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Joseph PL, Gonçalves C, Applewhite J, Fleary SA. Examining provider anticipatory guidance for adolescents' preventive health: A latent class approach. J Pediatr Nurs 2024; 76:e117-e125. [PMID: 38429211 DOI: 10.1016/j.pedn.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Low rates of anticipatory guidance (AG) are reported across studies with adolescents, and little is known about how these conversations differ across early versus middle adolescence. This study explored adolescent-provider AG conversations for preventive health skills; the study objectives were to (1) identify patterns of provider-adolescent AG conversations across early and middle adolescence and (2) determine socio-demographic characteristics associated with these AG conversations. DESIGN AND METHOD Data from the 2019 National Survey of Children's Health were used to identify patterns of provider-adolescent AG conversations. The sample included 5500 early and 6730 middle adolescents (Mage = 14.67 years old, SD = 1.71, 51.7% boys, 79% White). Multiple group latent class analysis and multinomial regressions were estimated using four indicators of AG conversations (i.e., skills to manage health and healthcare, changes in healthcare that happen at 18, making positive choices about health, and receiving a medical history summary). RESULTS Three types of AG conversations were identified: high AG, low AG, and parent unaware. Among early and middle adolescents, adolescents that were older, girls, had private health insurance, and a personal provider were less likely to receive high AG compared to other types of AG. CONCLUSIONS Policies and strategies to engage adolescents in AG conversations during and outside of the medical appointment are needed. PRACTICE IMPLICATIONS Tools, such as brief screeners, can be used to ensure all adolescents are receiving high AG. School-based health centers, community centers and organizations, and telehealth appointments with medical professionals may be additional opportunities for adolescents to receive AG.
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Affiliation(s)
- Patrece L Joseph
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599, USA.
| | | | - Janelle Applewhite
- Department of Educational Foundations and Exceptionalities, James Madison University, USA
| | - Sasha A Fleary
- Graduate School of Public Health and Health Policy, City University of New York, USA
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Malik FS, Weaver KW, Corathers SD, White PH. Incorporating the Six Core Elements of Health Care Transition in Type 1 Diabetes Care for Emerging Adults. Endocrinol Metab Clin North Am 2024; 53:53-65. [PMID: 38272598 DOI: 10.1016/j.ecl.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
A growing body of literature finds persistent problems in the provision of recommended health care transition services, as well as adverse outcomes associated with the lack of these services in emerging adults with type 1 diabetes. The Six Core Elements of Health Care Transition offers a structured approach to the phases of health care transition support for both pediatric and adult diabetes practices. This article reviews strategies to incorporate the Six Core Elements into ambulatory diabetes care to support successful health care transition for emerging adults with type 1 diabetes.
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Affiliation(s)
- Faisal S Malik
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Development, Seattle Children's Research Institute, Center for Child Health, Behavior, 1920 Terry Avenue, CURE-3, Seattle, WA 98101, USA.
| | - Kathryn W Weaver
- Department of Medicine, University of Washington School of Medicine, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Sarah D Corathers
- Cincinnati Children's Hospital Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 7012, Cincinnati, OH 45229, USA
| | - Patience H White
- Department of Medicine and Pediatrics, George Washington University School of Medicine, 5335 Wisconsin Avenue NW, Suite 440, Washington, DC 20015, USA
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Brown CL, Restall G, Diaz FAS, Anang P, Gerhold K, Pylypjuk H, Wittmeier K. Understand me: Youth with chronic pain on how knowledge gaps influence their pain experience. Can J Pain 2023; 7:2146489. [PMID: 36733474 PMCID: PMC9888456 DOI: 10.1080/24740527.2022.2146489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background There is a perceived lack of readily available resources to support self-management skills in youth living with chronic pain. The perspectives of youth regarding information gaps may improve the effectiveness of resources developed for them. Aim The aim of this study was to explore the perspectives of youth living with chronic pain on the interactions among their pain experiences, chronic pain resources and research. Methods Using an interpretive paradigm, we interviewed seven participants (age range 12-19 years) diagnosed with chronic pain. Two frameworks for meaningful engagement of citizens in research and policy informed the interview guide. Data were analyzed inductively using content analysis approaches to examine patterns and develop themes. Results The participants' perceptions were captured by the overarching theme of "understand me." Four subthemes elaborate on the relationship between the participants' experiences and how their lives could be enhanced through research and knowledge mobilization. In the subtheme "my unique pain experience," the participants help us understand them by chronicling the variation in presentation of their chronic pain. The subtheme "people don't know it's a thing" emphasizes that there is general misunderstanding of chronic pain by the public and in the participants' support systems. The first two subthemes influence the third, which describes how the pain "kind of stops you from living." The fourth subtheme, "knowledge offers hope," offers a solution to dismantling misunderstanding of youth living with chronic pain. Conclusion Future work needs to focus on embedding health literacy and knowledge mobilization into health and education structures to promote developmentally relevant self-management skills.
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Affiliation(s)
- Cara L. Brown
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada,CONTACT Cara L. Brown Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R125, 771 McDermot Ave. Winnipeg, MBR3E 0T6, Canada
| | - Gayle Restall
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Francis Austin S. Diaz
- Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Polina Anang
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kerstin Gerhold
- Children’s Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada,Mississippi Center for Advanced Medicine, Mississippi, USA
| | - Heidi Pylypjuk
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristy Wittmeier
- Children’s Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada,Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Bechraki E, Mavrikaki E, Gialamas V, Galanaki E. Development and validation of an instrument for the health literacy assessment of secondary school students (HeLiASeSS). HEALTH EDUCATION 2022. [DOI: 10.1108/he-08-2021-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe development of health literacy skills is of paramount importance especially for students, as it is associated with their wellbeing and academic success. Assessing students' health literacy is necessary for its advancement. This study comes to fill the need for a valid multidimensional health literacy assessment instrument for secondary school students.Design/methodology/approachInitially, the authors defined the conceptual framework within which the items of this instrument were generated. Its final form was obtained through three pilot studies. A test-retest followed and, finally, a nationwide survey was conducted on Greek seventh-, ninth- and tenth-grade students (N = 2,800).FindingsA 37-item instrument, the Health Literacy Assessment for Secondary School Students (HeLiASeSS), was developed which includes the following nine dimensions/skills of health literacy: “access to”, “understand” and “evaluate” (health information), “functional communication”, “interactive communication” and “critical communication”, “relying on health information”, “self-efficacy regarding health matters” and “intention for active citizenship regarding health matters”. HeLiASeSS proved to have good stability (ICC = 0.943) and high internal consistency reliability (a = 0.903).Originality/valueHeLiASeSS offers the possibility of a reliable and valid assessment of secondary school students' health literacy skills providing a multidimensional evaluation of this construct and is expected to be useful in interventions aiming at promoting this type of literacy.
