Journal of Education and Health Promotion

Hospital health literacy conceptual explanation: A qualitative content analysis based on experts and population perspectives

. Fatemeh Bahrambeygi; . Sakineh Rakhshanderou; . Ali Ramezankhani; . Mohtasham Ghaffari

Volume 13, Issue 1 , January 2023, , Pages 1-13

Abstract

  BACKGROUND AND AIM: Given the complexities of the health care system and the importanceof the subject and effects of health literacy in all aspects of care, defining specific health ...  Read More BACKGROUND AND AIM: Given the complexities of the health care system and the importanceof the subject and effects of health literacy in all aspects of care, defining specific health literacy inthis context seems necessary. The purpose of this research was to explain the concept of hospitalhealth literacy (HHL), its definition, and the related dimensions using the qualitative research method.MATERIALS AND METHODS: An exploratory qualitative design was used. Exploratory, open‑ended,and face‑to‑face interviews based on the interview guide were used to elicit participants’ perspectivesbetween July 2021 and January 2022. By using the content analysis method, researchers codedtranscripts and collated these codes into sub‑categories and then merged them into the main categoryand explored the dimensions of the concept.RESULTS: A total of 23 service providers and 25 service recipients were included in the study.Analysis of qualitative data led to the identification of 6 categories and 25 sub‑categories includingcognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, medialiteracy, and emotional literacy.CONCLUSION: The findings of the present study provide a deep understanding of the conceptof HHL that could be applied to develop valid and reliable measurement tools for assessing HHLamong a variety of populations. Also, it is hoped that the present attempt can be useful to guidefuture research and interventions as well as to provide a clear base for planning, implementing, andevaluating interventions aimed at promoting individuals’ health literacy in health settings.

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Factors affecting nonadherence to treatment among type 2 diabetic patients with limited health literacy: Perspectives of patients, their families, and healthcare providers

. Nasrin Pourhabibi; . Roya Sadeghi; . Bahram Mohebbi; . Elham Shakibazadeh; . Mojgan Sanjari; . Azar Tol; . Mehdi Yaseri

Volume 12, Issue 10 , November 2022, , Pages 1-13

Abstract

  BACKGROUND: Treatment adherence is one of the behaviors associated with type 2 diabetes thatpredicts whether it will be successfully treated or develop complications and become uncontrolled.This ...  Read More BACKGROUND: Treatment adherence is one of the behaviors associated with type 2 diabetes thatpredicts whether it will be successfully treated or develop complications and become uncontrolled.This study aimed to determine factors affecting nonadherence to treatment among diabetic patientswith limited health literacy from the perspectives of patients, their families, and healthcare providers.MATERIALS AND METHODS: This qualitative study with a content analysis approach was conductedon 84 eligible type 2 diabetes patients with limited health literacy and poor adherence to treatment,as well as their families and healthcare providers using a purposive sampling method, in Kerman cityin 2021. Interviews were conducted using a semistructured interview guide with a broad, open‑endedquestion to provide a general history of the disease separately. The interviewer asked participantsto identify the perceived barriers to treatment nonadherence. Each interview lasted 45–60 min.MAXQDA version 20 and inductive content analysis were used to code and analyze extracted data.RESULTS: Four major themes emerged from the patients’ perspectives as “financial problems,”“individual factors,” “problems related to medication availability,” and “healthcare providers’ poorpractices.” Two major themes were classified from the perspective of patients’ families as “financialproblems” and “Individual factors,” and four major themes were identified from the viewpoint ofhealthcare providers including “financial problems,” “individual factors,” “scarcity and medicationavailability,” and “poor practice of the healthcare provider.” These mentioned barriers were confirmedregarding treatment nonadherence among study participants.CONCLUSION: Study findings revealed different factors of treatment nonadherence among diabeticpatients with limited health literacy. Therefore, these factors should be considered in tailoringpromotive educational and supportive interventions. Considering the importance of adherence totreatment patients, planning empowerment family‑based interventions focusing on health literacyimprovement seems necessary.

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A modified Delphi study to identify strategies to promote health literacy in parents of children with cancer

. Somaye Sayahi; . Masoud Bahrami; . Ahmad Ali Eslami; . Alireza Moafi

Volume 12, Issue 10 , November 2022, , Pages 1-6

Abstract

  BACKGROUND: Parents play a key role in the care, monitoring, management of symptomsexperienced in children with cancer, the support, and follow‑up of treatment. However, there is ...  Read More BACKGROUND: Parents play a key role in the care, monitoring, management of symptomsexperienced in children with cancer, the support, and follow‑up of treatment. However, there is apaucity of research as how to improve the health literacy of parents with cancer. The aim of thisstudy was to identify the best and most important strategies to promote health literacy in parents ofchildren with cancer.MATERIALS AND METHODS: A two‑step modified Delphi method was used to establish consensusin Iran in 2021. Fourteen experts representing oncology, clinical nursing, and faculty members ofnursing were selected by purposive sampling. In round one, 90 strategies to promote health literacyobtained in the qualitative study were distributed to the experts, which were scored from 1 to 5. Inorder to discuss statements without consensus in the first round, round two was held in a face‑to‑facemeeting. Descriptive statistics such as mean, standard deviation, and percentage of responsefrequency were used to calculate agreement levels between experts.RESULTS: In round one, 57 statements reached a consensus. In round two, 21 statements reached aconsensus. Finally, 78 statements reached consensus representing four domains including functionalhealth literacy, interactive health literacy, critical health literacy, and care health literacy.CONCLUSION: Delphi method helps to identify the best and most important strategies to use inhealth literacy promotion programs for parents of children with cancer. Identifying these strategieswill help health officials, planners, and policymakers.

