Further, current approaches may be inadequate for some population groups, such as Indigenous people in Australia, whose healthcare experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the Western biomedical health system. This study aimed to assess the extent to which existing patient experience measures used in Australia collect information about critical aspects of cancer care, as previously identified by Indigenous people affected by cancer and their health care providers.MethodsA two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures selected as suitable comparators; (2) comparators were examined in detail and mapped against topics identified in earlier research as important to Indigenous people with cancer. Gaps in topic coverage in comparators were identified.ResultsNo comparators completely captured the critical aspects of cancer care identified by Indigenous people affected by cancer and their health care providers. The number of topics 'partially' captured by the four comparators ranged from 4 to 7 out of 9. While most topics were partially covered, the lack of questions around culture and cultural safety was notable.ConclusionsExisting tools are likely to miss key aspects of Indigenous peoples' experiences of cancer care in Australia. Failure to adequately assess care experiences related to cultural safety may compromise efforts to improve health outcomes. Addressing gaps requires development of experience measures that are strengths-based, reflect an Indigenous worldview and measure aspects of experience relevant to Indigenous people.
| S-EPMC8042987 | biostudies-literature
Project description:ObjectiveFood literacy (FL) and nutrition literacy (NL) are concepts that can help individuals to navigate the current food environment. Building these skills and knowledge at a young age is important for skill retention, confidence in food practices and supporting lifelong healthy eating habits. The objectives of this systematic review were to: (i) identify existing tools that measure FL and NL among children and/or adolescents and (ii) describe the psychometric properties.DesignA 4-phase protocol was used to systematically retrieve articles. The search was performed in May 2021. Study characteristics and psychometric properties were extracted, and a narrative synthesis was used to summarise findings. Risk of bias was assessed using the COSMIN checklist.SettingSix databases were searched to identify current tools.ParticipantsChildren (2-12 years) and adolescents (13-18 years) participated in this study.ResultsTwelve tools were identified. Three tools measured FL, 1 tool measured NL, 4 tools measured both FL and NL, and 4 tools measured subareas of NL-more specifically, critical NL, food label and menu board literacy. Most tools were self-reported, developed based on a theoretical framework and assessed some components of validity and/or reliability for a specific age and ethnic group. The majority of tools targeted older children and adolescents (9-18 years of age), and one tool targeted preschoolers (3-6 years of age).ConclusionsMost widely used definitions of FL and NL do not acknowledge life-stage specific criterion. Continued efforts are needed to develop a comprehensive definition and framework of FL and NL appropriate for children, which will help inform future assessment tools.
| S-EPMC9991546 | biostudies-literature
Project description:Background:The National Action Plan to Improve Health Literacy makes the case that a wide range of organizations and professionals must work together to improve health information and services to achieve a health literate society. The context and framework for this collaboration and action, however, have yet to be well-articulated. We report on our use of a community health needs assessment model to describe county and state health literacy activities, gaps, assets, and opportunities. This approach combines the public health best practice of learning about communities through systematic assessments and the emerging health literacy best practice of studying organizational behaviors. Brief description of activity:A community health literacy assessment was implemented from January 2018 to April 2018. The purpose was to collect information about county and state-level health literacy activities, gaps, assets, and opportunities. We used this information to characterize the status of health literacy in Maryland and establish an initial baseline for county and state strategic planning work and future collaboration. Implementation:An environmental scan of each county in Maryland identified health indicators, community resources, and health organizations or professionals. Organizational representatives participated in interviews about their health literacy work. Interviews were analyzed to identify themes as well as summarize and quantify perspectives by county. We convened a forum, disseminated preliminary findings, and performed member checking to assess agreement with the results. Results:The team interviewed 56 individuals from 49 organizations. Themes of health literacy definitions as well as organizational ranking on the use of health literacy best practices are discussed in this article. Forty public health professionals, including 10 interview participants, attended the forum. Member checking assessed interview participants' agreement with results and interpretations, which were found to be accurate portrayals of their responses. Lessons learned:Lessons learned include being flexible with the interview approach, performing member checking, and allowing participants to self-define health literacy. Our experience shows a small team can perform a large-scale assessment that provides actionable information at state and county-levels. The results can influence future interventions, inform strategic planning and collaboration, and lead us toward a health literate society. [HLRP: Health Literacy Research and Practice. 2019;3(4):e216-e226.]. Plain Language Summary:A systematic community health needs assessment framework was used to collect information about health literacy activities, assets, gaps, and opportunities at the state and county level. Participant feedback showed the team accurately captured the activities, assets, gaps, and opportunities to improve health literacy practices. A needs assessment framework is feasible for describing community health literacy.