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Senahad N, Loahasiriwong W, Maneenin N. Sociocultural, health knowledge, and health literacy among children ages 9-10 years in Thailand. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:137. [PMID: 35677268 PMCID: PMC9170210 DOI: 10.4103/jehp.jehp_886_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/06/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Health literacy (HL) enables a person to make good decisions regarding health care, disease prevention, and health promotion to maintain and improve health. In Thailand, most existing studies focus on adults' HL rather than children. This research aimed to determine the influence of sociocultural and health knowledge on HL among children ages 9-10 years in Thailand. MATERIALS AND METHODS A cross-sectional study was conducted among 1650 children aged 9-10 years. The respondents were recruited using multistage random sampling from 39 primary schools of 13 provinces in all four regions of Thailand. A self-administered structured questionnaire was used to collect the required data. The multilevel analysis was used to determine the association between sociocultural, health knowledge, and HL while controlling the effects of covariates. The result was presented as adjusted odd ratios and its 95% confidence interval (CI). RESULTS Of the total 1650 respondents, 86.24% (95% CI: 84.49%-87.82%) had adequate and excellent levels of HL. The multivariable analysis indicated factors that were significantly associated with adequate and excellent levels HL including adequacy of per diem (adjusted odds ratio [adj. OR] = 6.78; 95% CI: 3.54-12.97) and had good relationship with teachers (adj. OR = 2.19; 95% CI: 1.55-3.09). Sources of health education which were received health education from parents (adj. OR = 3.51; 95% CI: 2.39-5.14), from teachers (adj. OR = 2.03; 95% CI: 1.43-2.89), and from the Internet (adj. OR = 1.83; 95% CI: 1.12-2.99) were also significantly associated with HL. Another significant factor was had good level of health knowledge (adj. OR = 1.86; 95% CI: 1.30-2.66) when control clustering effect of region, provinces, school, and classroom size. CONCLUSIONS More than 85% of children ages 9-10 years in Thailand had adequate and excellence levels of HL. Sociocultural and health knowledge had influence on children HL.
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Affiliation(s)
- Nopparat Senahad
- Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Thailand
| | | | - Naowarat Maneenin
- Lecturer, Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen, Thailand
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Liu C, Wang D, Liu C, Jiang J, Wang X, Chen H, Ju X, Zhang X. What is the meaning of health literacy? A systematic review and qualitative synthesis. Fam Med Community Health 2021; 8:fmch-2020-000351. [PMID: 32414834 PMCID: PMC7239702 DOI: 10.1136/fmch-2020-000351] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The objective of this review was to clarify what health literacy represents. A systematic
review with qualitative syntheses was performed (CRD42017065149). Studies concerning
health literacy in all settings were included. Studies before 15 March 2017 were
identified from PubMed, Medline, Embase, Web of Science, Scopus, PsycARTICLES and the
Cochrane Library. The included literature either had defined the concept of health
literacy or made a detailed explanation of health literacy. A total of 34 original studies
met the inclusion criteria, including 13 involved in previous systematic reviews and 21
new studies. Health literacy was commonly conceptualised as a set of knowledge, a set of
skills or a hierarchy of functions (functional-interactive-critical). The construct of
health literacy covers three broad elements: (1) knowledge of health, healthcare and
health systems; (2) processing and using information in various formats in relation to
health and healthcare; and (3) ability to maintain health through self-management and
working in partnerships with health providers. Health literacy is defined as the ability
of an individual to obtain and translate knowledge and information in order to maintain
and improve health in a way that is appropriate to the individual and system contexts.
This definition highlights the diversity of needs from different individuals and the
importance of interactions between individual consumers, healthcare providers and
healthcare systems.
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Affiliation(s)
- Chenxi Liu
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Dan Wang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Chaojie Liu
- Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Junnan Jiang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Xuemei Wang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Haihong Chen
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Xin Ju
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
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Wong JYH, Zhang W, Wu Y, Choi EPH, Lo HHM, Wong W, Chio JHM, Tam HLC, Ngai FW, Tarrant M, Wang MP, Ngan HYS, Fong DYT. An Interactive Web-Based Sexual Health Literacy Program for Safe Sex Practice for Female Chinese University Students: Multicenter Randomized Controlled Trial. J Med Internet Res 2021; 23:e22564. [PMID: 33709941 PMCID: PMC7998327 DOI: 10.2196/22564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/27/2020] [Accepted: 12/12/2020] [Indexed: 11/16/2022] Open
Abstract
Background Sexual health concerns among young adults worldwide help to motivate preventative practices against sexually transmitted infections. To foster better sexual health, sexual health literacy must be enhanced. Little research has been conducted on the impact of gender power dynamics on sexual health, such as sexual coercion, even though the prevalence of sexual coercion remains high in China. Objective This study describes the development and systematic evaluation of a web-based sexual health literacy intervention called “Smart Girlfriend” for female Chinese university students. Methods A multicenter randomized controlled trial was conducted with 781 female university students at 5 universities with dormitories in Hong Kong. Inclusion criteria were used to select unmarried, female, Chinese university students who were ≥18 years old and had not received a sexual health intervention in the past 12 months. Participants were randomly assigned to 2 groups: one group received an interactive web-based sexual health literacy intervention and the other group received a single webpage of online information about condom use. The intervention content was based on the Health Belief Model and the Continuum of Conflict and Control theory. The primary outcome was self-reported consistency of condom use with every partner at 3-month and 6-month follow-up assessments, analyzed using zero/one inflated beta (ZOIB) regression. The secondary outcome was an appraisal of the knowledge, attitudes, norms, and self-efficacy of condom use using the 25-item Multidimensional Condom Attitudes Scale (MCAS). The intention to treat was applied in analyses. Results Of 1503 individuals that were screened, 781 (52%) were randomized into 2 groups. The retention rates at the 3-month and 6-month follow-ups were 92% and 91%, respectively. Most participants were born locally (536/746, 72%), and 18% (134/746) self-reported as a sexual minority. ZOIB results regarding the consistency of condom use were not significant [model 1: odds ratio (OR) 2.25 with a 95% credible interval (CrI) of 0.84-6.36; model 2: OR 8.03 (95% CrI 0.22-330.31); model 3: OR 1.21 (95% CrI 0.78-1.86)]. Consistency in the intervention group was 5% higher (95% CI −1.90 to 11.63) than the control group at the 3-month follow-up, and 1% higher (95% CI −5.81 to 8·02) at the 6-month follow-up. MCAS scores at the 3-month follow-up were significantly higher in the intervention group (mean 122.51, SD 15.97) than the control group (mean 119.86, SD 15.85; P=.02). Conclusions An interactive web-based sexual health literacy program did not significantly increase the consistency of condom use compared to a single webpage of condom use information; however, it did temporarily improve knowledge, attitudes, norms, and self-efficacy regarding condom use. Future revisions of this intervention should be personalized and delivered with a proactive approach. Trial Registration ClinicalTrials.gov NCT03695679; https://clinicaltrials.gov/ct2/show/NCT03695679