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Factors affecting the health literacy status of patients with type 2 diabetes through demographic variables: A cross‑sectional study

. Arash Ziapour; . Farbod Ebadi Fard Azar; . Behzad Mahaki; . Morteza Mansourian

Volume 12, Issue 8 , September 2022, , Pages 1-10

Abstract

  BACKGROUND: Health literacy (HL) is the ability of a person to acquire the process, understand thenecessary health information, and make the health services needed for conscious health ...  Read More BACKGROUND: Health literacy (HL) is the ability of a person to acquire the process, understand thenecessary health information, and make the health services needed for conscious health decisions.Besides, diabetes is the most common metabolic disorder that affects patients’ quantity and qualityof life. This study focused on determining the factors that affect the HL status of patients with type 2diabetes (T2D) through the role of the demographic variables.MATERIALS AND METHODS: This descriptive‑analytical research survey recruited a samplebased on 280 patients with T2D at the Diabetes Research Center of Ayatollah Taleghani Hospitalin Kermanshah in 2020. This study selected patients with T2D using a simple random samplingtechnique. The study applied the demographic information questionnaire and the Functional,Communicative, and Critical HL Scale to collect data from patients with T2D. This study used theSPSS version 23 on the received data sets to perform statistical analysis, including t‑test, analysisof the variance, and multiple regression, to predict the factors affecting HL among diabetes patients.RESULTS: The study results showed that the mean age of the participating patients with T2D was55.80 ± 13.04. The results indicated the mean score and standard deviation of total HL score in patientswith T2D 2.70 ± 0.44. The findings specified a statistically significant relationship between HL, gender,education, occupation, income, and place of residence. Results indicated that β‑coefficients of themultiple regression analysis and the income variable (β = 0.170), age (β = 0.176), and employmentvariable (β = 0.157). These are the most predictive of the HL of patients with T2D.CONCLUSION: The results of this study specified that the HL rate of individuals with diabetes type 2is average. The potential communicative and critical HL influence is essential for communication andeducation for diabetes patients in the primary health‑care system settings. The findings indicate thatcommunicative and critical HL related to patients’ management and functional HL looks passablein this study.

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Sociocultural, health knowledge, and health literacy among children ages 9–10 years in Thailand

. Nopparat Senahad; . Wongsa Loahasiriwong; . Naowarat Maneenin

Volume 12, Issue 4 , April 2022, , Pages 1-7

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, ...  Read More 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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Awareness, practices, and myths related to coronavirus disease‑19 among rural people in Kolar District, South India: A community‑based mixed‑methods study

. Surahalli J Naresh; . Mahendra M Reddy; . Ravishankar Suryanarayana; . Ananta Bhattacharyya; . Prasanna B T Kamath

Volume 12, Issue 2 , February 2022, , Pages 1-8

Abstract

  BACKGROUND: Capturing the baseline information on awareness, practices, and prevailing myths related to the ongoing coronavirus disease‑19 (COVID‑19) pandemic in rural India ...  Read More BACKGROUND: Capturing the baseline information on awareness, practices, and prevailing myths related to the ongoing coronavirus disease‑19 (COVID‑19) pandemic in rural India will help in planning interventions to improve the health literacy on COVID‑19. The aim of the study was to assess the level of awareness, practices, and myths regarding COVID‑19 among rural population of Kolar district in South India.MATERIALS AND METHODS: A concurrent mixed‑methods study with a quantitative community‑based cross‑sectional analytical design and a qualitative phenomenological design was conducted in five randomly selected villages during June 2020. A prevalidated and pretested semi‑structured questionnaire was administered to one adult in the households selected using systematic random sampling to capture the sociodemographic details and their awareness, practices, and myths related to COVID‑19. The supervisors additionally and concurrently used a nonparticipant observation technique to record the real‑time behaviors and preventive practices adopted by the villagers. Quantitative analysis was done using STATA and included multivariable regression analysis, and the association was reported using prevalence rates along with their 95% confidence intervals (CIs). Qualitative analysis was done manually as per discussion and concordance among supervisors and reported as categories along with supporting statements.RESULTS: Among the 298 respondents, “poor awareness” was seen in 128 (43.0%, 95% CI: 37.5%–48.6%). Among the responders, 89 (29.9%) believed in the myth that “Corona disease is due to God’s wrath or curse.” The field observations were categorized under three categories – “avoidance of masks,” “nonexistent social distancing,” and “rampant spitting.”CONCLUSION: About two in five villagers were found to have “poor awareness” to COVID, and practices related to COVID were found to be largely unsatisfactory. Lower level of education and belonging to nuclear family were associated with “poor awareness.” Various myths were identified that has to be debunked on priority basis by the government, especially targeting the people having low level of education in rural India.

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The association between sexual health literacy and sexual function of women in Iran

. Leila Dehghankar; . Rahman Panahi; . Marzieh Khatooni; . Somayeh Fallah; . Farnoosh Moafi; . Mohammad Anbari; . Fatemeh Samiei Siboni

Volume 12, Issue 1 , January 2022, , Pages 1-6

Abstract

  BACKGROUND: Considering the importance of sexual health literacy in promoting individual sexualhealth and ultimately improving family and social health as well as the effect of health ...  Read More BACKGROUND: Considering the importance of sexual health literacy in promoting individual sexualhealth and ultimately improving family and social health as well as the effect of health literacy onsexual function, this study was designed and conducted to determine the association between sexualhealth literacy and sexual function among women.MATERIALS AND METHODS: This was a cross‑sectional study. A total of 420 women referringto health centers were entered into the study using one‑stage cluster sampling method. Datacollection tools included a demographic questionnaire, Iranian Adult Sexual Health LiteracyAssessment Questionnaire, and the Persian version of the Female Sexual Function AssessmentQuestionnaire (FSFI). Data were collected and entered into SPSS 22 and logistic regression.RESULTS: The results of the logistic regression test showed that the variable of sexual health literacywas effective on women’s sexual function (P = 0.021) so that the chances of having a desirable sexualfunction in women with excellent were 4.222 times more than women with inadequate health literacy;the variables of employment status, level of education, duration of marital life, and the number ofsexual intercourses per recent week were the factors affecting women’s sexual function (P < 0.05).CONCLUSION: The results of this study pointed out the existence of an undesirable level of sexualfunction and a desirable level of sexual health literacy among participating women. Hence, designingand implementing the training plans to promote sexual function among these women is necessary.

