Health literacy research and practice最新文献

{"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}

{"title":"The Relationship Between Health Literacy and Mental Health Attitudes and Beliefs.","authors":"Sasha A Fleary,&nbsp;Patrece L Joseph,&nbsp;Carolina Gonçalves,&nbsp;Jessica Somogie,&nbsp;Jessica Angeles","doi":"10.3928/24748307-20221018-01","DOIUrl":"https://doi.org/10.3928/24748307-20221018-01","url":null,"abstract":"<p><strong>Background: </strong>Mental health first aid programs show promise in reducing stigma and increasing help-seeking. However, the success of these and other mental health interventions are likely affected by health literacy. Yet, health literacy is understudied in the mental health literature and rarely considered in mental health interventions.</p><p><strong>Objective: </strong>This study explored the relationship between health literacy and mental health stigma, aversion to mental health help-seeking, and willingness to interact with individuals with mental illnesses.</p><p><strong>Methods: </strong>Adults (<i>N</i> = 601, mean age = 45.64) completed online surveys of their health literacy and mental health attitudes and beliefs. Hierarchal linear regression models were estimated to examine the relationship between health literacy and mental health attitudes and beliefs. Path models were estimated to determine if stigma mediated the relationship between health literacy and (1) aversion to help-seeking and (2) willingness to interact with individuals with mental illnesses.</p><p><strong>Key results: </strong>Adults with higher functional and communicative health literacy had lower mental health stigma and aversion to mental health help-seeking. Adults with higher communicative health literacy and empowerment were more willing to interact with individuals with mental illnesses. Mental health stigma partially mediated the relationships between communicative health literacy and aversion to mental health help-seeking and willingness to interact with individuals with mental illnesses. Mental health stigma fully mediated the relationships between functional health literacy and aversion to mental health help-seeking and willingness to interact with individuals with mental illnesses.</p><p><strong>Conclusions: </strong>Results support including health literacy in mental health interventions and reiterate addressing stigma in community and clinical settings. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2022;6(4):e270-e279.</b>] Plain Language Summary: Many adults with mental health problems do not get help because of negative beliefs about mental health. We found that adults with more skills for accessing, understanding, and using health information had fewer negative opinions and were more willing to interact with others with mental health problems. Improving those skills may reduce negative opinions about mental health and seeking help.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":" ","pages":"e270-e279"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40453170","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":"Validation of the Short-Test of Functional Health Literacy in Adults for the Samoan Population.","authors":"Va'atausili Tofaeono,&nbsp;Katherine Tong,&nbsp;Angela Sy,&nbsp;Kevin Cassel,&nbsp;Ian Pagano,&nbsp;Lana Sue Ilima Ka'opua,&nbsp;Luana Scanlan,&nbsp;Lemala Thompson,&nbsp;Tulimalefoi Vaofanua,&nbsp;Jueta B McCutchan,&nbsp;Victor Tofaeono","doi":"10.3928/24748307-20220920-01","DOIUrl":"https://doi.org/10.3928/24748307-20220920-01","url":null,"abstract":"<p><strong>Background: </strong>Health literacy encompasses various levels of communication for an individual, provider, and an organization. Validated and reliable tools have been developed to assess health literacy; however, there is a paucity of tools available to assess health literacy in native languages for indigenous and racial/ethnic minority populations.</p><p><strong>Objective: </strong>This article shares the process taken to translate and evaluate validation and reliability of the Short Test of Functional Health Literacy in Adults for use with the Samoan population.</p><p><strong>Methods: </strong>Respondent-driven sampling was used to collect data from 1,543 adults age 45 years and older in American Samoa. A confirmatory factor analysis using a two-factor model for validation was conducted.</p><p><strong>Key results: </strong>The validation results indicated a \"good fit\" in multiple indices and Cronbach's alpha indicated high internal consistency in both the English and Samoan languages.</p><p><strong>Conclusions: </strong>Developing culturally validated and reliable health literacy assessment tools is important to help health care professionals decrease health disparities and address inadequate health literacy in all cultures. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2022;6(4):e247-e256.</b>] Plain Language Summary: The INSPIRE project studied the Short Test of Functional Health Literacy in Adults (STOFHLA) tested on the American Samoan population age 50 years and older. The results would show if the STOFHLA is a valid tool to measure functional health literacy in American Samoa adults.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"6 4","pages":"e247-e256"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/0e/hlrp1022tofaeonoor-prt.PMC9545820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955933","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-Learning Material of Evidence-Based Medicine for Laypersons.","authors":"Satoe Okabayashi,&nbsp;Kyoko Kitazawa,&nbsp;Takashi Kawamura,&nbsp;Takeo Nakayama","doi":"10.3928/24748307-20221113-01","DOIUrl":"https://doi.org/10.3928/24748307-20221113-01","url":null,"abstract":"<p><strong>Background: </strong>There is a need for evidence-based medicine (EBM) education for laypersons. However, there are few materials or opportunities to learn EBM for Japanese laypersons.