The Swiss Health Literacy Survey: development and psychometric properties of a multidimensional instrument to assess competencies for health (original) (raw)
Related papers
Translation and validation of a multidimensional instrument to assess health literacy
Health Expectations, 2014
Background The patients' task to find, evaluate and transfer health information to one's individual condition and life requires competences that are summarized by the term 'health literacy'. Poor health literacy is associated with poorer health outcomes, like a higher rate of rehospitalization, lower receipt of screenings and a higher frequency of doctor visits. Objective Three levels of health literacy are distinguished: functional, communicative and critical health literacy. Aim of this study was to translate and adapt the 'Functional Communicative Critical Health Literacy' (FCCHL) questionnaire to German, and assess its psychometric properties. Methods/Design The FCCHL was sent to 9075 participants enrolled in a RCT on health coaching. 4040 participants responded. Besides descriptive and reliability analysis, confirmatory factor analysis was performed to test the questionnaire's postulated scale structure in a calibration (N = 3000) and a validation sample (N = 1040) for cross-validation.
Health Literacy Competencies for European Health Care Personnel
HLRP: Health Literacy Research and Practice, 2017
Background: Health literacy as a concept is gaining importance in European countries, although it is still not adequately addressed among health personnel. Health literacy supports the self-management of patients in maintaining and improving health, which could decrease the burden on health systems in Europe. However, health professionals lack adequate knowledge about health literacy and the skills to promote health literacy among their patients. Objective: The Health Literacy Practices and Educational Competencies for Health Professionals (a health literacy training curriculum for health professionals) was recently developed in the United States, and the study presented here aimed to refine that assessment for health personnel in European settings. Methods: The modified Delphi method was used and data collected online via electronic communication to achieve consensus among an expert panel. The participants were a group of 20 health literacy and health care experts from 10 professional fields representing 13 European countries. The participants rated health literacy competencies on a four-point Likert scale and provided written feedback and recommendations. If a predetermined threshold of 70% or more of the participants agreed on the competency, the consensus was defined (similar to the criteria in the Health Literacy Practices and Educational Competencies for Health Professionals intervention). Key Results: After three rounds of ratings and modifications, consensus agreement was reached on 56 health literacy competencies (20 knowledge items, 25 skills items, 11 attitude items) and 38 practices. Eight items were removed from the original list and eight new items were added to the final list. Conclusions: This study is the first known attempt to develop a measurable list of health literacy competencies for health personnel in Europe. Further work is needed to develop educational curricula, standard national and regional guidelines, and questionnaires for the process of implementation to maximize health literacy responsiveness in health care organizations. [Health Literacy Research and Practice. 2017;1(4):e247-e256.] Plain Language Summary: The Health Literacy Practices and Educational Competencies for Health Professionals was recently developed in the United States. This study aimed to refine that assessment for health care professionals in Europe. The modified Delphi method was used and data collected online via electronic communication, and in the end, 56 health literacy competencies were included. METHODS Expert Panel The panelists (Table 1) were identified based on their expertise and leadership role in health care, health communication, or health literacy. They were identified based on recommendations from one key informant in the European health literacy network and another key informant in the health communication network. Emails were sent to the identified experts requesting them to voluntarily participate in the study. This was a convenience sample of members of certain professional networks, namely Health Literacy Europe, the European Forum for Primary Care, the European Health Communication Network, and the European consensus on learning objectives for a core communication curriculum in health care professions study. To ensure representation of different European regions, the invitation was sent to health lit
SAGE Open Medicine
Objectives: Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. The assessment of health literacy profiles in a population is potentially crucial to respond to health needs. The Health Literacy Questionnaire explores nine dimensions of health literacy and has been shown to display robust psychometric properties. The aim was to test the validity of the multidimensional Health Literacy Questionnaire and to describe the health literacy profiles in a French population at risk of cardiovascular disease. Methods: Data were collected using self-administered questionnaires from 175 participants attending health education and support programmes in local associations of patients in Paris. Analysis included scale reliability, confirmatory factor analysis, and health literacy profiles via descriptive statistics. Results: In confirmatory factor analysis, the nine-factor structure was close to the original Health Literacy Questionnaire. A nine-factor confirmatory factor analysis model was fitted to the 44 items with no cross-loadings or correlated residuals allowed. Given the restricted nature of the model, the fit was satisfactory: χ 2 WLSMV (866 df) = 1383.81, p = 0.0000, comparative fit index = 0.925, Tucker-Lewis index = 0.918, root mean square error of approximation = 0.058, weighted root mean square residual = 1.175. Composite reliability ranged from 0.77 to 0.91. Among the 9 scales of the Health Literacy Questionnaire, the highest scores were found for scale 1 'Feeling understood and supported by healthcare professionals' and scale 9 'Understand health information enough to know what to do' and the lowest for scale 2 'Having sufficient information to manage my health' and scale 7 'Navigating the healthcare system'. Conclusion: The French version of the Health Literacy Questionnaire was shown to be psychometrically robust with good reliability. In the context of France, the 9 scales of Health Literacy Questionnaire allow a thorough assessment of health literacy strengths and weaknesses to respond to health literacy needs and improve the accessibility of health information and services.