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Health literacy and its dimensions in elderly people in Farsan city, Iran

. Reza Mahmoodi; . Akbar Hassanzadeh; . Majid Rahimi

Volume 11, Issue 8 , September 2021, , Pages 1-5

Abstract

  BACKGROUND: Health literacy is an important variable in the promotion and improvement of thehealth of all social groups, especially the elderly people. It indicates cognitive and social ...  Read More BACKGROUND: Health literacy is an important variable in the promotion and improvement of thehealth of all social groups, especially the elderly people. It indicates cognitive and social skills thatspecify the individuals’ motivation and ability to access and perceive information using methodsfor health retention and improvement. The present research aimed to study health literacy and itsrelevant dimensions in a population over 60 years of age in Farsan city.MATERIALS AND METHODS: A cross‑sectional study on 384 older people in Farsan city wasconducted, using a standard health literacy questionnaire including 33 items and 5 dimensions ona 5‑point Likert scale for collecting data. Data analysis was done using descriptive and analyticalstatistics, using the multiple linear regression analysis.RESULTS: Among the dimensions, the highest and lowest scores belonged to decision‑making andreading skill dimensions, respectively. The multiple linear regression analysis revealed that amongthe demographical variables, education level, age, sex, and job were the best predictors of totalscores of health literacy (P < 0.001).CONCLUSIONS: The health‑related institutions should make effort to improve the elderly people’shealth literacy based on general literacy, using suitable methods with less need to read and payingattention to personal characteristics.

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Relationship between health literacy in substance use and alcohol consumption and tobacco use among adolescents, Northeast Thailand

. Suneerat Yangyuen; . Chatchada Mahaweerawat; . Sawan Thitisutthi; . Udomsak Mahaweerawat

Volume 11, Issue 3 , March 2021, , Pages 1-6

Abstract

  BACKGROUND: Health literacy (HL) is an important role‑play in health risk behaviors such asalcohol drinking and smoking. Inadequate HL in substance use (HLSU) is a barrier to reduce ...  Read More BACKGROUND: Health literacy (HL) is an important role‑play in health risk behaviors such asalcohol drinking and smoking. Inadequate HL in substance use (HLSU) is a barrier to reduce therisk of alcohol and tobacco use. This study aims to investigate the association of HLSU with alcoholconsumption and tobacco use among Thai adolescents. Hence, the strengthening of HL programintervention may applied to reduce substance abuse among Thai adolescents.MATERIALS AND METHODS: This was a cross‑sectional study conducted on 1087 universitystudents studying in three universities located in northeastern area with multistage sampling methodsby geographical areas. The data were collected by self‑administered questionnaire. Multiple logisticregression was applied to determine the effect of HLSU of alcohol consumption and tobacco use.RESULTS: Most adolescents were drinkers (60.7%) and about 20.7% were smokers. Approximately40% of them reported as inadequate HLSU. Adolescents with inadequate HLSU and a high level ofpositive alcohol expectancies and smoking outcome expectancies (SOE) were more likely to drinkalcohol and smoke. Conversely, those who had a high level of negative alcohol drinking and SOEwere less likely to consume alcohol and tobacco.CONCLUSION: Adolescents’ alcohol consumption and tobacco use were influenced by HL, henceimproving adolescents’ HLSU could help prevent or reduce the risk of drinking and smoking behaviors.

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Effect of Information, Education, and Communication activity on health literacy of cardiovascular diseases among school‑going adolescents in Delhi

. Srishti Yadav; . Anita Khokhar

Volume 11, Issue 2 , February 2021, , Pages 1-7

Abstract

  BACKGROUND: Heart attack and stroke account for >80% of deaths due to cardio‑vasculardiseases (CVDs) in India. Adolescents are the most susceptible group to adopt risky behaviorscausing ...  Read More BACKGROUND: Heart attack and stroke account for >80% of deaths due to cardio‑vasculardiseases (CVDs) in India. Adolescents are the most susceptible group to adopt risky behaviorscausing CVDs such as use of tobacco and alcohol, sedentary lifestyle, and unhealthy diet. Thisstudy was conducted to assess the health literacy of CVDs such as heart attack and stroke amongschool‑going adolescents and change in health literacy after different information, education, andcommunication (IEC) activities.MATERIALS AND METHODS: It was a school‑based interventional study conducted in two schoolsamong students of classes 6, 7, and 8. The educational interventions were done in the form ofpamphlets, posters, and lectures on heart attack and stroke. The postintervention data were collected2 weeks after the first intervention and 3 months after the last intervention.RESULTS: There were a higher proportion of students with satisfactory level of knowledge of heartattack and stroke both at 2 weeks and 3 months after the interventions in both the schools, and theresults were statistically significant (P < 0.05).CONCLUSION: The health literacy regarding CVDs has improved when compared to baseline afterIEC activities among school‑going adolescents.

