Health literacy research and practice最新文献

{"title":"Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health.","authors":"Sarah J Schmiege, Luohua Jiang, Judith Albino, Rachel L Johnson, Anne R Wilson, Angela G Brega","doi":"10.3928/24748307-20230419-01","DOIUrl":"10.3928/24748307-20230419-01","url":null,"abstract":"<p><strong>Background: </strong>Although health literacy (HL) skills may change over time, most research treats HL as a constant, using baseline HL to predict other health-related constructs. Few studies have explored change in HL over time.</p><p><strong>Objective: </strong>We examined person-level differences in HL trajectories. We identified subgroups (latent classes) based on longitudinal assessments of HL and examined the association of class membership with demographic and oral health variables.</p><p><strong>Methods: </strong>We used four measurement waves of parental HL data, reflecting the risk of limited HL, collected as part of an intervention to reduce dental decay in American Indian children (<i>N</i> = 579 parent-child dyads at baseline). Repeated measures latent class analysis (RMLCA) models were estimated to identify subgroups of HL trajectories over time. We examined class membership in association with baseline demographics and with 36-month assessments of parental oral health knowledge, beliefs, and behaviors as well as pediatric oral health.</p><p><strong>Key results: </strong>A four-class model best fit the data. The largest class (<i>high HL</i>; 49.7% of the sample) was characterized by high levels of HL at all waves. A second class (improving HL; 17.7%) improved over all waves. The remaining two classes were characterized as moderate HL (20%) and low HL (12.6%) and maintained relatively stable HL levels over time. Higher educational attainment was associated with membership in the <i>high HL</i> and <i>improving HL</i> classes. Older age among this young-adult sample and higher income also were associated with <i>high HL</i> class membership. Parents in the high HL and <i>improving HL</i> classes exhibited more favorable performance on measures of oral health knowledge, beliefs, and behavioral adherence than did those in the other classes. Class membership was not associated with pediatric oral health.</p><p><strong>Conclusions: </strong>RMLCA demonstrated person-level variability in HL trajectories. Longitudinal patterns were associated with baseline demographics and prospectively with parental oral health knowledge, beliefs, and behaviors, but not with pediatric oral health. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(2):e89-e98.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 2","pages":"e89-e98"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/90/hlrp0523schmiegeor-prt.PMC10169466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9704430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Health Literacy, Quality of Life, and Treatment Adherence in Patients with Acute Coronary Syndrome.","authors":"Mohammad Ali Zakeri,&nbsp;Asghar Tavan,&nbsp;Ali Esmaeili Nadimi,&nbsp;Golamreza Bazmandegan,&nbsp;Maryam Zakeri,&nbsp;Nadia Sedri","doi":"10.3928/24748307-20230320-01","DOIUrl":"https://doi.org/10.3928/24748307-20230320-01","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome is a significant global health concern that can affect patients' health outcomes and quality of life. In addition, adherence to treatment and health literacy can affect health outcomes.</p><p><strong>Objective: </strong>This study aimed to investigate the relationship between treatment adherence, health literacy, and quality of life among patients with acute coronary syndrome.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 407 patients in Iran from April 2019 to November 2019. Patients were selected by convenience sampling method. Data were collected using demographic questionnaire, World Health Organization Quality of Life Brief Version, Adherence to Treatment Questionnaire, and Health Literacy for Iranian Adults questionnaire. SPSS 25 was used for statistical analysis.</p><p><strong>Results: </strong>Based on descriptive statistics in this study, most of the participants had good treatment adherence level (56.5%); 28.7% of the participants had insufficient health literacy level. The mean score of quality of life was 51.41 ± 12.03, which was greater than the midpoint of the questionnaire. Furthermore, Pearson's correlation coefficient showed a negative association between health literacy, treatment adherence (r = -0.167, <i>p</i> < .01), and quality of life (r = -0.153, <i>p</i> < .01), and a positive association between treatment adherence and quality of life (<i>r</i> = 0.169, <i>p</i> < .01).</p><p><strong>Conclusion: </strong>The results of the current study showed a negative relationship between health literacy, quality of life, and treatment adherence among patients with acute coronary syndrome. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(2):e71-e79.