Health literacy and the use of healthcare services in Belgium

Vandenbosch, Jessica; Broucke, Stephan Van den; Vancorenland, Sigrid; Avalosse, Hervé; Verniest, Rebekka; Callens, Michaël

doi:10.1136/jech-2015-206910

Cited by 130 publications

(130 citation statements)

References 30 publications

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“…In a study involving 9617 members of a Belgian health insurance fund it was confirmed that low HL was associated with more admissions to one-day clinics, general practitioner home consultations, psychiatric consultations, ambulance transportation and with longer stays in general hospitals [31]. The study undertaken by Garcia-Codina et al [29] showed that low HL was modestly associated with low levels of physical activity, having self-perceived chronic disorders and not undertaking preventive activities.…”

Section: Discussionmentioning

confidence: 94%

“…z o.o., Rybnik, Poland) [33], a company which has considerable experience in the conduct of opinion polls. This minimum size of the sample was established after taking into consideration the size of the population (31,535,606, according to Statistics Poland, the central statistical office in Poland [34]), the fraction of 0.5, and a confidence level of 0.95. For the sample of 1000 respondents, the level of the sampling error was 3.1%.…”

Section: Surveymentioning

confidence: 99%

“…Therefore, a shortened but also validated, the 16-item version has been used in many surveys (HLS-EU-Q16) [5,12,[25][26][27][28][29]. The HLS-EU-Q16 questionnaire has been used not only in direct interviews with respondents [27,29] but also for telephone-based studies [12,26,30] or online surveys [31]. In some studies, the paper-based questionnaire was self-administered by respondents [32].The only previous study of HL on a nationally representative sample of the Polish population was undertaken as part of the HLS-EU project [4] using the HLS-EU-Q47 questionnaire.…”

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confidence: 99%

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Determinants and Consequences of Limited Health Literacy in Polish Society

Duplaga

2020

IJERPH

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Background: Health literacy (HL) is perceived as one of the most important concepts for modern health promotion activities to be successful. The research undertaken in the context of HL usually focuses on its antecedents and consequences, either for specific groups of patients or society or for the whole population. Objectives: The main aim of this study was to assess the antecedents and consequences of limited health literacy (HL) in a nationally representative sample of the Polish population. Methods: The analysis was carried out on the data obtained from a sample of 1000 Polish citizens through a telephone-based survey undertaken using a short, 16-item questionnaire developed within the European Health Literacy Project (HLS-EU). The total HLS score was calculated according to the guidelines published by the HLS-EU project. Chi2 test and logistic regression models were used for the analysis of the relationships between the variables. Results: The mean HL score (standard deviation) in the study sample was 12.99 (3.11). HL was related to age, marital and vocational status. Limited HL was associated with a lower self-assessment of health (OR, 95% CI: 2.52, 1.54-4.13), the prevalence of obesity and disability (1.71, 1.13-2.57, and 1.92, 1.25-2.94, respectively), less frequent physical activity (0.70, 0.49-0.99), a lower consumption of fruits and vegetables (0.47, 0.34-0.65), and with more frequent hospitalisations (2.02, 1.38-2.95). Conclusions: The assessment of HL using the16-item HLS-EU questionnaire may be a useful tool to enable health behaviours and utilisation of health care resources by society to be predicted.The research undertaken in the context of HL usually focuses on its antecedents and consequences, either for specific groups of patients or citizens or for the whole population. The available evidence from population studies shows that health literacy may depend on sex, age, level of education, economic and/or social status, and the type of vocational activities. In the research carried out to date, it has been demonstrated that lower HL is displayed by men rather than by women [4][5][6][7], by people having lower levels of educational attainment than by those with higher levels [4][5][6][7][8][9][10][11][12], by single people than by married people [7,13], by people with lower social status than by those with a higher status [8,11,14], by people of lower rather than those of higher economic status or income [4,[7][8][9]13,15,16] and, finally, by people living in more challenging conditions [6,8]. In most studies, there was also a general trend for HL decreasing with age [4,6,8,9,15].The efforts undertaken in the last decade resulted in a comprehensive assessment of the consequences of limited health literacy. In 2011, the updated version of the systematic review authored by Berkman et al. [16] was published. This stated that low HL might be associated with more frequent hospital admissions and the use of emergency care; lower participation in screening programmes, e.g., mammography; lower receipt of ...