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Establishing criterion validity for the Revised Critical Nutrition Literacy Tool in U.S. college students

. Janette Bedoyan; . Jade McNamara; . Melissa D. Olfert; . Carol Byrd‑Bredbenner; . Geoffrey W. Greene

Volume 11, Issue 1 , January 2021, , Pages 1-8

Abstract

  BACKGROUND: Critical nutrition literacy (CNL) plays an important role in how college students makeeveryday decisions about nutrition choices. Increasing CNL is an aim of many introductory ...  Read More BACKGROUND: Critical nutrition literacy (CNL) plays an important role in how college students makeeveryday decisions about nutrition choices. Increasing CNL is an aim of many introductory nutritioncourses, but there are limited instruments measuring this construct. This study aimed to assess thechangeability of CNL and the relationship between CNL and markers of diet quality in young adults.DESIGN: This was a two‑phase research project consisting of a nonexperimental, pre–post studyand a cross‑sectional assessment from 2018 to 2019. Participants were U.S. college students,18‑24 years old, recruited from introductory‑level courses from three participating universities, locatedin Rhode Island, West Virginia, and New Jersey.SUBJECTS AND METHODS: Interventions consisted of (1) a 4‑credit, 13‑week nutrition courseand (2) a cross‑sectional, online behavior, environment, and perception survey. CNL was measuredusing the Revised CNL Tool (CNLT‑R) instrument across both phases. Measures for phasesinclude: (1) the changeability of CNL and (2) the relationship between CNL and markers of diet quality.ANALYSIS: Paired t‑tests and multivariate analysis of variance were utilized through SPSSversion 25.0.RESULTS: CNL score significantly increased from baseline to postintervention from 3.38 ± 0.48 to3.61 ± 0.55 (P = 0.014). There was an overall significant effect of CNL on markers of diet quality, suchas cups of fruits and vegetables (F/V) and teaspoons of added sugar (F [2,1321] = 3.12, P < 0.05;Wilks’ Λ = 0.99).CONCLUSIONS: This research found that an introduction to nutrition course was associated withan increase in CNL and that CNL is related to diet quality. The instrument could be used by nutritioneducators as an outcome assessment. Future research should investigate other components of theCNL construct as well as predictive validity.

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Determinants of online health information‑seeking behavior: A cross‑sectional survey among residents of an urban settlement in Delhi

. Pragyan Paramita Parija; . Poornima Tiwari; . Priyanka Sharma; . Sunil Kumar Saha

Volume 10, Issue 12 , December 2020, , Pages 1-5

Abstract

  Background: In health care, the rapid proliferation of health information on the internet has resultedin more patients turning to the digital media as their first source of health information ...  Read More Background: In health care, the rapid proliferation of health information on the internet has resultedin more patients turning to the digital media as their first source of health information and acquiringknowledge. The present study was conducted to assess use of the digital medium as a medicalinformation resource in health-related states and to determine their experience and perceptions aboutthe quality and reliability of the information available among the participants.Methodology: The study was done in an urban settlement of Delhi among adults who use any digitalmedia. A sample of 321 were selected though convenient sampling. The information was collectedthrough a semi-structured, self-administered, pre-tested questionnaire which contained questionson socio-demographic profile, internet usage and awareness about Digital India. Bivariate analysiswas done to determine the association between various socio-demographic variables associatedwith internet usage for health information.Results: In the present study, 88.2% (283/321) were using the internet for health informationthrough digital media. This study found out that younger age group (18-30 years), literate andhigher socioeconomic group (upper middle and above) population were more likely to access healthinformation via digital media which was found out to be statistically significant.Conclusion: Access to health information through digitization can improve health literacy amongthe population and help in promoting a preventive aspect to health problems and disease. They canbe the building blocks to build “Swasth Bharat (Healthy India)”.

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Development of health literacy among postgraduate students: From information literacy perspective

. Abolfazl Taheri; . Mostafa Langarizadeh; . Jalil Ghani Dehkordi; . Omid Yousefianzadeh

Volume 10, Issue 12 , December 2020, , Pages 1-6

Abstract

  OBJECTIVES: Involving the patients in health‑related decisions requires high health literacy. Healthliteracy is related to the concept of information literacy through its emphasis ...  Read More OBJECTIVES: Involving the patients in health‑related decisions requires high health literacy. Healthliteracy is related to the concept of information literacy through its emphasis on information skills.Hence, the aim of this study was to investigate the relationship between information literacy andhealth literacy.STUDY DESIGN: We carried out an original research.MATERIALS AND METHODS: This is an applied research that is carried out in a survey method.The statistical population of this study is MSc and PhD students at School of Health Managementand Information Science in Iran University of Medical Sciences who were selected by stratifiedrandom sampling. A standard health literacy questionnaire including access dimensions, readingskills, comprehension, evaluation, decision‑making, and application of health information was used toassess the health literacy status of the students. To measure information literacy, the questionnaireincludes identifying information needs, locating information, organizing information, and evaluatinginformation were used. The data were analyzed by tests of one‑sample t‑test, Pearson correlation,and simple linear regression with spss software version 18 produced by IBM located at New York.RESULTS: The results showed that the level of information literacy among students was higherthan the average level. The average of information literacy rate in the sample is 49.09. In thisregard, the most frequent information is gained from the internet, interacting with friends, and askingpractitioners and health workers. In addition, there is a positive and significant relationship betweenall dimensions of information literacy with health literacy and information literacy affects 35.4% ofhealth literacy changes.CONCLUSIONS: It can be said that information literacy is a predictor of health literacy. Furthermore,the pattern of people’s health information has moved to new information environments and to improvehealth having sufficient information seeking and information literacy skills are essential.