| S-EPMC6786688 | biostudies-other
Project description:BACKGROUND:This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. METHODS:Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. RESULTS:After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of "poor", 19 tools were in the category of "fair", 20 tools were in the category of "good", and 4 tools were in the category of "excellent" in at least one dimension. CONCLUSION: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.
| S-EPMC7333397 | biostudies-literature
Project description:BackgroundThis study aimed to validate the Chinese version of the Health Literacy Assessment Scale for Adolescents (HAS-A) and conduct a comparative analysis of adolescent health literacy between Taiwan and other countries.MethodsThe Chinese version of the HAS-A was completed by 2,312 adolescents in the fifth and sixth grades of a primary school. Psychometric properties were examined using consistent internal reliability and confirmatory factor analysis. These assessments were compared with the results from different regions to explore health literacy inequality.ResultsConstruct validity was good, and internal consistency was acceptable. The scale, particularly regarding communication health literacy, was associated with parents' socioeconomic status, and family income had a more significant impact on children's health literacy than community income. Health literacy disparities appear in different countries, with Taiwan exhibiting the lowest level of communication health literacy.ConclusionThe results indicate that the HAS-A is a valuable tool for assessing the health literacy of 10-11-year-old adolescents and can uncover health literacy inequality among different regions.
| S-EPMC10696858 | biostudies-literature
Project description:OBJECTIVE: To impute limited health literacy from commonly measured socio-demographic data and to compare it to the Short-Test of Functional Health Literacy in Adults (S-TOFHLA) for estimating the influence of limited health literacy on health status in the elderly. METHODS: The Prudential Medicare Study assesses the S-TOFHLA score, leading to a "reference standard" classification of 25% of people with inadequate literacy; the National Health Interview Survey has no such assessment. We estimated a regression of S-TOFHLA on sex, age, years of schooling, and race/ethnicity in The Prudential Medicare Study data to derive a Demographic Assessment for Health Literacy (DAHL) score, and imputed inadequate literacy to the 25% with the lowest DAHL scores. Using regression, we then examined associations between several health status measures (including hypertension, diabetes, physical and mental SF-12) and inadequate literacy (imputed or test-based). RESULTS: Estimates of association using imputed inadequate literacy closely approximate those obtained using S-TOFHLA-based inadequate literacy for most outcomes examined. CONCLUSIONS: As few population surveys measure health literacy, the DAHL, a readily calculated health literacy proxy score, may be useful for expanding the scope of health literacy research in national survey data.
| S-EPMC2533384 | biostudies-other
Project description:BACKGROUND:In order to play an active role in their health care, patients need information and motivation. Current delivery systems limit patients' involvement because they do not routinely provide them with enough details of their own clinical results, conditions and other important clinical data. The purpose of this study was to identify, from the perspective of patients, which topics matter the most, who should be communicating them, and when and how should they be provided. METHODS:We conducted a qualitative, phenomenological study analysing the content of subjective experiences, feelings and behaviours. We organized two focus groups with 13 participants and 15 in-depth interviews. Transcripts of the focus groups and interviews were checked for accuracy and then entered into Atlas ti™ v7.5.13 qualitative software. Two independent researchers performed a qualitative inductive content analysis to classify the data in two levels: themes and categories. RESULTS:The qualitative analysis provided 377 units of meaning synthesized into 22 categories and six themes: hospitalization procedure, Health Literacy relating to the patient's condition, information content, satisfaction, professional-patient relationship, and patient proactivity. Patients described which information they wished for, when they needed it, and who would provide it, usually related to actions such as admission, discharge or diagnostic tests. Oral information was more difficult to comprehend than the written kind, as patients can check written information several times if needed. Nurses were the most available professionals, and patients found easier to relate to them and ask them questions. Moreover, patients identified physicians as those professionals responsible for providing clinical information. CONCLUSIONS:Our results showed that patients suffered from poor Health Literacy regarding their personal condition, as they were unable to describe the symptoms, the type of tests being performed or their results, and some of them also had difficulties in naming the specific disease or comorbidities they had. During the hospitalization process, patients were in good shape to come with doubts and actively asked for more information. Healthcare organizations and professionals were offered the chance to ensure the correct communication and comprehension to their patients.
| S-EPMC7035644 | biostudies-literature