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Section: Discussionmentioning

confidence: 94%

Section: Surveymentioning

confidence: 99%

mentioning

confidence: 99%

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Determinants and Consequences of Limited Health Literacy in Polish Society

Duplaga

2020

IJERPH

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“…We used the following cut off points: 0–8 is inadequate health literacy, 9–12 is limited, and 13–16 is sufficient health literacy. For more information on the HLS-EU 16 and the method of data management we used see Vandenbosch et al [19]. In this study, we divided the respondents in two groups: inadequate/limited health literacy (HL low) and sufficient health literacy (HL high).…”

Section: Methodsmentioning

confidence: 99%

Beyond Reading and Understanding: Health Literacy as the Capacity to Act

Rademakers

Heijmans

2018

IJERPH

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Many health literacy interventions have a limited focus on functional/cognitive skills. In psychosocial models, the capacity to act however is seen as a major driver of behavioural change. This aspect is often lacking in health literacy concepts. In this study, we examine the impact of both aspects of health literacy (functional/cognitive and capacity to act) on specific healthcare outcomes (healthcare use, experiences with patient-centered care, shared-decision making, and self-management). In a sample of a national panel of people with a chronic disease (NPCD), questions about health literacy, patient activation, and outcomes were asked. The results indicated that 39.9% had limited HL levels and 36.9% had a low activation score. Combined, 22.7% of the sample scored low on both aspects, whereas 45.8% had adequate levels on both. Patients who score low on both use more healthcare and have less positive experiences with patient-centered care, shared decision making, and self-management. Patients who have adequate competency levels in both respects have the best outcomes. Both cognitive and non-cognitive aspects of health literacy are important, and they enhance each other. The capacity to act is especially important for the extent to which people feel able to self-manage.

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“…People with limited health literacy are, on average, less knowledgeable about their disease and treatment, less able to successfully perform self-care tasks, and have poorer self-efficacy. This translates to worse health outcomes including greater hospitalization, mortality risk, use of emergency services, and decreased use of preventive care (e.g., Baker, 2006; Baker, Parker, Williams, & Clark, 1998; Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011; Kindig, Panzer, Nielsen-Bohlman, 2004; Paasche-Orlow & Wolf, 2007; Vandenbosch et al, 2016). …”

mentioning

confidence: 99%

Interview Administration of PROMIS Depression and Anxiety Short Forms

Taple¹,

Griffith²,

Wolf³

2019

HLRP: Health Literacy Research and Practice

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Background: Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence how patients report symptoms, leading to underestimates or overestimates of symptom severity. No prior studies have examined health literacy measurement bias. Objective: The purpose of the current study was to determine whether PROMIS (Patient-Reported Outcomes Measurement Information System) anxiety and depression short forms, administered by interview, capture symptoms equally across health literacy groups. We examined the psychometric properties of PROMIS anxiety and depression short forms using differential item functioning (DIF) analysis by level of health literacy. Methods: The sample analyzed included 888 adults, age 55 to 74 years, in Chicago, IL. Health literacy was measured using the Test of Functional Health Literacy in Adults. PROMIS short forms assessed anxiety and depression. Key Results: DIF was present in 3 of 8 depression items, and 3 of 7 anxiety items. All items flagged for DIF had lower item-slopes for people with limited health literacy. Conclusions: Items with DIF were less strongly related to anxiety and depression, and thus less precise. Overall, impact of DIF on PROMIS scores was negligible, likely mitigated by interview administration. Although overall test impact of health literacy was minimal, DIF analyses flagged items that were potentially too complex for people with limited health literacy. Design and validation of patient-reported surveys should incorporate respondents with a range of health literacy and methods to identify and reduce measurement bias. [ HLRP: Health Literacy Research and Practice . 2019;3(3):e196–e204.] Plain Language Summary: This study suggests that people with limited health literacy may respond differently to questions about depression and anxiety than people with adequate health literacy. Therefore, it is important to be aware of differences in literacy ability when creating and using questionnaires.

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Health literacy and the use of healthcare services in Belgium

Cited by 130 publications

References 30 publications

Determinants and Consequences of Limited Health Literacy in Polish Society

Determinants and Consequences of Limited Health Literacy in Polish Society

Beyond Reading and Understanding: Health Literacy as the Capacity to Act

Interview Administration of PROMIS Depression and Anxiety Short Forms

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