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Affiliation(s)
| | - Wen Zhang
- School of Nursing, University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Yongda Wu
- School of Nursing, University of Hong Kong, Hong Kong SAR, Hong Kong
| | | | - Herman Hay Ming Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong
| | - Wendy Wong
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Jasmine Hin Man Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong SAR, Hong Kong
| | - Hau Lin Cherry Tam
- Department of Social and Behavioural Science, City University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Fei Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong SAR, Hong Kong
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Smith C, Goss HR, Issartel J, Belton S. Health Literacy in Schools? A Systematic Review of Health-Related Interventions Aimed at Disadvantaged Adolescents. CHILDREN-BASEL 2021; 8:children8030176. [PMID: 33668861 PMCID: PMC7996245 DOI: 10.3390/children8030176] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 02/08/2023]
Abstract
Socioeconomically disadvantaged populations are at greater risk of adopting unhealthy behaviours and developing chronic diseases. Adolescence has been identified as a crucial life stage to develop lifelong healthy behaviours, with schools often suggested as the ideal environment to foster healthy habits. Health literacy (HL) provides a possible solution to promote such healthy behaviours. The aim of this study was to review school-based HL-related interventions targeting socioeconomically disadvantaged adolescents and to identify effective intervention strategies for this population. Searches were performed in six databases. Inclusion criteria included age: 12–16; the implementation of a school-based intervention related to HL aimed at socioeconomically disadvantaged populations; an intervention focused on: physical activity (PA), diet, mental health, substance abuse or sleep. Forty-one articles were included, with the majority focusing on PA and diet (n = 13), PA (n = 9) or mental health (n = 7). Few interventions focused solely on substance abuse (n = 2) or sleep (n = 1), and none targeted or assessed HL as an outcome measure. There was huge heterogeneity in study design, outcomes measures and effectiveness reported. Effective intervention strategies were identified that can be used to guide future interventions, including practical learning activities, peer support and approaches targeting the school environment, the parents or that link the intervention to the community.
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Spillane A, Belton S, McDermott C, Issartel J, Osborne RH, Elmer S, Murrin C. Development and validity testing of the Adolescent Health Literacy Questionnaire (AHLQ): Protocol for a mixed methods study within the Irish school setting. BMJ Open 2020; 10:e039920. [PMID: 33177140 PMCID: PMC7661365 DOI: 10.1136/bmjopen-2020-039920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Health literacy research has focused predominantly on the adult population, and much less is understood about this concept from an adolescent perspective. The tools currently available to measure adolescent health literacy have been adapted from adult versions. This limits their applicability to young people because of the developmental characteristics that impact on adolescents' behaviour, including impulse control and judgement skills. This protocol describes the intended development and validity testing of a questionnaire to measure health literacy in adolescents. METHODS AND ANALYSIS This protocol describes this mixed methods study that has three phases: the first phase will involve grounded research with adolescents using qualitative group interviews, co-design and concept mapping workshops to understand what health and healthy behaviours mean to adolescents and to explore their health literacy needs and the potential domains for the questionnaire. The draft health literacy domains identified will be presented to the youth advisory panel, and the questionnaire will be altered based on their feedback. Cognitive pretesting of the questionnaire items will also be conducted. Phase 2 will involve piloting the questionnaire to a two-stage random sample of young people in five urban and rural schools in Ireland. Test-retest reliability will be conducted using Pearson correlation coefficient. Confirmatory factor analysis will also be conducted to analyse the psychometric properties of the questionnaire. Phase 3 will involve the questionnaire being rolled out to a nationally representative sample of adolescents (n=6052) in Ireland to assess their levels of health literacy. ETHICS AND DISSEMINATION Ethical approval to conduct this study has been granted from the University College Dublin Human Research Ethics Committee - Sciences (LS-20-08). Informed assent from adolescents and informed consent from parents/guardians will be sought. The findings of this research will be disseminated at national and international conferences, as well as through publication in peer-reviewed journals.
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Affiliation(s)
- Ailbhe Spillane
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Sarahjane Belton
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Clare McDermott
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Johann Issartel
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Shandell Elmer
- Centre for Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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McClintock HF, Alber JM, Schrauben SJ, Mazzola CM, Wiebe DJ. Constructing a measure of health literacy in Sub-Saharan African countries. Health Promot Int 2020; 35:907-915. [PMID: 31504512 PMCID: PMC7821704 DOI: 10.1093/heapro/daz078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006-15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy. Logistic regression was employed to examine the relationship between demographic characteristics and health literacy. A total of 224 751 individuals between the ages of 15 and 49 years were included. The derived health literacy measure demonstrated good internal consistency (Cronbach's α = 0.72) and good content validity. The prevalence of high health literacy overall was 35.77%; females 34.08% and males 39.17%; less than or equal to primary education 8.93%, some secondary education 69.40% and ≥complete secondary 84.35%. High health literacy varied across nations, from 8.51% in Niger to 63.89% in Namibia. This is the first known study to evaluate a measure of health literacy relying on the NAM definition utilizing a large sample from 14 countries in Sub-Saharan Africa. Our study derived a robust indicator of NAM-defined health literacy. This indicator could be used to examine determinants and outcomes of health literacy in additional countries.