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Investigating the effect of health literacy level on improving the quality of care during pregnancy in pregnant women covered by health centers

. Leila Asadi; . Fatemeh Amiri; . Hadise Safinejad

Volume 10, Issue 10 , October 2020, , Pages 1-6

Abstract

  BACKGROUND: Health literacy is the capacity to acquire, process, and understand basic informationand services necessary for appropriate health decisions. Given the importance of health ...  Read More BACKGROUND: Health literacy is the capacity to acquire, process, and understand basic informationand services necessary for appropriate health decisions. Given the importance of health literacy inwomen, the aim of the present study was to determine the effect of health literacy level on improvingthe quality of care during pregnancy in pregnant women.MATERIALS AND METHODS: The present study was a cross‑sectional analytical study. In thisstudy, 130 women referred to Yazd health centers were examined. Health literacy questionnairesand a researcher‑made checklist of the quality of pregnancy care were used to gather information.The researcher‑made checklist of the quality of pregnancy care was in accordance with the standardprotocol of the Ministry of Health and Medical Education, entitled Integrated Health Care for PregnantMothers, which was validated and reliable. SPSS statistical software version 19 and t‑test and ANOVAstatistical tests were used to analyze the data.RESULTS: According to the findings, the average score of health literacy in pregnant women was74.09, which showed that the level of health literacy was in the marginal or border range. Peoplewith higher health literacy received significantly more prenatal counseling than other women andhad a planned pregnancy (P = 0.04).CONCLUSION: The level of health literacy in pregnant women is unfavorable. Given that the highlevel of health literacy in women in society can lead to an increase in the quality of pregnancy care, soto increase health literacy in women, it is recommended that regular training in society by health‑careproviders be given more attention.

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Association between health literacy and adopting preventive behaviors of breast cancer in Iran

. Rahman Panahi; . Peyman Namdar; . Fatemeh Samiei Siboni; . Somayeh Fallah; . Mohammad Anbari; . Leila Dehghankar; . Leili Yekefallah; . Mahya Shafaei

Volume 10, Issue 9 , September 2020, , Pages 1-7

Abstract

  BACKGROUND: Health literacy plays an important role in adopting preventive behaviors. Consideringthe relatively high prevalence of breast cancer in women, this study aimed to assess ...  Read More BACKGROUND: Health literacy plays an important role in adopting preventive behaviors. Consideringthe relatively high prevalence of breast cancer in women, this study aimed to assess the associationbetween health literacy and adopting the preventive behavior of breast cancer in Iran.METHODS: This was a descriptive, cross‑sectional study, in which 375 female students at ImamKhomeini International University in Qazvin in the academic year of 2018–2019 were selected througha stratified random sampling method. Demographic and background questionnaire, the standardquestionnaire of Health Literacy for Iranian Adults in addition to another questionnaire for measuringbreast cancer preventive behaviors, were used for collecting data. Data were analyzed using SPSS22 using descriptive statistics and logistic regression.RESULTS: The mean of the breast cancer preventive behaviors and health literacy were 8.92 ±1.82 out of 16 and 70.80 ± 12.49 out of 100. Regression results showed that there was a statisticallysignificant association between the adoption of breast cancer preventive behaviors and physicalactivity (P < 0.001) and health literacy (P < 0.018). Accordingly, the chance for adopting the preventivebehaviors in good level among students with rare and without physical activity was 0.105 and0.100 times, respectively, more than students who had been doing physical activity on a daily basis.Moreover, the same chance among students with adequate and very adequate health literacy was1.802 and 2.169 times more than students with inadequate health literacy.CONCLUSION: The results indicated that students with lower levels of health literacy and lessphysical activity had shown less tendency to adopt preventive behaviors of breast cancer. Therefore,special attention should be paid to health literacy (HL), particularly physical activity, application ofhealth information, and assessment in students when designing educational programs to preventbreast cancer.

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Effect of health literacy among students on the adoption of osteoporosispreventive behaviors in Iran

. Rahman Panahi; . Leili Yekefallah; . Mahya Shafaei; . Leila Dehghankar; . Mohamad Anbari; . Narges Hosseini; . Elham Hasannia

Volume 10, Issue 7 , July 2020, , Pages 1-6

Abstract

  BACKGROUND: In chronic diseases such as osteoporosis, understanding the factors that improveprevention, such as health literacy (HL), is essential in reducing the incidence of these ...  Read More BACKGROUND: In chronic diseases such as osteoporosis, understanding the factors that improveprevention, such as health literacy (HL), is essential in reducing the incidence of these diseases.This study aimed to determine the association between HL and adoption of osteoporosis‑preventivebehaviors among students in Qazvin.SUBJECTS AND METHODS: This is a cross-sectional study in which 375 female students(aged 15–18 years) at high schools (grades 10th, 11th, and 12th) in Qazvin city were selected, in2019. Sampling method was multistage. To collect data, the standardized questionnaire for measuringHL in adolescents (health literacy measure in adolescents), in addition to another questionnaire forassessing osteoporosis‑preventive behaviors, was used. Data were analyzed using SPSS 22 bydescriptive statistics and logistic regression. The association considered significant when P < 0.05.RESULTS: The mean scores of adoption of osteoporosis‑preventive behaviors and HL were22.43 ± 5.60 and 70.84 ± 12.58, respectively. Logistic regression showed that there was a significantassociation between the adoption of osteoporosis‑preventive behaviors and HL (P = 0.001). Inaddition, the association between the adoption of osteoporosis‑preventive behaviors and age wasalso significant (P = 0.048 and odds ratio = 3.35).CONCLUSIONS: Young students and those of low HL showed less adoption of osteoporosis‑preventivebehaviors. Therefore, it is necessary to pay more attention to design educational programs that mayraise the knowledge and awareness of those students about such these diseases, mainly prevention.