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 2","pages":"e71-e79"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10104679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9703373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"e-Health Literacy Scale, Patient Attitudes, Medication Adherence, and Internal Locus of Control.","authors":"Donrie J Purcell,&nbsp;Gesulla Cavanaugh,&nbsp;Kamilah B Thomas-Purcell,&nbsp;Joshua Caballero,&nbsp;Drenna Waldrop,&nbsp;Victoria Ayala,&nbsp;Rosemary Davenport,&nbsp;Raymond L Ownby","doi":"10.3928/24748307-20230417-01","DOIUrl":"https://doi.org/10.3928/24748307-20230417-01","url":null,"abstract":"<p><strong>Background: </strong>Health literacy is related to a variety of health outcomes, including disease control, health-related quality of life, and risk for death. Few studies have investigated the relation of electronic health literacy (e-health literacy) to outcomes or the mechanism by which they may be related.</p><p><strong>Methods: </strong>Secondary data were drawn from participants in a larger study on chronic disease self-management who were age 40 years and older, had at least one chronic health condition and a health literacy score of 8th grade or below on the validated short form of the Rapid Estimate of Adult Literacy in Medicine. Participants completed the e-Health Literacy Scale (eHEALS), the Multidimensional Health Locus of Control scale, a modified version of the Attitudes Toward Health Care Providers Scale (ATHCPS), the Wake Forest Physician Trust Scale (WFPTS), and the Gonzalez-Lu adherence questionnaire. Hypothesized relations were evaluated in a bootstrapped path analytic model using the Mplus statistical software.</p><p><strong>Key results: </strong>Participants included 334 individuals (mean age: 57.5 years; 173 women and 161 men) with Black, Indigenous, and People of Color accounting for 83.3% of the participants and White individuals making up 16.7% of the participants. Model results showed that after controlling for age, education, gender, and race, the eHEALS score was significantly related to the ATHCPS and WFPTS but not to the Gonzalez-Lu adherence questionnaire (<i>p</i> < .05). The eHEALS score was significantly related to the Multidimensional Health Locus of Control scale. Analysis of indirect effects showed that a portion of the relation between e-health literacy and patient attitude and adherence was mediated by internal locus of control (all <i>p</i> < .05).</p><p><strong>Conclusions: </strong>In this study, e-health literacy was related to important patient attitude and behavior variables via locus of control. This finding has implications for the importance of improving patients' ability to use the internet to access and effectively use health information. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(2):e80-e88.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 2","pages":"e80-e88"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9704429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Mothers' Health Literacy: Findings From the KUNO-Kids Study.","authors":"Maja Pawellek,&nbsp;Angela Köninger,&nbsp;Michael Melter,&nbsp;Michael Kabesch,&nbsp;Christian Apfelbacher,&nbsp;Susanne Brandstetter","doi":"10.3928/24748307-20230131-01","DOIUrl":"https://doi.org/10.3928/24748307-20230131-01","url":null,"abstract":"<p><strong>Background and objective: </strong>The aim of this study was to analyze the longitudinal development of health literacy (HL) in a large cohort of new mothers in Germany and to investigate which determinants are associated with the initial HL level and with change over time.</p><p><strong>Methods: </strong>Longitudinal data from 1,363 mothers participating with their child in the KUNO-Kids Health Study was used; data were collected at birth of the child (baseline), after 6 and 12 months, using interviews and self-report questionnaires. The HL of mothers was assessed with the health care scale of the European Health Literacy Survey Questionnaire, which has 16 items on accessing, understanding, appraising, and applying health information in the health care setting. Latent growth curve models were used to analyze average trajectories and predictors of HL in the total sample and in the subgroup of first-time mothers.</p><p><strong>Key results: </strong>HL values increased from baseline (<i>M</i> = 35.46, standard deviation [<i>SD</i>] = 7.34) over 6 months (<i>M</i> = 37.31, <i>SD</i> = 7.31) to 12 months (<i>M</i> = 38.01, <i>SD</i> = 7.41). The increase was statistically significant in the total sample (1.188, standard error [SE] = 0.087, <i>p</i> < .001) and in the subgroup of first-time mothers (1.357, <i>SE</i> = 0.113, <i>p</i> <. 001), with a steeper trajectory for mothers with lower HL at baseline. Several personal and situational variables were associated with HL at baseline (e.g., education, child health) and with its development (e.g., number of children).</p><p><strong>Conclusion: </strong>Overall, new mothers became slightly more health literate during their child's first year of life. However, some groups of mothers could benefit from support in developing HL skills even before childbirth. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(1):e39-e51.</b>] Plain Language Summary: We investigated how health literacy (that is the ability to find, understand, and apply health information) develops in new mothers in Germany. Mothers told us that this ability slightly improved during the child's first year of life. Some mothers still have difficulties in dealing with health information; these mothers should be supported even before childbirth.