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Affiliation(s)
- Heather F McClintock
- Department of Public Health, College of Health Sciences, Arcadia University, 450 S. Easton, Glenside, PA, 19038, USA
| | - Julia M Alber
- Department of Kinesiology and Public Health, California Polytechnic State University, 1 Grand Ave, San Luis Obispo, CA 93407, USA
| | - Sarah J Schrauben
- Department of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Carmella M Mazzola
- Department of Public Health, College of Health Sciences, Arcadia University, 450 S. Easton, Glenside, PA, 19038, USA
| | - Douglas J Wiebe
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA
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11
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Sheanon NM, Beal SJ, Kichler JC, Casnellie L, Backeljauw P, Corathers S. Readiness for transition to adult care in adolescents and young adults with Turner syndrome. J Pediatr Endocrinol Metab 2020; 33:1165-1171. [PMID: 32866122 DOI: 10.1515/jpem-2020-0155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/16/2020] [Indexed: 01/15/2023]
Abstract
Objectives Turner syndrome (TS) is a complex and chronic medical condition that requires lifelong subspecialty care. Effective transition preparation is needed for successful transfer from pediatric to adult care in order to avoid lapses in medical care, explore health issues such as fertility, and prepare caregivers as adolescents take over responsibility for their own care. The objective of this study was to evaluate accuracy of knowledge of personal medical history and screening guidelines in adolescents and young adults (AYA) with TS. Methods This was a prospective cross-sectional study of 35 AYA with TS of ages 13-22 years recruited from a tertiary care center. AYA completed questionnaires on personal medical history, knowledge of screening guidelines for TS, and the Transition Readiness Assessment Questionnaire (TRAQ). Results Eighty percent of AYA with TS were 100% accurate in reporting their personal medical history. Only one-third of AYA with TS were accurate about knowing screening guidelines for individuals with TS. Accuracy about knowing screening guidelines was significantly associated with TRAQ sum scores (r = 0.45, p < 0.05). However, there was no association between knowledge of personal medical history and TRAQ sum scores. Conclusions Transition readiness skills, TS-specific knowledge, and accurate awareness of health-care recommendations are related, yet distinct, constructs. Understanding of one's personal medical history is not an adequate surrogate for transition readiness. Validated tools for general transition, like the TRAQ, can be used but need to be complemented by TS-specific assessments and content. Providers are encouraged to identify opportunities for clinical and educational interventions well in advance of starting transfer to adult care.
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Affiliation(s)
- Nicole M Sheanon
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah J Beal
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Lori Casnellie
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Philippe Backeljauw
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah Corathers
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Tsubakita T, Kawazoe N, Ichikawa M, Matsumoto S, Sugawara M. Assessing Knowledge-Based and Perceived Health Literacy Among Japanese Adolescents: A Cross-Sectional Study. Glob Pediatr Health 2020; 7:2333794X20944311. [PMID: 32923522 PMCID: PMC7450286 DOI: 10.1177/2333794x20944311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 05/15/2020] [Accepted: 06/17/2020] [Indexed: 11/23/2022] Open
Abstract
Health literacy assessment is a major aspect of planning health education for
adolescents. We evaluated the health literacy of Japanese adolescents using both
perceived and knowledge-based health literacy scales. Study questionnaires were
administered to 773 junior and senior high school students aged 12 to 18 years.
We tested a model describing the hierarchical relations between functional,
communicative, critical, and knowledge-based health literacy using path
analysis. Critical health literacy was found to be influenced by functional,
communicative, and knowledge-based health literacy, while functional and
knowledge-based health literacy were correlated. The model, with slight
modification, was supported. The result indicates that perceived functional
health literacy scores did not directly correlate with higher perceived critical
health literacy; rather, they only informed critical health literacy when
participants had high knowledge-based health literacy.
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Affiliation(s)
| | - Nobuo Kawazoe
- Nagoya University of Commerce and Business, Nisshin, Aichi, Japan
| | - Mahoko Ichikawa
- Nagoya University of Commerce and Business, Nisshin, Aichi, Japan
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Sarhan MBA, Shannon HS, Fujiya R, Jimba M, Giacaman R. Psychometric properties of an Arabic-language health literacy assessment scale for adolescents (HAS-A-AR) in Palestine. BMJ Open 2020; 10:e034943. [PMID: 32565456 PMCID: PMC7311025 DOI: 10.1136/bmjopen-2019-034943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Health literacy research in Palestine is limited, and a locally validated tool for use among adolescents has been unavailable until now. Therefore, this study aimed to adapt health literacy assessment scale for adolescents (HAS-A) into Arabic language (HAS-A-AR) and Palestinian context and to investigate its psychometric properties. DESIGN We conducted a cross-sectional household survey using a stratified random sample and household face-to-face interviews. SETTING AND PARTICIPANTS We conducted 1200 interviews with sixth to ninth graders in the Ramallah and al-Bireh district of the West Bank, Palestine in 2017. METHODS We translated and adapted HAS-A to be sensitive to the Palestinian context and tested its psychometric properties. We evaluated face and content validity during the back-translation process and checked for construct validity through exploratory factor analysis (EFA). We tested for internal consistency using Cronbach's alpha, MacDonald's omega test and the greatest lower bound (GLB). Furthermore, we calculated the scale's average inter-item correlation. RESULTS EFA revealed that HAS-A-AR has a similar structure to the original HAS-A. It extracted three factors (communication, confusion and functional health literacy) whose eigenvalues were >1. Together they explained 57% of the total variance. The proportions of adolescents with high levels of communication, confusion and functional health literacy were 45%, 68% and 80%, respectively. Cronbach's alpha, MacDonald's omega and the GLB values for communication subscale were 0.87, 0.88 and 0.90, and they were 0.78, 0.77 and 0.79 for confusion subscale, while they were 0.77, 0.77 and 0.80, respectively, for functional healthy literacy subscale. The average inter-item correlation for the subscales ranged between 0.36 and 0.59. CONCLUSION HAS-A-AR is a valid and reliable health literacy measuring instrument with appropriate psychometric properties. HAS-A-AR is currently available for use among adolescents in Palestine and the surrounding Arab countries with similar characteristics as Palestine, including language, culture and political instability.
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Affiliation(s)
- Mohammed B A Sarhan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Harry S Shannon
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rika Fujiya
- Faculty of Nursing and Medical Care, Keio University, Fugisawa, Kanagawa, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Rita Giacaman
- Institute of Community and Public Health, Birzeit University, Birzeit, State of Palestine
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Vamos CA, Thompson EL, Logan RG, Griner SB, Perrin KM, Merrell LK, Daley EM. Exploring college students' sexual and reproductive health literacy. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:79-88. [PMID: 30388946 DOI: 10.1080/07448481.2018.1515757] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/03/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
Objective: To assess college students' sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n = 43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students' SRH literacy.
