Nothing about me without me: why an EU health literacy strategy embracing the role of citizens and patients is needed

Roediger, Alexander; Immonen-Charalambous, Kaisa; Kujawa, Markus; Sørensen, Kristine

doi:10.1186/s13690-019-0342-4

Cited by 5 publications

(5 citation statements)

References 6 publications

(2 reference statements)

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“…To calculate the score of the HLS-EU-Q16, the answers were dichotomised into two categories with two scores-easy (easy or very easy) and difficult (difficult or very difficult). The HL score is a sum score and three levels have been defined-inadequate HL (0-8), problematic HL (9)(10)(11)(12) and adequate HL (13)(14)(15)(16). The categories were dichotomised into adequate and not adequate (inadequate and problematic).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, HL provides the capability to change one's beliefs if necessary [6]. Conversely, limited HL is an increasing problem affecting the general population [7][8][9][10][11][12][13][14][15]. A low level of HL leads to the misuse of available health resources and inappropriate access to care, which is defined as the degree of adaptation between patient skills and health-care system requirements [12,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Measuring Health Literacy in Southern Italy: A cross-sectional study

Schiavone

Attena

2020

PLoS ONE

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Introduction Health Literacy (HL) is an important determinant of individual health. Limited HL is an increasing problem affecting the general population. This study aims to assess the level of HL in patients attending outpatient medical facilities in general medicine located in Naples and Caserta and investigate the association of HL with health behaviours and health status. Materials and methods The study involved patients attending outpatient medical facilities in general medicine. The questionnaire had four sections-the sociodemographic information, the 16-items version of the European Health Literacy Survey questionnaire, the general self-efficacy scale (GSE) and the health status scale (EQ-VAS). Univariate and multivariate analyses were performed to investigate the sociodemographic determinants of HL. The Pearson correlation coefficients were determined to compare HL with health behaviours (GSE) and health status (EQ-VAS). Results The study showed that 61.6% of 503 patients had a low level of HL. After the multivariate analysis, HL was found to be higher among patients with higher education level and general self-efficacy score �30. There were no differences in HL between the age groups and people with or without chronic diseases. HL was stronger correlated with GSE than with EQ-VAS (0.53 vs 0.27). Conclusion This is the first study on HL for Southern Italy. It showed a low level of HL. As the sample was not representative of the reference population, we cannot derive a corresponding conclusion for the general population of Southern Italy. Therefore, more data in Italy are needed to plan actions for improving HL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Measuring Health Literacy in Southern Italy: A cross-sectional study

Schiavone

Attena

2020

PLoS ONE

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“…Given its health effects, several European Union (EU) initiatives address HL: in 2007, HL was identified as a policy priority in the European Commission's health strategy "Together for Health 2007-2013" 8 ; in 2012, improving HL was included among the priorities of the Health 2020 strategy of the World Health Organization (WHO) Regional Office for Europe 9 ; and in 2014, the first comparative survey on population literacy across eight EU countries was conducted 10 . At the international level, the WHO included HL as one of the key health promotion pillars needed for a successful 2030 Agenda for Sustainable Development 11 .…”

Section: Introductionmentioning

confidence: 99%

What is the Prevalence of Low Health Literacy in European Union Member States? A Systematic Review and Meta-analysis

et al. 2021

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Background Many studies have shown that low health literacy (HL) is associated with several adverse outcomes. In this study, we systematically reviewed the prevalence of low HL in Europe. Methods PubMed, Embase, and Scopus were searched. Cross-sectional studies conducted in the European Union (EU), published from 2000, investigating the prevalence of low HL in adults using a reliable tool, were included. Quality was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled prevalence estimates. A meta-regression analysis was performed to assess the association between low HL and the characteristics of the studies. Results The pooled prevalence of low HL ranged from of 27% (95% CI: 18–38%) to 48% (95% CI: 41–55%), depending on the literacy assessment method applied. Southern, Western, and Eastern EU countries had lower HL compared to northern Europe (β: 0.87, 95% CI: 0.40–1.35; β: 0.59, 95% CI: 0.25–0.93; and β: 0.72, 95% CI: 0.06–1.37, respectively). The assessment method significantly influenced the pooled estimate: compared to word recognition items, using self-reported comprehensions items (β: 0.61, 95% CI: 0.15–1.08), reading or numeracy comprehensions items (β: 0.77, 95% CI: 0.24–1.31), or a mixed method (β: 0.66, 95% CI: 0.01–1.33) found higher rates of low HL. Refugees had the lowest HL (β: 1.59, 95% CI: 0.26–2.92). Finally, lower quality studies reported higher rates of low HL (β: 0.56, 95% CI: 0.06–1.07). Discussion We found that low HL is a public health challenge throughout Europe, where one in every three to almost one in every two Europeans may not be able to understand essential health-related material. Additional research is needed to investigate the underlying causes and to develop remedies. PROSPERO Registration CRD42019133377

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“…In recent years, the number of published studies on HL has steadily increased and it is now considered as one of the main determinants of health and healthcare service use [ 2 ]. At present, low levels of HL are quite common: for instance, the results of the first European Health Literacy Survey (HLS-EU), conducted in 2011 in eight European Countries, showed that about 47% of respondents reported limited HL skills [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Health Literacy, Socio-Economic Determinants, and Healthy Behaviours: Results from a Large Representative Sample of Tuscany Region, Italy

Zanobini

Lorini

Lastrucci

et al. 2021

IJERPH

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Background: Health Literacy (HL) is one of the main determinants of health and is crucial for the prevention of noncommunicable diseases, by influencing key health-related behaviours. The aim of the present study was to assess the role of HL and sociodemographic factors in predicting the adoption of two healthy behaviours—physical activity and fruits and vegetables consumption. Methods: This study was conducted on the Tuscan population subsample of the Italian Behavioral Risk Factor Surveillance System in 2017–2018. HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Results: About 40% of the 7157 interviewees reported an inadequate or problematic HL level. Female sex, poor financial status, foreign nationality, and low education were associated with a problematic HL level, while an inadequate HL level was associated with being 50–69 years old, low education level, foreign nationality, poor financial status and unemployment or inactive status. Inadequate HL level was a strong predictor of both eating less than three portions of fruits/vegetables per day and not engaging in sufficient PA during leisure times. Conclusions: Our findings showed that an inadequate level of HL could negatively affect physical activity and diet, independently from the other sociodemographic conditions, confirming the role of HL as a relevant social determinant of health.

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Nothing about me without me: why an EU health literacy strategy embracing the role of citizens and patients is needed

Cited by 5 publications

References 6 publications

Measuring Health Literacy in Southern Italy: A cross-sectional study

Measuring Health Literacy in Southern Italy: A cross-sectional study

What is the Prevalence of Low Health Literacy in European Union Member States? A Systematic Review and Meta-analysis

Health Literacy, Socio-Economic Determinants, and Healthy Behaviours: Results from a Large Representative Sample of Tuscany Region, Italy

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