No abstract

Background: Health literacy (HL) is the ability to access, understand, appraise, and apply health information across the three domains of the health continuum: health care, disease prevention, and health promotion. It is needed for people to effectively manage their health. Information on population HL level is useful for crafting appropriate and targeted interventions to improve HL. Objective: The aim of this study was to describe the HL level of Filipino people at the national and subnational levels. Methods: A cross-sectional survey was conducted between 2018 and 2019 with 2,303 randomly selected Filipino people age 15 to 70 years, using an adapted Asia version of the European Health Literacy Survey Questionnaire-47. Prevalence estimates for limited HL and the corresponding 95% confidence interval (CI) were computed at the national and subnational levels. Key Results: The nationwide prevalence of limited HL was 51.5% (95% CI, [49.5%, 53.6%]), while sub-national prevalence estimates ranged from 48.2% to 65.4%. The prevalence varied across HL dimensions, with difficulty in access to information having the highest level. Similarly, prevalence across domains was variable; health care-related HL had the highest prevalence of limited HL. The HL levels for different dimensions and domains also varied across subnational groups. Conclusion: Many Filipino people had limited HL, and prevalence estimates varied across HL dimensions, HL domains, subnational groupings, and sociodemographic characteristics. The results highlight the need for targeted interventions focusing on subgroups with limited HL and on dimensions and domains where Filipino people have limited HL. [ HLRP: Health Literacy Research and Practice . 2022;6(2):e104–e112.] Plain Language Summary: The National Health Literacy Survey is the first nationwide survey on the prevalence of HL in the Philippines, involving 2,303 randomly selected Filipino residents age 15 to 70 years. Many Filipino people have limited HL, and the prevalence of HL varies across the components of HL, subnational groupings, and sociodemographic characteristics, highlighting the need for targeted interventions.

Background Health literacy determines an individual’s decision-making process in providing judgment concerning appropriate healthcare. Considering the various purposes of literacy for people, functional health literacy (FHL) was identified as a type of literacy that is measured by the application of literacy skills to health-related materials as a result of health education. The objective of this study was to identify the possible socio-demographic correlates of FHL of Filipinos. Methods A cross-sectional survey was conducted among 2,303 Filipinos aged 15 to 70 years old in 2018–2019 utilizing the National Health Literacy Survey. Functional health literacy was determined using the FHL-5 Test which measured prose, document, and numeracy skills. Descriptive analysis presented socio-demographic characteristics and level of FHL. Log-binomial regression was used to estimate associations of FHL adequacy with socio-demographic characteristics. Results Overall, the study involved 1,997 (86.7%) qualified participants. Most of them demonstrated prose literacy skills and had adequate FHL. Adjusted regression analyses showed that participants with a college-level education (Adjusted prevalence ratio [APR]: 1.43, 95% confidence interval [95% CI] 1.27–1.60), categorized under domestic service occupation (APR 1.19, 95% CI: 1.03–1.37), and those residing in urban areas (APR: 1.14, 95% CI 1.06–1.24) were significantly more prevalent in exhibiting FHL adequacy. In contrast, male participants and individuals aged 60 years or above were less likely to demonstrate FHL adequacy. Conclusions The study presents a baseline assessment of the functional health literacy level, measured using the FHL-5 Test, of adults in the Philippines. Majority of the participants demonstrated FHL adequacy, with relatively higher scores in prose than numeracy literacy. The measurement of FHL adequacy can inform policies on methods of health education and communication, emphasizing the need to stratify the audience based on socio-demographic characteristics and adapt the content and design of informational materials for population-based health educational programs.

Background:Protein-energy malnutrition is a major cause of functional decline in the elderly and isclearly an important component of frailty. However, limited evidence is available about how to select frailindividuals most benefiting from protein-energy supplementation. Objectives:1) To investigate factors associatedwith stronger benefits from protein-energy supplementation, and 2) to test the hypothesis that the severity offrailty is associated with the efficacy of protein-energy supplementation. Design:Secondary analysis of data froma pre-post-intervention study and a clinical trial. Setting:National Home Healthcare Services in Gangbuk-gu,Seoul, South Korea. Participants:123 community-dwelling frail older adults [usual gait speed (UGS) <0.6m/secand Mini Nutritional Assessment (MNA) <24]. Intervention:Each participant was received with two 200 mL perday of commercial liquid formula (providing additional 400 kcal of energy and 25 g of protein per day) for 12weeks. Measurements:Relative change in the Physical Functioning (PF) and Short Physical Performance Battery(SPPB) score between the baseline and 12-week follow-up assessments were measured. Results:Multilevelmixed-effect linear regression analysis showed that a lower level of baseline UGS was associated with a greaterimprovement in PF and SPPB score after adjustment for age, gender, education, living status, beneficiary ofpublic assistance, number of chronic diseases, compliance, and type of dataset (p<0.001). A lower level ofbaseline MNA score was associated with greater change in PF and SPPB score after adjustment for multiplecovariates (p<0.045). Participants with severe frailty (UGS <0.3 m/sec + MNA <17) showed 52.4% and 44.6%more relevant improvements in PF and SPPB score, respectively, than those with mild frailty (UGS 0.3-0.6 m/sec+ MNA 17-24) (p<0.001). Conclusion:Slower UGS and lower MNA score are independently associated with thegreater efficacy of protein-energy supplementation on functional status.

Functional health literacy (FHL) involves skills in writing, reading, oral expression, comprehension, and numerical calculations to successfully function and complete health-related tasks. This study aimed to develop and validate an instrument for measuring FHL in the Philippines using a mixed-method design. FHL-5TEST is an instrument consisting of five questions developed in consultation with local experts, translated to major Philippine languages, and underwent translation analysis, pretesting, cultural adaptation, and validation. A cross-sectional study was conducted in a random sample of 15-70-year-old Filipino residents to validate the instrument. The FHL-5TEST demonstrated high internal consistency, with a Cronbach’s alpha of 0.7690. Across different cut-off values, the sensitivity and specificity of the instrument in detecting limited FHL ranged from 60.9% to 86.0% and from 61.6% to 97.2%, respectively. The study demonstrated that the FHL-5TEST is a valid and reliable instrument to measure functional health literacy in the Philippines.