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Affiliation(s)
- Cheryl A Vamos
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rachel G Logan
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Stacey B Griner
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Karen M Perrin
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Laura K Merrell
- Department of Health Sciences, James Madison University, Harrisonburg, VA, USA
| | - Ellen M Daley
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
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Hoffman S, Rueda HA, Beasley L. Youth Perspectives of Healthcare in Central Mexico: An Application of Massey's Critical Health Literacy Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E896. [PMID: 30871111 PMCID: PMC6427344 DOI: 10.3390/ijerph16050896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 12/25/2022]
Abstract
Attention to health literacy is essential more now than ever given the recognition, attention, and resources being dedicated to addressing health disparities throughout the world. Unfortunately, health literacy research is scarce in many parts of the world, particularly among youth. Using focus group discussions with junior high school students (N = 98) in a rural town of Central Mexico, we sought to learn about their experiences utilizing healthcare services at a local health clinic. The themes that naturally emerged from focus group discussions aligned with Massey's framework on critical health literacy among US youth, and included problems navigating the health system, embarrassment speaking to doctors about sensitive issues, and minimal importance being placed on preventative care. This suggests that Massey's framework may be appropriate to use when seeking to understand and promote health literacy among youth in Mexico. Furthermore, the challenges faced by adolescent participants in this study suggest that additional research is needed to assess how youth in other areas of Mexico are faring in efforts to understand and access their new and evolving universal healthcare system.
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Affiliation(s)
- Steven Hoffman
- School of Social Work, Brigham Young University, Provo, UT 84660, USA.
| | - Heidi Adams Rueda
- Department of Social Work, University of Texas at San Antonio, San Antonio, TX 78207, USA.
| | - Lauren Beasley
- Knoxville Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA.
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Krause C, Sommerhalder K, Beer-Borst S, Abel T. Just a subtle difference? Findings from a systematic review on definitions of nutrition literacy and food literacy. Health Promot Int 2018; 33:378-389. [PMID: 27803197 PMCID: PMC6005107 DOI: 10.1093/heapro/daw084] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Nutrition literacy and food literacy have become increasingly important concepts in health promotion. Researchers use one or the other term to describe the competencies needed to maintain a healthy diet. This systematic review examines whether these terms are synonymous or if their meanings are substantially different. We searched major bibliographic databases (Web of Science, PubMed, ScienceDirect, CINAHL, SocIndex and ERIC) for publications that provided an original definition of nutrition or food literacy. Then we used Nutbeam’s tripartite health literacy model as an analytical grid. The definitions we found included specific competencies, which we mapped to the domains of functional, interactive, or critical literacy. In the 173 full-text publications we screened, we found six original definitions of nutrition literacy, and 13 original definitions of food literacy. Seven food literacy definitions were integrated into a conceptual framework. Analysing their structure revealed that nutrition literacy and food literacy are seen as specific forms of health literacy, and represent distinct but complementary concepts. Definitions of nutrition literacy mainly described the abilities necessary to obtain and understand nutrition information. Definitions of food literacy incorporated a broader spectrum of theoretical and practical knowledge and skills. To be food literate also means to apply information on food choices and critically reflect on the effect of food choice on personal health and on society. Since food literacy is based on a more comprehensive understanding of health behaviours, it is the more viable term to use in health promotion interventions. For the practical implication, a harmonization of the different definitions is desirable.
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Affiliation(s)
- Corinna Krause
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
| | - Kathrin Sommerhalder
- Health Division, Bern University of Applied Sciences, Murtenstrasse 10, CH-3008 Bern, Switzerland
| | - Sigrid Beer-Borst
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
| | - Thomas Abel
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
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Kim JN, Oh YW, Krishna A. Justificatory Information Forefending in Digital Age: Self-Sealing Informational Conviction of Risky Health Behavior. HEALTH COMMUNICATION 2018; 33:85-93. [PMID: 27892700 DOI: 10.1080/10410236.2016.1242040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study proposes the idea of justificatory information forefending, a cognitive process by which individuals accept information that confirms their preexisting health beliefs, and reject information that is dissonant with their attitudes. In light of the sheer volume of often contradictory information related to health that is frequently highlighted by the traditional media, this study sought to identify antecedents and outcomes of this justificatory information forefending. Results indicate that individuals who are exposed to contradictory health information, currently engage in risky health behavior, are comfortable using the Internet to search for information, and are currently taking steps to maintain their health are likely to actively select health information that confirms their preexisting notions about their health, and to reject information that is contradictory to their beliefs. Additionally, individuals who engage in justificatory information forefending were also found to continue to engage in risky health behavior. Implications for theory and practice are discussed.
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Affiliation(s)
- Jeong-Nam Kim
- a Gaylord College of Journalism and Mass Communication , University of Oklahoma
- b Debiasing and Lay Informatics (DaLI) Lab , University of Oklahoma
| | - Yu Won Oh
- b Debiasing and Lay Informatics (DaLI) Lab , University of Oklahoma
| | - Arunima Krishna
- c Department of Mass Communication, Advertising, and Public Relations , Boston University
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Gravholt CH, Andersen NH, Conway GS, Dekkers OM, Geffner ME, Klein KO, Lin AE, Mauras N, Quigley CA, Rubin K, Sandberg DE, Sas TCJ, Silberbach M, Söderström-Anttila V, Stochholm K, van Alfen-van derVelden JA, Woelfle J, Backeljauw PF. Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting. Eur J Endocrinol 2017; 177:G1-G70. [PMID: 28705803 DOI: 10.1530/eje-17-0430] [Citation(s) in RCA: 584] [Impact Index Per Article: 83.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/07/2017] [Indexed: 12/14/2022]
Abstract
Turner syndrome affects 25-50 per 100,000 females and can involve multiple organs through all stages of life, necessitating multidisciplinary approach to care. Previous guidelines have highlighted this, but numerous important advances have been noted recently. These advances cover all specialty fields involved in the care of girls and women with TS. This paper is based on an international effort that started with exploratory meetings in 2014 in both Europe and the USA, and culminated with a Consensus Meeting held in Cincinnati, Ohio, USA in July 2016. Prior to this meeting, five groups each addressed important areas in TS care: 1) diagnostic and genetic issues, 2) growth and development during childhood and adolescence, 3) congenital and acquired cardiovascular disease, 4) transition and adult care, and 5) other comorbidities and neurocognitive issues. These groups produced proposals for the present guidelines. Additionally, four pertinent questions were submitted for formal GRADE (Grading of Recommendations, Assessment, Development and Evaluation) evaluation with a separate systematic review of the literature. These four questions related to the efficacy and most optimal treatment of short stature, infertility, hypertension, and hormonal replacement therapy. The guidelines project was initiated by the European Society for Endocrinology and the Pediatric Endocrine Society, in collaboration with The European Society for Pediatric Endocrinology, The Endocrine Society, European Society of Human Reproduction and Embryology, The American Heart Association, The Society for Endocrinology, and the European Society of Cardiology. The guideline has been formally endorsed by the European Society for Endocrinology, the Pediatric Endocrine Society, the European Society for Pediatric Endocrinology, the European Society of Human Reproduction and Embryology and the Endocrine Society. Advocacy groups appointed representatives who participated in pre-meeting discussions and in the consensus meeting.