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Health literacy and its predictors among urban and rural adults in Bijar County

. Bahman Baraie; . Tahereh Pashaei; . Edris Kakemam; . Hassan Mahmoodi

Volume 10, Issue 7 , July 2020, , Pages 1-6

Abstract

  BACKGROUND AND PURPOSE: The World Health Organization has identified health literacy (HL)as one of the most important determinants of people’s health. Therefore, this research ...  Read More BACKGROUND AND PURPOSE: The World Health Organization has identified health literacy (HL)as one of the most important determinants of people’s health. Therefore, this research aimed toinvestigate the status of HL and its predictors.MATERIALS AND METHODS: This research was a cross-sectional study that was performed on 600adults in Bijar County, Iran. Cluster sampling was used to select the samples. Data were collectedusing the questionnaire of HL for Iranian adults. Data were analyzed using one-way analysis ofvariance, Student’s t-test, and multiple linear regression in SPSS 21.RESULTS: The mean score of HL was 3.6 out of 5; 69% and 29% of the samples had a moderateto-high health status, respectively. Among the dimensions of HL, the highest and the lowest meanswere perception (3.94) and evaluation (3.21), respectively. Based on the multiple regression results,the variables (gender – B = −0.142, confidence interval [CI]: −0.409 to −0.011, P = 0.39; educationlevel – B = 0.391, CI: 0.149–0.287, P = 0.00; and income level – B = 0.203, CI: 0.00–0.00, P = 0.01)were significantly positively associated with HL.CONCLUSION: The results of this study can be applied to educational interventions through mediaand radio-television to increase public awareness. Education is also strongly recommended in termsof demographic variables and characteristics to promote HL in the society.

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Relationship between electronic health literacy, quality of life, and self-efficacy in Tehran, Iran: A community-based study

. Zahra Raisi Filabadi; . Fatemeh Estebsari; . Arezoo Sheikh Milani; . Shahoo Feizi; . Maliheh Nasiri

Volume 10, Issue 7 , July 2020, , Pages 1-7

Abstract

  BACKGROUND: The concept of electronic health literacy has become a main focus of health-careprofessionals along with the increasing use of the Internet. In Iran, the Internet not yet ...  Read More BACKGROUND: The concept of electronic health literacy has become a main focus of health-careprofessionals along with the increasing use of the Internet. In Iran, the Internet not yet has muchimpact on providing health services, and the physicians’ and patients’ community are now morewilling to use the traditional method for diagnosing disease and prescribing medicines. This studyaimed to determine the correlation between electronic health literacy, quality of life (QoL), and selfefficacy among Tehran citizens.MATERIALS AND METHODS: The present study is a descriptive, cross-sectional study with acorrelation approach that was conducted on 400 clients of community health centers of ShahidBeheshti University of Medical Sciences in 2019. Samples were selected by stratified random samplingmethod. Data were collected using E-Health Literacy Questionnaire (α = 0.88), 12-item Short-FormHealth Survey (α = 0.73), and General Self-Efficacy Scale (α = 0.87). Analytic statistics were usingby descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlationcoefficient and regression analysis) at the significant level (P < 0.05).RESULTS: Correlation between electronic health literacy and QoL was 0.14 and with self-efficacy was0.10, which was positive and statistically significant (P < 0.05). In addition, the correlation betweenQoL and self-efficacy was 0.33, which was positive, statistically significant, and moderate (P < 0.05).CONCLUSION: According to the findings of this study, it is possible to improve the QoL through thepromotion of electronic health literacy and self-efficacy. The results of this study can be used as abasis for health service providers and policymakers in designing and implementing health-relatedinterventions.

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Association between health literacy with knowledge, attitude, and performance of health‑care providers in applying health literacy education strategies for health education delivery

. Manezheh Bahramian; . Arash Najimi; . Athar Omid

Volume 10, Issue 1 , January 2020, , Pages 1-5

Abstract

  BACKGROUND AND AIM: Recognized as one of the key elements of growth and development,education is an important strategy for successful provision of services in all social dimensions. ...  Read More BACKGROUND AND AIM: Recognized as one of the key elements of growth and development,education is an important strategy for successful provision of services in all social dimensions. Moreover,it is categorized among empowerment tools to achieve goals. In the field of health, health educationencourages people to be healthy. This study aimed to evaluate the health literacy of health‑careproviders and its relationship with strategies of using health literacy in the provision of health education.MATERIALS AND METHODS: This cross‑section correlational study was carried out on a groupof health‑care providers in Isfahan, Iran, in the second trimester of the Persian year 1397 (2018).Participants were selected by multistage sampling, for which two questionnaires of Test of FunctionalHealth Literacy in Adults and inventory of strategies of using health literacy in education were applied.The validity and reliability of the research tools were formerly approved. In addition, data analysis wasperformed in SPSS version 21 using Pearson’s correlation coefficient and linear regression model.RESULTS: In total, 230 participants with a mean age of 34.32 ± 7.71 years were entered intothe study, 92.9% of whom were female and 7.1% were male. The mean health literacy score ofthe participants was 79.60 ± 12.41. In the sections of knowledge, attitude, and performance wererelated to the use of health literacy education strategies, and we obtained the means 5.20 ± 1.94,43.11 ± 4.11, and 28.96 ± 6.73, respectively. Moreover, Pearson’s results were indicative of asignificant relationship between health literacy of health‑care providers and knowledge (r = 0.245;P < 0.05) and performance (r = 0.208. P < 0.05) regarding the use of education strategies. However,no significant association was found between health literacy of health‑care providers and attitudetoward the use of health literacy education strategies (r = 0.081; P = 0.225).DISCUSSION AND CONCLUSION: While the results showed that 75% of health‑care providers hada favorable level of health literacy, and despite the proper attitude toward the use of health literacyeducation strategies, the knowledge and performance of the participants were estimated at < 60% inthis regard. It is suggested that the potential of health‑care providers in terms of achieving, processing,and perceiving health‑related information and fundamental services be improved to enhance theirknowledge and performance regarding the use of health literacy education strategies.