</p><p><strong>Objective: </strong>The aim of this study was to develop and test the usability of e-learning material on EBM for health-conscious laypersons in Japan.</p><p><strong>Methods: </strong>This study was conducted in two steps. First, content elements for the material were identified using purposive evaluation and a prototype of the e-learning material was developed. Following this, usability testing of the material was conducted. A questionnaire survey and qualitative semi-structured focus group interviews were conducted with health-conscious laypersons. Subsequently, the material was refined and finalized.</p><p><strong>Key results: </strong>A total of 217 descriptions related to EBM were extracted from 12 materials and were integrated into 56 major elements. Each element was rated from the viewpoint of usefulness for laypersons and reviewed by four expert panelists, and finally 18 elements were confirmed, most of which were critical appraisal skills related to critical health literacy. For the usability testing after constructing the material, 25 laypersons participated, and 19 (76%) felt <i>very</i>/<i>rather</i> much interest in the contents of the material in the questionnaire. The results of five focus group interviews showed that the effectiveness of the e-learning material was influenced by the story and characters, and whether the contents of the material were consistent with interviewees' daily interests.</p><p><strong>Conclusions: </strong>The e-learning material on EBM was found to be of interest to health-conscious laypersons and appeared to be useful in participants' daily lives. This study successfully developed novel e-learning material on the essential components of EBM for laypersons in Japan. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2022;6(4):e290-e299.</b>] Plain Language Summary: This study developed and tested the usability of e-learning material to encourage health-conscious laypersons in Japan to learn the fundamentals of evidence-based medicine. Most of the contents of the material are related to critical health literacy. The usability testing showed that the material was of interest to non-health professionals and useful for dealing with health information in their daily lives.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"6 4","pages":"e290-e299"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/b2/hlrp1222okabayashioa-prt.PMC9726227.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10466873","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":"Housing and Food Insecurity, Health Literacy, and Maladaptive Coping Behaviors.","authors":"Patrece L Joseph,&nbsp;Janelle Applewhite,&nbsp;Sasha A Fleary","doi":"10.3928/24748307-20221019-01","DOIUrl":"https://doi.org/10.3928/24748307-20221019-01","url":null,"abstract":"<p><strong>Background: </strong>Stressors related to social determinants of health (SDH), such as housing and food insecurity, are implicated in chronic disease risk. Maladaptive strategies for coping with these stressors may exacerbate risk.</p><p><strong>Objective: </strong>Given the limited research on SDH-related stressors and maladaptive coping, this study examined the relationship between two SDH-related stressors (housing and food insecurity) and maladaptive coping behaviors (i.e., emotional eating and stress-related cigarette and alcohol use) in adults. Further, because health literacy (HL), another SDH, may be a protective factor, this study explored whether HL moderated these relationships.</p><p><strong>Methods: </strong>Data were collected from adults (<i>N</i> = 500, Mean age = 49.01 years, standard deviation = 16.36; 40% White) in the United States. A series of hierarchical logistic regressions predicting maladaptive coping behaviors from demographics, SDH-related stressors (i.e., housing or food insecurity), and HL variables were estimated.</p><p><strong>Key results: </strong>Housing insecurity was associated with increased odds of emotional eating (odds ratio [OR] = 1.48, <i>p</i> < .001), stress-related cigarette use (<i>OR</i> = 1.34, <i>p</i> = .001), and stress-related alcohol use (<i>OR</i> = 1.32, <i>p</i> = .001). Food insecurity was associated with increased odds of emotional eating (<i>OR</i> = 1.49, <i>p</i> = .012), stress-related cigarette (<i>OR</i> = 1.68, <i>p</i> = .002), and stress-related alcohol use (<i>OR</i> = 1.49, <i>p</i> = .013). Higher functional HL scores were associated with decreased odds of emotional eating after accounting for housing (<i>OR</i> = 0.79, <i>p</i> = .017) and food insecurity (<i>OR</i> = 0.76, <i>p</i> = .004). Communicative and critical HL moderated the relationship between food insecurity and emotional eating.</p><p><strong>Conclusions: </strong>Examining HL in relation to SDH-related stressors and maladaptive coping behaviors is complex. HL may be less protective for maladaptive coping behaviors that are likely addictive. Because HL domains may require cooperation between individuals and systems related to stressors, multi-systemic interventions are necessary to reduce maladaptive coping behaviors. [<b><i>HLRP: Health Literacy Research and Practice</i>. 2022;6(4):e280-e289.</b>] Plain language summary: Stress related to inadequate resources for housing and food may be related to adults' poor coping behaviors (e.g., emotional eating and stress-related cigarette and alcohol use). Adults who experienced housing and food insecurity were more likely to report emotional eating and using cigarettes and alcohol when stressed. Adults with higher functional health literacy were less likely to report emotional eating.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":" ","pages":"e280-e289"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40453168","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}