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 1","pages":"e39-e51"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/e7/hlrp0223pawellekor-prt.PMC9918306.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10787302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy and Adherence to Clinical Recommendations in Head and Neck Cancer.","authors":"Randall J Harley,&nbsp;Karley Atchison,&nbsp;Jinhong Li,&nbsp;Karen Losego,&nbsp;Tamara Wasserman-Wincko,&nbsp;Jonas T Johnson,&nbsp;Marci L Nilsen","doi":"10.3928/24748307-20230222-01","DOIUrl":"https://doi.org/10.3928/24748307-20230222-01","url":null,"abstract":"<p><strong>Background: </strong>After definitive cancer treatment, survivors of head and neck cancer (HNC) are commonly recommended to participate in therapies aimed at reducing the burden of treatment-related side effects.</p><p><strong>Objective: </strong>In this study, we evaluated whether adherence to referral to physical therapy (PT) and speech-language pathology therapy (SLPT) is related to patient health literacy (HL).</p><p><strong>Methods: </strong>This is a retrospective cohort analysis of patients attending a multidisciplinary HNC survivorship clinic between 2017 and 2019. HL was measured using the Brief Health Literacy Screen, with scores below 10 indicating inadequate HL. Chi-square and logistic regression were used to evaluate the association between HL and adherence to PT or SLPT referral.</p><p><strong>Key results: </strong>From the overall cohort (<i>N</i> = 454), 80 patients (18%) had inadequate HL. Compared to those with adequate HL, patients with inadequate HL were significantly less likely to complete initial PT evaluation (74% vs. 58%, <i>p</i> = .034) but were not significantly less likely to complete initial SLPT evaluation (70% vs. 61%, <i>p</i> = .37). After adjusting for age, primary tumor site, and treatment stage, we found that patients with inadequate HL were half as likely to follow up for initial PT evaluation (odds ratio 0.45, <i>p</i> = .032).</p><p><strong>Conclusion: </strong>Overall, inadequate HL is associated with reduced adherence to PT but is not associated with adherence to SLPT among HNC survivors. These results highlight the clinical importance of HL and underscore the need for interventions to facilitate adherence to treatment for patients with inadequate HL. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(1):e52-e60.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 1","pages":"e52-e60"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/19/hlrp0323harleyor-prt.PMC9991085.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9474137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy as a Mediator of the Relationship Between Socioeconomic Position and Pre-Exposure Prophylaxis Uptake Among Men Who Have Sex with Men Living in France.","authors":"Youssoufa M Ousseine,&nbsp;Cécile Allaire,&nbsp;Virginie Ringa,&nbsp;Nathalie Lydie,&nbsp;Annie Velter","doi":"10.3928/24748307-20230224-01","DOIUrl":"https://doi.org/10.3928/24748307-20230224-01","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, several research studies have mentioned a potential mediating effect of health literacy (HL) on the relationship between socioeconomic position and health prevention behaviors. However, no study to date has investigated this hypothesis on HIV prevention behaviors.</p><p><strong>Objective: </strong>The present study aimed to evaluate whether HL mediates the relationship between socioeconomic status (SES) and pre-exposure prophylaxis (PrEP) uptake in men who have sex with men (MSM).</p><p><strong>Methods: </strong>The study is based on data collected in the Enquête Rapport au Sexe [report to sex] 2019 survey, an anonymous, self-administered online cross-sectional survey in France conducted between February 16, 2019 and March 31, 2019. Data on education level and perceived financial situation were used as measures of SES, whereas HL was assessed from the Health Literacy Questionnaire's \"ability to actively engage with health care providers\" scale. Mediation analyses were performed with a model-based causal moderated mediation analysis package in R software. Analyses were adjusted for age, place of residence, marital status, and social support.</p><p><strong>Key results: </strong>The study sample included 13,629 MSM. Median age was 32 years. The majority had an education level higher than upper secondary school (78%) and an adequate HL level (73%). Almost two-thirds perceived their financial situation as comfortable (62%). Overall, PrEP uptake was low (9.5%). The analyses did not show a mediating effect of HL on the relationship between education and PrEP uptake. However, a total mediation effect of HL was observed on the relationship between perceived financial situation and uptake.</p><p><strong>Conclusions: </strong>In the context of PrEP uptake, MSM ability to actively engage with health care providers may offset the effect of a difficult financial situation. In the current French context, where PrEP is now also available in general practitioner settings, this result could inform the development of training and support policies for health professionals and the way in which sexual health issues are addressed in consultations. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(1):e61-e70.</b>].</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 1","pages":"e61-e70"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/2a/hlrp0323ousseineor-prt.PMC9991084.