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A problem‑based learning health literacy intervention program on improving health‑promoting behaviors among girl students

. Neda Karimi; . Shahrzad Saadat‑Gharin; . Azar Tol; . Roya Sadeghi; . Mehdi Yaseri; . Bahram Mohebbi

Volume 9, Issue 12 , December 2019, , Pages 1-11

Abstract

  BACKGROUND: Health‑promoting behaviors are essential beliefs and actions to develop andsustain the adolescent health; however, people with inadequate health literacy have poorer healthstatus. ...  Read More BACKGROUND: Health‑promoting behaviors are essential beliefs and actions to develop andsustain the adolescent health; however, people with inadequate health literacy have poorer healthstatus. This study aimed to determine the effect of a problem‑based learning (PBL) health literacyprogram on improving health‑promoting behaviors among female students (15–18 years) at highschools in 2018–2019.METHODS: This study was a quasi‑experimental intervention one which carried out on 377 girlstudents using a cluster sampling method of intervention (n = 183) and control (n = 194) groups. Theintervention was performed in four educational sessions of PBL health literacy program using relatedscenarios for 90 min. Data were collected through demographic variables, the Health Literacy Measurefor Adolescents, and the Health‑Promoting Lifestyle Profile II. Participants filled the questionnairesimmediately and 3 months after the intervention in both the groups.RESULTS: There were significant differences comparing the mean score of health literacydimensions in numeracy (P < 0.001), use (P < 0.001), communication (P < 0.001), access (P = 0.03),self‑efficacy (P < 0.001), and total health literacy (P < 0.001) after intervention. These differencesalso observed in numeracy (P < 0.001), use (P = 0.03) and total health literacy (P < 0.001) infollow‑up between the intervention and control groups. The mean scores of health‑promoting lifestyledimensions in all dimensions immediately after intervention (P < 0.001) and follow‑up (P ≤ 0.006)showed significant differences between the two groups, while the intervention group revealed ahigher mean scores.CONCLUSION: It seems that PBL health literacy and practicing real‑life scenarios can improvethe adolescent lifestyle. It is recommended to examine the effectiveness of the program for otherhealth‑related behaviors among other populations.

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Health literacy and its associated demographic factors in 18–65‑year‑old, literate adults in Bardaskan, Iran

. Hamid Joveini; . Alireza Rohban; . Parisa Askarian; . Mina Maheri; . Masoumeh Hashemian

Volume 9, Issue 12 , December 2019, , Pages 1-8

Abstract

  AIMS: Improvement of general health literacy is one of the ways to achieve the desired publichealth condition. To this end, the first step is to determine the health literacy level ...  Read More AIMS: Improvement of general health literacy is one of the ways to achieve the desired publichealth condition. To this end, the first step is to determine the health literacy level and its associateddemographic factors in individuals.SETTINGS AND DESIGN: This study was a cross‑sectional, descriptive‑analytic survey conductedon 700 adults (age range: 18–65 years) in Bardaskan, Iran. The required samples were selectedvia random cluster sampling method.SUBJECTS AND METHODS: The demographic questionnaire was used to collect sociodemographicinformation. The Health Literacy for Iranian Adults questionnaire was used to determine the level ofhealth literacy in participants.STATISTICAL ANALYSIS: Data analysis was conducted using SPSS software version 20 throughdescriptive and inferential statistics. Results were considered statistically significant at P ≤ 0.05.RESULTS: A total of 700 participants with a mean (standard deviation) age of 31.25 (9.32) yearsparticipated in this study. The primary sources of health information were physicians and healthstaff (50.9%) followed by the Internet (19.7%). The health literacy level of 18.1% of the participantswas inadequate, 27.7% was marginal, 39.4% was adequate, and 14.7% was excellent. The meanoverall scores of health literacy and its subscales were within the adequate range (66.1–84.0). Therelationships of health literacy level with age, education, marital status, occupational status, andhistory of disease were statistically significant (P < 0.001).CONCLUSION: It seems necessary to design and implement a variety of educational programs toimprove the general health literacy of the citizens of Bardaskan. Educational programs need to focuson groups with higher priority such as elderly people, individuals with lower educational levels, widows/widowers and divorced/separated individuals, unemployed and retired individuals, homemakers, andindividuals with a history of disease.

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Determining the relationship between health literacy level and quality of life among the elderly living in nursing homes

. Aidin Aryankhesal; . Noureddin Niknam; . Mahdi Hasani; . Nezamaddin Mengelizadeh; . Nahid Aghaei; . Zeinab Ghaedchukamei; . Asaad Ranaei; . Ehsan Allah Kalteh; . Beheshteh Naghdi

Volume 9, Issue 11 , November 2019, , Pages 1-9

Abstract

  BACKGROUND: The literacy level of the elderly is predictive of health behaviors, averagehospitalization in health centers, and the type of verbal interaction with health service providers;as ...  Read More BACKGROUND: The literacy level of the elderly is predictive of health behaviors, averagehospitalization in health centers, and the type of verbal interaction with health service providers;as the level of literacy changes, the quality of life may also change. This study aimed to determinethe relationship between health literacy level and quality of life among the elderly living in nursinghomes in 2018–2019.MATERIALS AND METHODS: This study was of a descriptive‑analytic, correlation type that wasperformed on 175 elderly of selected nursing homes in Tehran. The research tools included theAbbreviated Mental Test; Control, Autonomy, Pleasure and Self‑realization questionnaire‑19;and Health Literacy of Iranian Adults Questionnaire (HELIA). Data were analyzed using descriptiveand inferential statistics by SPSS 22 software.RESULTS: The total score of health literacy and the quality of life of the elderly was 51.01 and47.75, respectively. The literacy of most of the studied samples was “inadequate” and “not muchadequate” (0–66). The relationship between health literacy and quality of life in the elderly wassignificant, and there was a direct and statistically significant relationship between them (P = 0.003).That is, by an increase in literacy rates, the scores of quality of life of elderly people were alsoincreased. The correlation was equal to r = −0.28. Health literacy has the ability (31.98%) to predictthe quality of life.CONCLUSION: The results showed a lack of enough education literacy, the average quality of life,and the existence of a significant relationship between health literacy and quality of life in the elderly.The wide range of inadequate literacy in the elderly reveals the importance of paying more attentionto the issue of literacy in health planning and health promotion at the national and local levels.