Abilities, skills and knowledge in measures of health literacy
Patient Education and Counseling, 2014
Objective: Health literacy has been recognized as an important factor in patients' health status and outcomes, but the relative contribution of demographic variables, cognitive abilities, academic skills, and health knowledge to performance on tests of health literacy has not been as extensively explored. The purpose of this paper is to propose a model of health literacy as a composite of cognitive abilities, academic skills, and health knowledge (ASK model) and test its relation to measures of health literacy in a model that first takes demographic variables into account.
BMC public health, 2013
Background: Several measurement tools have been developed to measure health literacy. The tools vary in their approach and design, but few have focused on comprehensive health literacy in populations. This paper describes the design and development of the European Health Literacy Survey Questionnaire (HLS-EU-Q), an innovative, comprehensive tool to measure health literacy in populations. Methods: Based on a conceptual model and definition, the process involved item development, pre-testing, field-testing, external consultation, plain language check, and translation from English to Bulgarian, Dutch, German, Greek, Polish, and Spanish. Results: The development process resulted in the HLS-EU-Q, which entailed two sections, a core health literacy section and a section on determinants and outcomes associated to health literacy. The health literacy section included 47 items addressing self-reported difficulties in accessing, understanding, appraising and applying information in tasks concerning decisions making in healthcare, disease prevention, and health promotion. The second section included items related to, health behaviour, health status, health service use, community participation, socio-demographic and socio-economic factors. Conclusions: By illuminating the detailed steps in the design and development process of the HLS-EU-Q, it is the aim to provide a deeper understanding of its purpose, its capability and its limitations for others using the tool. By stimulating a wide application it is the vision that HLS-EU-Q will be validated in more countries to enhance the understanding of health literacy in different populations.
Pielegniarstwo XXI wieku / Nursing in the 21st Century
Introduction. The concept of health literacy is often used as “health competence”, “health ability. It involves the skills and motivation of people to obtain and understand health information. To improve health understanding and assessment of health literacy, many instruments have been developed to measure health competences in different populations. Among them there is the multidimensional, comprehensive questionnaire HLS-EU-Q16, developed by the Consortium of European Countries. Aim. Review of health literacy studies using the European Health Competence Questionnaire (HLS-EU-Q16) based on literature analysis. Method. Thematic review, unsystematic literature covering the years 2010-2018. The number of 17 source items was analyzed by the authors. Results. The overall level of health literacy was higher in European research than in non-European research. Low levels of health literacy were found in the elderly and chronically ill, immigrants and prisoners, as well as people with low e...
Sinergie Italian Journal of Management, 2019
Purpose of the paper: Health services' quality relies on the patients' ability to participate in the provision of care as co-creators of value. Among others, individual health literacy-i.e. the ability to access, understand, process and use health information for the purposes of health protection and promotion-is crucial to realize the full potential of patient involvement. This paper investigates the consequences of inadequate individual health literacy on self-efficacy perception and awareness of health-related issues, which are expected to affect the process of patient empowerment. Methodology: A sample of 438 Italian patients was built. The Newest Vital Sign (NVS) was used to assess individual health literacy skills. A self-reporting survey was administered to assess the patients' self-efficacy, awareness of health-related issues and health services' use. Also, socio-demographic variables were collected to investigate the correlates of limited health literacy. Findings: Problematic health literacy was prevailing. The lower the health literacy skills, the poorer the individual self-efficacy and the lower the awareness of healthrelated issues. Interestingly, inadequate health literacy was associated with increased access to emergency care and hospital services. Practical implications: Inadequate health literacy is likely to prevent patient empowerment. Actually, it performs as a barrier to patient involvement in the provision of care. Policy makers should attach a specific health literacy concern to health policies intended to promote patient participation in the provision of care. Besides, health care providers should arrange and implement tailored health literacy promotion initiatives, in an attempt to realize the full potential of patient empowerment and improve the quality of care. Originality of the paper: Although health literacy is a well-established topic, evidence on the consequences of limited health literacy on health behaviors is still inconsistent. This paper contributes in advancing scientific knowledge on the issue, delving into the effects of limited health literacy on self-efficacy perceptions, awareness of health-related issues and health services' use.