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Affiliation(s)
- Claus H Gravholt
- Departments of Endocrinology and Internal Medicine
- Departments of Molecular Medicine
| | - Niels H Andersen
- Departments of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Gerard S Conway
- Department of Women's Health, University College London, London, UK
| | - Olaf M Dekkers
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mitchell E Geffner
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Karen O Klein
- Rady Children's Hospital, University of California, San Diego, California, USA
| | - Angela E Lin
- Department of Pediatrics, Medical Genetics Unit, Mass General Hospital for Children, Boston, Massachusetts, USA
| | - Nelly Mauras
- Division of Endocrinology, Nemours Children's Health System, Jacksonville, Florida, USA
| | | | - Karen Rubin
- Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - David E Sandberg
- Division of Psychology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Theo C J Sas
- Department of Pediatric Endocrinology, Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Pediatrics, Dordrecht, The Netherlands
| | - Michael Silberbach
- Department of Pediatrics, Doernbecher Children's Hospital, Portland, Oregon, USA
| | | | - Kirstine Stochholm
- Departments of Endocrinology and Internal Medicine
- Center for Rare Diseases, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | | | - Joachim Woelfle
- Department of Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Philippe F Backeljauw
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Rocha PC, Rocha DC, Lemos SMA. Functional health literacy and quality of life of high-school adolescents in state schools in Belo Horizonte. Codas 2017; 29:e20160208. [PMID: 28813073 DOI: 10.1590/2317-1782/20172016208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 04/24/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose To investigate the association between functional health literacy and sociodemographic factors, quality of life, self-perception of health, and perception of contexts of violence in adolescents in state schools in Belo Horizonte. Methods This is a cross-sectional analytical observational study with a probabilistic sample of 384 adolescents between 15 and 19 years old. Data collection was carried out in schools and included self-reporting questionnaires to assess the functional health literacy, socioeconomic classification, self-perceived health, and quality of life. The reliability of internal consistency of the functional health literacy instrument was determined by calculating Cronbach's alpha coefficient. A multivariate logistic regression analysis was performed using hierarchical data entry according to the level of determination of the theoretical model established. In order to evaluate the association, a significance level of 5% was considered, while the Odds Ratio used as a measure of the magnitude of the associations. Results The functional health literacy instrument presented a coefficient of 0.766, indicating adequate internal consistency. More than half of teenagers presented good functional health literacy. In the final model of multivariate analysis, the variables not practicing a religion (p = 0.006; OR = 2.108); social domain of quality of life (p = 0.004; OR = 1.022); and educational domain of quality of life (p = 0.009; OR = 1.019) remained associated with functional health literacy. Conclusion Not practicing a religion and the increase in the scores of social and educational domains of quality of life increased the chances of better functional health literacy.
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Affiliation(s)
- Poliana Cristina Rocha
- Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.,Prefeitura Municipal de Belo Horizonte, Belo Horizonte (MG), Brasil
| | - Dálian Cristina Rocha
- Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.,Prefeitura Municipal de Betim, Betim (MG), Brasil
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Health literacy in childhood and youth: a systematic review of definitions and models. BMC Public Health 2017; 17:361. [PMID: 28441934 PMCID: PMC5405535 DOI: 10.1186/s12889-017-4267-y] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 04/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children and young people constitute a core target group for health literacy research and practice: during childhood and youth, fundamental cognitive, physical and emotional development processes take place and health-related behaviours and skills develop. However, there is limited knowledge and academic consensus regarding the abilities and knowledge a child or young person should possess for making sound health decisions. The research presented in this review addresses this gap by providing an overview and synthesis of current understandings of health literacy in childhood and youth. Furthermore, the authors aim to understand to what extent available models capture the unique needs and characteristics of children and young people. METHOD Six databases were systematically searched with relevant search terms in English and German. Of the n = 1492 publications identified, N = 1021 entered the abstract screening and N = 340 full-texts were screened for eligibility. A total of 30 articles, which defined or conceptualized generic health literacy for a target population of 18 years or younger, were selected for a four-step inductive content analysis. RESULTS The systematic review of the literature identified 12 definitions and 21 models that have been specifically developed for children and young people. In the literature, health literacy in children and young people is described as comprising variable sets of key dimensions, each appearing as a cluster of related abilities, skills, commitments, and knowledge that enable a person to approach health information competently and effectively and to derive at health-promoting decisions and actions. DISCUSSION Identified definitions and models are very heterogeneous, depicting health literacy as multidimensional, complex construct. Moreover, health literacy is conceptualized as an action competence, with a strong focus on personal attributes, while also recognising its interrelatedness with social and contextual determinants. Life phase specificities are mainly considered from a cognitive and developmental perspective, leaving children's and young people's specific needs, vulnerabilities, and social structures poorly incorporated within most models. While a critical number of definitions and models were identified for youth or secondary school students, similar findings are lacking for children under the age of ten or within a primary school context.
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Abstract
Child health literacy is a 'hot topic' of late, as researchers and practitioners work to attain an equitable and healthy future. Health literacy emphasizes the wide range of skills that people need to access, understand, evaluate and use health information to promote good health. In light of the recognition that health literacy is an important determinant of health for adults, addressing child health literacy early on is essential to maximize future health outcomes. Meeting children's specific needs arguably includes the delivery of information that can be easily accessed and understood by younger age groups. While much academic discourse pertains to the importance of building parental health literacy, there is less literature that explicitly focuses on child-centred health literacy. On the premise that health literacy is an asset, this paper provides an argument for investing in children's health literacy by working with children to encourage meaningful contributions in research and practice.
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Affiliation(s)
- Stefania Velardo
- 1 School of Education, Flinders University, Adelaide, South Australia, Australia.,2 Sport, Health and Physical Education Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Murray Drummond
- 1 School of Education, Flinders University, Adelaide, South Australia, Australia.,2 Sport, Health and Physical Education Research Centre, Flinders University, Adelaide, South Australia, Australia
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Hoffman S, Marsiglia FF, Nevarez L, Porta M. Health Literacy among Youth in Guatemala City. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:30-37. [PMID: 27392315 DOI: 10.1080/19371918.2016.1188741] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Health literacy (HL) is recognized as an important health construct that is correlated with various health-related outcomes, but outside of the United States there is limited HL research available, particularly among youth. This study looked at the HL and harmful health behavior (i.e., substance use) of 210 youth across 10 schools in Guatemala City. Based on results from the Newest Vital Sign (NVS) HL assessment, fewer than one third of youth sampled had adequate HL. Training/education to improve adolescent HL is needed in Guatemala City, and the unique skillset of social workers could be an idea method of reaching at-risk youth.