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9474138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Older Adult Health Literacy in the Day-to-Day Management of Polypharmacy and Making Decisions About Deprescribing: A Mixed Methods Study.","authors":"Robyn Gillespie, Judy Mullan, Lindsey Harrison","doi":"10.3928/24748307-20221216-01","DOIUrl":"10.3928/24748307-20221216-01","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy use in older adults is increasing and sometimes leads to poor health outcomes. The influence of health literacy in managing polypharmacy and making decisions about stopping medication has received limited attention.</p><p><strong>Objective: </strong>A mixed methods design was used to measure and investigate the influence of health literacy in the management of polypharmacy and decisions about deprescribing. Phase 1 involved two cross-sectional surveys, one with older adults using five or more medications and the other with general practitioners (GPs).</p><p><strong>Methods: </strong>Older adult health literacy was measured using the All Aspects of Health Literacy Scale. Phase 2 employed individual interviews with both older adults and GPs and further explored the reported use of health literacy in practice. SPSS version 24 was used to conduct descriptive statistical analysis of the Phase 1 survey responses and Phase 2 interviews were analyzed using thematic analysis with the assistance of NVivo 12.</p><p><strong>Key results: </strong>Phase 1 survey responses were received from 85 GPs and 137 older adults. Phase 2 interviews were conducted with 16 GPs and 25 older adults. Phase 1 results indicated that self-reported older adult health literacy was high, and that GPs believed older patients could engage in decisions about deprescribing. Phase 2 findings showed that older adults developed and employed complex health literacy practices to manage medications between consultations; however, few reported using their health literacy skills in consultations with their GPs. GPs noted that older adult involvement in decision-making varied and generally thought that older adults had low health literacy.</p><p><strong>Conclusion: </strong>Older adults reported using health literacy practices in the management of their sometimes-complex medication regimens. However, the role of health literacy in deprescribing decision-making was limited. The mixed methods approach allowed greater insight into older adult and GP practices that influence the acquisition and use of health literacy. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(1):e14-e25.</b>] Plain Language Summary: This report explores health literacy in the use of multiple medications and decisions to stop using medication/s in older age. Older adults reported good heath literacy and practiced many health literacy skills in the management of their medications. However, they did not always report the use of their health literacy skills when discussing their medications with their family doctor.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 1","pages":"e14-e25"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9833258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10711008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Puzzling Thank You.","authors":"Michael K Paasche-Orlow","doi":"10.3928/24748307-20221213-01","DOIUrl":"https://doi.org/10.3928/24748307-20221213-01","url":null,"abstract":"","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 1","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9833254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10588531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in the Mediating Role of HL in Socioeconomic Inequalities in Health Across Age Groups: Results from the Dutch Doetinchem Cohort Study.","authors":"Silvia S Klokgieters,&nbsp;H Susan J Picavet,&nbsp;Martijn Huisman,&nbsp;W M Monique Verschuren,&nbsp;Ellen A H Uiters,&nbsp;Almar A L Kok","doi":"10.3928/24748307-20230124-01","DOIUrl":"https://doi.org/10.3928/24748307-20230124-01","url":null,"abstract":"<p><strong>Background: </strong>Although it is known that health literacy (HL) plays an explanatory role in educational inequalities in health, it is unknown whether this role varies across age groups.</p><p><strong>Objective: </strong>The purpose of this study was to investigate whether the mediating role of HL in educational inequalities in four health outcomes varies across age groups: age 46 to 58 years, age 59 to 71 years, and age 72 to 84 years.</p><p><strong>Methods: </strong>We used data from the Dutch Doetinchem Cohort Study, which included 3,448 participants. We included years of education as predictor, chronic illness prevalence and incidence, mental and self-perceived health as outcomes, and HL, based on self-report, as mediator. We used multiple-group mediation models to compare indirect effects across age groups.