2017
Purpose. Health services’ quality strongly relies on the patients’ ability to participate in the provision of care and to perform as value co-creators. Among others, individual health literacy – that is to say the ability to access, understand, process and use health-related information for the purposes of health protection and promotion – is crucial to realize the full potential of patient involvement. This paper aims at investigating the consequences on problematic health literacy on both self-efficacy perception and awareness of health-related issues, which deeply affect the process of patient empowerment. Methodology. A sample of 438 Italian patients was built. The Newest Vital Sign (NVS) tool was used to assess health literacy skills. In addition, a self-reporting survey was administered to assess the patients’ self-efficacy, awareness of health-related issues and health services’ use. Also, socio-demographic variables were collected to investigate the main correlates of limite...
International Journal of Environmental Research and Public Health, 2018
Health literacy is a critical determinant of health, which can empower individuals and lead to engagement in collective health promotion action and is also a crucial component in the self-management of illness. The current study moves beyond a focus on functional health literacy and presents findings from a longitudinal qualitative (LQ) study consisting of three phases. This paper presents findings from the second phase of the study, which assessed the development of health literacy capacities of individuals attending a structured cardiovascular risk reduction programme in Ireland. The study objectives were to: explore perceptions of changes in interactions and information exchange within health consultations; identify the facilitators associated with changes in health literacy capacities; assess developments in engagement with broader contexts for health literacy capacities. A LQ study design was undertaken, which employed repeat interview methodology with 19 participants (aged 36-76 years) 12 weeks after beginning a structured cardiovascular risk reduction programme. Health literacy levels were assessed using the HLS-EU 47 item instrument in phase 1 (68% limited health literacy (HL), 32% adequate health literacy). A semi-structured interview guide, (informed by Sørensen's conceptual model of health literacy), was used to explore the development of health literacy and to identify changes in knowledge, attitudes and experiences over time. Thematic analysis was used, informed by aspects of Saldaña's framework for longitudinal qualitative data analysis. All participants reported having acquired increased understanding of issues relevant to their health and self-care. Participants described health literacy capacities that incorporate aspects of all levels of health literacy (functional, interactive and critical). Core themes were identified corresponding to changes in these levels: re-engagement with health information and increased understanding of risk and protective factors (changes in functional health literacy); changes in interactions with healthcare providers (HCP) (changes in interactive health literacy); enhanced psychological insights and understanding the broader determinants of health (changes in critical health literacy). Findings support the development of health literacy capacities across the functional, interactive and critical health literacy domains. Participants are capable of locating responsibility for health beyond the individual level and are making sense of knowledge within their own social contexts. Individuals, regardless of their initial health literacy levels, are capable of engaging with broader issues that can impact on their health and can be supported to develop these critical health literacy capacities.
Health literacy of Dutch adults: a cross sectional survey
2013
Background: Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify socioeconomic disparities in health. This paper is part of the European Health Literacy Survey (HLS-EU). It aims to add to the body of theoretical knowledge about health literacy by measuring perceived difficulties with health information in various domains of health, looking at a number of competences. The definition and measure of health literacy is still topic of debate and hardly any instruments are available that are applicable for the general population. The objectives were to obtain an initial measure of health literacy in a sample of the general population in the Netherlands and to relate this measure to education, income, perceived social status, age, and sex. Methods: The HLS-EU questionnaire was administered face-to-face in a sample of 925 Dutch adults, during July 2011. Perceived difficulties with the health literacy competences for accessing, understanding, appraising and applying information were measured within the domains of healthcare, disease prevention and health promotion. Multiple linear regression analyses were applied to explore the associations between health literacy competences and education, income, perceived social status, age, and sex. Results: Perceived difficulties with health information and their association with demographic and socioeconomic variables vary according to the competence and health domain addressed. Having a low level of education or a low perceived social status or being male were consistently found to be significantly related to relatively low health literacy scores, mainly for accessing and understanding health information. Conclusions: Perceived difficulties with health information vary between competences and domains of health. Health literacy competences are associated with indicators of socioeconomic position and with the domain in which health information is provided.