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Affiliation(s)
- Steven Hoffman
- a Department of Social Work , University of Texas at San Antonio , San Antonio , Texas , USA
| | - Flavio F Marsiglia
- b Department of Social Work , Arizona State University , Tempe , Arizona , USA
- c Southwest Interdisciplinary Research Center , Phoenix , Arizona , USA
| | - Lucinda Nevarez
- a Department of Social Work , University of Texas at San Antonio , San Antonio , Texas , USA
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Okan O, Pinheiro P, Zamora P, Bauer U. [Health literacy in childhood and adolescence: An overview and current state of research]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:930-41. [PMID: 26133161 DOI: 10.1007/s00103-015-2199-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Health literacy is multidisciplinary and brings together many concepts, and is of increasing importance for disease protection, health promotion, and prevention, and for health policy within Europe. Although its importance is increasingly recognised, adults are mostly the target audience, whereas children and adolescents, in addition to education and schools, have so far been neglected. OBJECTIVES The aim is to give an overview of the state of the art in childhood and adolescence health literacy research, and to identify any existing gaps. MATERIALS A literature review has been performed to identify the relevant research data. RESULTS Limitations in developmental and age-adjusted conceptual frameworks and a lack of prevalence data, however, significantly impede our understanding of the meaning of health literacy in children and adolescents. School health promotion programmes could serve as a platform for effective health literacy education, beginning in early childhood. CONCLUSIONS In addition to compatibility with a broader literacy perspective, the proximity to several theories of health promotion and defined concepts, and the importance of school health promotion and education, it is vital to focus research on current gaps in the understanding of health literacy determinants, health literacy as a determinant of health, and in terms of the design and systematic implementation of intervention programmes.
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Affiliation(s)
- Orkan Okan
- Fakultät für Erziehungswissenschaft, Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Raum: UHG M7-118, Postfach 10 01 31, 33501, Bielefeld, Deutschland,
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Valerio MA, Peterson EL, Wittich AR, Joseph CLM. Examining health literacy among urban African-American adolescents with asthma. J Asthma 2016; 53:1041-7. [PMID: 27359106 PMCID: PMC5056364 DOI: 10.1080/02770903.2016.1175473] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 03/31/2016] [Accepted: 04/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This exploratory study assessed health literacy among urban African-American high school students to improve understanding of the association between adolescent health literacy and asthma. METHODS We conducted a secondary data analysis of the control group (n = 181) of the Puff City randomized controlled trial (2006-2010), a web-based intervention to promote asthma management among students, grades 9 through 12. A validated self-report 3-item health literacy screening instrument was completed at final online follow-up survey. Logistic regression was used to explore the association between health literacy, demographic characteristics, quality of life, asthma management, and health care utilization. RESULTS Multivariate analysis revealed that an overall inadequate health literacy score was associated with students who were more likely to be younger (OR 0.61; 95% CI 0.44-0.84), not on Medicaid (OR 0.36; 95% CI 0.17-0.76), have at least one hospitalization (OR 1.29; 95% CI 1.07-1.56); and a lower overall quality of life (OR 0.75; 95% CI 0.59-0.95). Those lacking confidence in filling out medical forms, needing help reading hospital materials, and having difficulty understanding written information were more likely to not have a rescue inhaler (OR 0.49; 95% CI 0.25-0.94), have one or more emergency visits (OR 1.21 95% CI 1.02-1.43), and one or more hospitalizations (OR 1.19; 95% CI 1.01-1.41), respectively. CONCLUSIONS The findings indicate a significant association between inadequate health literary and suboptimal asthma management. It is important to advance understanding of adolescent health literacy, especially those at-risk, as they assume asthma self-management tasks and move toward independent adult self-care.
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Affiliation(s)
- Melissa A Valerio
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Edward L Peterson
- b Department of Public Health Sciences , Henry Ford Health System , Detroit , MI , USA
| | - Angelina R Wittich
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Christine L M Joseph
- c Department of Public Health Sciences , Health Disparities Research Collaborative, Henry Ford Health System , Detroit , MI , USA
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Cashin A, Heartfield M, Cox D, Dunn S, Stasa H. Knowledge and motivation: two elements of health literacy that remain low with regard to nurse practitioners in Australia. AUST HEALTH REV 2016; 39:470-475. [PMID: 25751752 DOI: 10.1071/ah14126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/15/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This paper presents analysis of consumer focus groups that were undertaken as a part of the project to develop the now current Nursing and Midwifery Board of Australia's Nurse Practitioner Standards for Practice. METHODS Six focus groups were conducted with consumers around Australia, including urban and remote areas. One purpose for these groups was to explore what was known of nurse practitioners and whether consumers could articulate the difference between the regulated titles of enrolled nurse, registered nurse and nurse practitioner. RESULTS Consumers' knowledge of nurses' roles in the Australian primary healthcare system, and hence system literacy (particularly in terms of navigating the system), was low. Of perhaps greatest importance is the fact that those consumers with low health systems literacy also exhibited a low level of motivation to seek new knowledge. Many consumers relied on the medical profession to direct care. CONCLUSION The low levels of health literacy raise questions of how to meaningfully include health consumers in innovative health-related policy work.
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Affiliation(s)
- Andrew Cashin
- School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia. Email
| | - Marie Heartfield
- School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia. Email
| | - Darlene Cox
- Health Care Consumers' Association Inc, 100 Maitland Street, Hackett, ACT 2602, Australia. Email
| | - Sandra Dunn
- Clinical Practice, School of Health, Casurina Campus, Charles Darwin University, NT 0811, Australia. Email
| | - Helen Stasa
- Sydney Nursing School, University of Sydney, NSW 2050, Australia.