</p><p><strong>Key results: </strong>In the complete sample without age stratification, HL partly mediated the effect of education on all health outcomes except for incidence of chronic diseases. These indirect effect estimates were larger for subjective (self-perceived health, proportion mediated [PM] = 37%, and mental health, <i>PM</i> = 37%) than for objective health outcomes (prevalence of chronic disease, <i>PM</i> = 17%). For the prevalence of chronic disease, the indirect effect estimate was significantly larger among individuals age 46 to 58 years compared to individuals age 59 to 71 years and for incidence of chronic disease also compared to individuals age 72 to 84 years. All other indirect effect estimates did not differ significantly between age groups. Using an alternative cut-off point for HL or adjusting for cognitive functioning did not meaningfully change the results.</p><p><strong>Conclusions: </strong>Overall, we found that the explanatory role of HL in educational inequalities in mental and subjective health was stable but that it varied across age groups for chronic diseases, where it was largest among individuals age 46 to 58 years. Future studies may investigate the benefits of starting to intervene on HL from a younger age but means to improve HL may also benefit the subjective health of older adults with lower education. <b>[<i>HLRP: HL Research and Practice</i>. 2023;7(1):e26-e38.]</b> Plain Language Summary: This study examined age-group differences in the mediating role of HL in the relationship between education and health. Overall, we found that the explanatory role of HL in educational inequalities in mental and subjective health was stable but that it varied across age groups for chronic diseases, where it was largest among individuals age 46 to 58 years compared to individuals age 59 to 71 years and individuals age 72 to 84 years.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 1","pages":"e26-e38"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/e5/hlrp0223klokgietersor-prt.PMC9918305.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10772874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy and Serious or Persistent Mental Illness: A Mixed Methods Study.","authors":"Allen McLean,&nbsp;Donna Goodridge,&nbsp;James Stempien,&nbsp;Douglas Harder,&nbsp;Nathaniel Osgood","doi":"10.3928/24748307-20221215-01","DOIUrl":"https://doi.org/10.3928/24748307-20221215-01","url":null,"abstract":"<p><strong>Background: </strong>Health literacy is increasingly recognized as a major determinant of health; however, our insights into the health literacy strengths and needs of adults living with serious or persistent mental illness remain limited by a notable lack of research in this area. Improving our understanding is important because people in this group are especially vulnerable to numerous negative health outcomes, many preventable.</p><p><strong>Objective: </strong>To assess the health literacy strengths and needs of people living with serious or persistent mental illness in terms of their ability to acquire, understand, and use information about their illness and the health services they require.</p><p><strong>Methods: </strong>A cross-sectional convergent mixed methods design guided by the Ophelia Access and Equity Framework. People diagnosed with serious or persistent mental illness were offered participation. Quantitative and qualitative data was collected using questionnaires (Health Literacy Questionnaire [HLQ], World Health Organization [WHO-5]) and semi-structured interviews. Hierarchical cluster analysis identified and grouped participants with similar health literacy scores into mutually exclusive groups, for the development of clinical vignettes.</p><p><strong>Key results: </strong>Participants struggled most with the appraisal of health information (HLQ mean 2.72, standard deviation [<i>SD</i>] .63 [scale 1-4]) and navigating what they often perceived to be a confusing health care system (HLQ mean 3.29, SD .79 [scale 1-5]). On the other hand, most participants reported positive experiences with their health care providers (HLQ mean 3.19, SD .62 [scale 1-4]) and generally felt understood and supported. The cluster analysis suggests we should not assume people living with serious or persistent mental illness have homogeneous HL strengths and needs, meaning a one-size-fits-all solution for improving health literacy in this diverse group will likely not be a successful strategy. It will be important to explore solutions that embrace patient-centered care approaches.</p><p><strong>Conclusions: </strong>This study is one of only a handful assessing the health literacy strengths and needs of people living with serious or persistent mental illness. By collecting both quantitative and qualitative data, then analyzing the results using sophisticated cluster analysis methods, the authors were able to develop clinical vignettes per the Ophelia Framework that offer results in a practical way that can be readily understood and acted upon by stakeholders. We found that the HLQ is a measure of HL that is acceptable to mental health clients, and our findings provide preliminary data on the use of this instrument in the mental health population. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2023;7(1):e2-e13.</b>] Plain Language Summary: This study explored the health literacy strengths and needs of people living with serious or pers","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"7 1","pages":"e2-e13"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/0b/hlrp0123mcleanor-prt.PMC9833263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10703539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}