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Investigating the effect of education on health literacy and its relation to health‑promoting behaviors in health center

. Tahere h Bayati; . Azizallah Dehghan; . Fatemeh Bonyadi; . Leyla Bazrafkan

Volume 8, Issue 10 , October 2018, , Pages 1-6

Abstract

  BACKGROUND: Health literacy is a combination of reading and listening skills, data analysis,decision‑making, and the ability to implement these skills during the necessary health ...  Read More BACKGROUND: Health literacy is a combination of reading and listening skills, data analysis,decision‑making, and the ability to implement these skills during the necessary health situations.This study was conducted with the purpose of determining the effect of educational intervention onhealth literacy and its impact on health‑promoting behaviors of the health ambassadors in the healthand treatment centers of the health network in Kazeroon (Fars province, Iran).MATERIALS AND METHODS: The present study is a quasi‑experimental study using before‑after testprocedure on 256 health ambassadors. Random systematic sampling method was used and to assess thehealth literacy, Montazeri’s health questionnaire was used, also the standard questionnaire (health‑promotinglifestyle profile‑I) was applied to determine the status of the health‑promoting behaviors. Two questionnaireswere filled out by the health ambassadors before and following the intervention. Data analysis wasperformed using SPSS software 22, through t‑test, ANOVA, and Pearson correlation.RESULTS: The mean health literacy scores of the ambassadors before educational interventionwere 79.22 which increased to 95.49 after intervention. Moreover, the results of the study showeda direct significant correlation of health literacy with all the dimensions of health‑promoting behaviorquestionnaire before and after the intervention (P < 0.001).CONCLUSIONS: Educational interventions can be used to enhance the health literacy of healthambassadors and have a significant impact on improving health‑promoting behaviors.

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Health literacy in patients with epidermolysis bullosa in Iran

. Mohammad Mahdi Parvizi; . Kamran Bagheri Lankarani; . Farhad Handjani; . Sulmaz Ghahramani; . Zahra Parvizi; . Sara Rousta

Volume 7, Issue 6 , December 2017, , Pages 1-6

Abstract

  INTRODUCTION: Health literacy is a set of different skills, including reading, listening, analyzing,deciding, and applying these skills related to health status. Epidermolysis bullosa ...  Read More INTRODUCTION: Health literacy is a set of different skills, including reading, listening, analyzing,deciding, and applying these skills related to health status. Epidermolysis bullosa (EB) is a rarehereditary genetic disease which affects several aspects of the life of patients and their families. Theaim of this study was to assess the health literacy of patients with EB in Iran.MATERIALS AND METHODS: Thirty‑three patients from Iran with EB, aged above 15 years-old,were enrolled in the study. Iranian Health Literacy Questionnaire, which measures health literacy infive domains including reading, access, perception, assessment, and decision-making skills, wasused for collecting the data. SPSS analytical software, version 22, was used for statistical analysis.RESULTS: In total, 19 (57.6%) patients were male and 14 (42.4%) female with an age range of15-41 years. Nineteen (57.6%) patients had inadequate health literacy in reading skills. One‑third ofpatients had enough health literacy in the realm of access, and two‑thirds were excellent in perception.Overall, there was no significant correlation between the level of health literacy with age (P = 0.92),sex (P = 0.55), race (P = 0.58), and educational level (P = 0.51) of the patients.CONCLUSION: The majority of the patients had inadequate health literacy in reading skills whilethese patients had acceptable health literacy in perception, assessment, and decision‑making skills.Improvement of health literacy of these patients should be a priority for health policy makers with theaim of increasing their quality of life and decreasing their personal and social problems.

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The relationship between media literacy and health literacy among pregnant women in health centers of Isfahan

. Farideh Akbarinejad; . Mohammad Reza Soleymani1; . Leila Shahrzadi

Volume 7, Issue 1 , March and April 2017, , Pages 1-6

Abstract

  Background: The ability to access, analyze, evaluate, and convey information in various formsof media including print and nonprint requires media literacy, but the capacity to obtain, ...  Read More Background: The ability to access, analyze, evaluate, and convey information in various formsof media including print and nonprint requires media literacy, but the capacity to obtain, process,and understand basic information and services needed for appropriate decisions regardinghealth, considered an important element in a woman’s ability to participate in health promotionand prevention activities for herself and her children, is needed to a level of health literacy. Thepurpose of this study was to determine the relationship between media literacy and healthliteracy among pregnant women in health centers in Isfahan. Materials and Methods: Thisstudy used a descriptive correlation study. Data collection tools include Shahin media literacyand functional health literacy in adults’ questionnaires. The population include pregnantwomen in health centers of Isfahan (4080 people). Ten out of the 351 health centers in Isfahanwere selected as cluster. Data were analyzed using both descriptive and inferential statistics.Results: Media literacy of respondents in the five dimensions was significantly lower thanaverage 61.5% of pregnant women have inadequate health literacy, 18.8% had marginal healthliteracy, and only 19.7% of them have had adequate health literacy. There was a significantpositive relationship between media literacy and health literacy among pregnant women.Conclusion: This study showed that the majority of pregnant women covered by healthcenters had limited health literacy and media literacy. Since one of the basic requirements forthe utilization of health information is needed for adequate media literacy, promotion of medialiteracy is necessary for the respondents.

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