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Ghanbari S, Ramezankhani A, Montazeri A, Mehrabi Y. Health Literacy Measure for Adolescents (HELMA): Development and Psychometric Properties. PLoS One 2016; 11:e0149202. [PMID: 26881933 PMCID: PMC4755574 DOI: 10.1371/journal.pone.0149202] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/28/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Health literacy refers to personal competencies for the access to, understanding of, appraisal of and application of health information in order to make sound decisions in everyday life. The aim of this study was to develop and evaluate the psychometric properties of an instrument for the measurement of health literacy among adolescents (the Health Literacy Measure for Adolescents-HELMA). METHODS This study was made up of two phases, qualitative and quantitative, which were carried out in 2012-2014 in Tehran, Iran. In the qualitative part of the study, in-depth interviews with 67 adolescents aged 15-18 were carried out in 4 high schools to generate the initial item pool for the survey. The content validity of the items was then assessed by an expert panel review (n = 13) and face validity was assessed by interviewing adolescents (n = 16). In the quantitative part of the study, in order to describe the psychometric properties of the scale, validity, reliability (internal consistency and test-retest) and factor analysis were assessed. RESULTS An item pool made up of 104 items was generated at the qualitative stage. After content validity was considered, this decreased to 47 items. In the quantitative stage, 582 adolescents aged 15-18 participated in the study with a mean age of 16.2 years. 51.2% of participants were females. In principal component factor analysis, 8 factors were loaded, which accounted for 53.37% of the variance observed. Reliability has been approved by α = 0.93 and the test-retest of the scale at two-week intervals indicated an appropriate stability for the scale (ICC = 0.93). The final questionnaire was approved with 44 items split into eight sections. The sections were titled: gain access to, reading, understanding, appraise, use, communication, self-efficacy and numeracy. CONCLUSION The Health Literacy Measure for Adolescents (HELMA) is a valid and reliable tool for the measurement of the health literacy of adolescents aged 15-18 and can be used to evaluate different levels of functional, interactive, and critical health literacy in adolescents.
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Affiliation(s)
- Shahla Ghanbari
- Department of Public Health, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Public Health, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Rocha PC, Lemos SMA. Aspectos conceituais e fatores associados ao Letramento Funcional em Saúde: revisão de literatura. REVISTA CEFAC 2016. [DOI: 10.1590/1982-021620161819615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo é revisar as produções científicas acerca da avaliação do letramento funcional em saúde em associação com a qualidade de vida; e analisar metodologicamente os estudos observacionais sobre a temática. Trata-se de revisão integrativa de literatura produzida com base em artigos relacionados aos seguintes eixos temáticos: letramento funcional em saúde e qualidade de vida, com busca realizada nas bases de dados PubMed, Lilacs, Biblioteca Virtual em Saúde. Após a aplicação dos critérios de inclusão obteve-se 538 artigos e após a aplicação dos critérios de exclusão foram selecionados 11 artigos sendo nove estudos internacionais e dois nacionais. A revisão constou de compilação e construção de linha histórica das publicações, análise metodológica dos estudos observacionais e elaboração de nuvem de textos. A maior parte dos artigos tem análise quantitativa; público alvo adultos e idosos e medem o nível de letramento funcional em saúde. Os estudos verificaram relação positiva do letramento funcional em saúde com a baixa escolaridade, idade mais avançada, sexo masculino e baixa renda. Os principais cenários foram ambientes assistenciais. O letramento funcional em saúde apresentou associação com variáveis sócio-demográficas como sexo, idade e escolaridade. A maior parte dos estudos encontrados na busca teve como objetivo relacionar o letramento a patologias e foi realizado em ambientes clínicos (ambulatórios e hospitais). Dos oito artigos observacionais incluídos na presente revisão atenderam totalmente aos critérios metodológicos para elaboração desse tipo de estudo.
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O′Neill B, Gonçalves D, Ricci-Cabello I, Ziebland S, Valderas J. An overview of self-administered health literacy instruments. PLoS One 2014; 9:e109110. [PMID: 25478813 PMCID: PMC4257499 DOI: 10.1371/journal.pone.0109110] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/28/2014] [Indexed: 11/18/2022] Open
Abstract
With the increasing recognition of health literacy as a worldwide research priority, the development and refinement of indices to measure the construct is an important area of inquiry. Furthermore, the proliferation of online resources and research means that there is a growing need for self-administered instruments. We undertook a systematic overview to identify all published self-administered health literacy assessment indices to report their content and considerations associated with their administration. A primary aim of this study was to assist those seeking to employ a self-reported health literacy index to select one that has been developed and validated for an appropriate context, as well as with desired administration characteristics. Systematic searches were carried out in four electronic databases, and studies were included if they reported the development and/or validation of a novel health literacy assessment measure. Data were systematically extracted on key characteristics of the instruments: breadth of construct (“generic” vs. “content- or context- specific” health literacy), whether it was an original instrument or a derivative, country of origin, administration characteristics, age of target population (adult vs. pediatric), and evidence for validity. 35 articles met the inclusion criteria. There were 27 original instruments (27/35; 77.1%) and 8 derivative instruments (8/35; 22.9%). 22 indices measured “general” health literacy (22/35; 62.9%) while the remainder measured condition- or context- specific health literacy (13/35; 37.1%). Most health literacy measures were developed in the United States (22/35; 62.9%), and about half had adequate face, content, and construct validity (16/35; 45.7%). Given the number of measures available for many specific conditions and contexts, and that several have acceptable validity, our findings suggest that the research agenda should shift towards the investigation and elaboration of health literacy as a construct itself, in order for research in health literacy measurement to progress.
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Affiliation(s)
- Braden O′Neill
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Daniela Gonçalves
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Ignacio Ricci-Cabello
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jose Valderas
- Medical School, University of Exeter, Exeter, United Kingdom
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Ormshaw MJ, Paakkari LT, Kannas LK. Measuring child and adolescent health literacy: a systematic review of literature. HEALTH EDUCATION 2013. [DOI: 10.1108/he-07-2012-0039] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Massey P, Prelip M, Calimlim B, Afifi A, Quiter E, Nessim S, Wongvipat-Kalev N, Glik D. Findings toward a multidimensional measure of adolescent health literacy. Am J Health Behav 2013; 37:342-50. [PMID: 23985181 DOI: 10.5993/ajhb.37.3.7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore a multidimensional measure of health literacy that incorporates skills necessary to manage one's health environment. METHODS We designed a questionnaire to assess variation in an expanded understanding of health literacy among publicly insured adolescents in California (N = 1208) regarding their health care experiences and insurance. RESULTS Factor loading and item clustering patterns reflected in the exploratory principal components factor analysis suggest that the data are parsimoniously described by 6 domains. CONCLUSION This multidimensional measure becomes relevant in an era of health care reform in which many will for the first time have health insurance requiring them to navigate a system that uses a managed care model.
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Affiliation(s)
- Philip Massey
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
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