The relevance of context in understanding health literacy skills: Findings from a qualitative study

Abstract

BackgroundConceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of people's health experiences.ObjectivesTo describe individuals’ experiences of accessing, understanding, appraising and applying health information; explore the barriers and facilitators to using these skills; and to describe the experience of information exchange in health consultations.DesignA longitudinal qualitative methodology with thematic analysis of interviews was used. Health literacy levels were assessed using the HLS‐EU‐47–Item Questionnaire. Findings are presented from the first round of data collection.Setting and participantsTwenty‐six participants purposefully selected from a CVD risk reduction programme at three separate time points.ResultsFour key themes identified: using health literacy capacities for managing health; psychological and structural factors that impact on these capacities; and the relationship quality with the health‐care provider (HCP). Although limited health literacy was prevalent across the sample (65%), all individuals were very proactive in attempting to utilize health literacy skills. Findings emphasize the importance of contextual factors such as the quality of communication with the health‐care provider, perceptions of control, attitudes to family medical history, navigating structural barriers and being supported in managing treatment and medication side‐effects.Discussion and ConclusionFindings are relevant for health‐care providers in order to enhance the patient‐provider relationship and to ensure optimum health outcomes for all individuals regardless of health literacy levels.

A Qualitative Study of the Development of Health Literacy Capacities of Participants Attending a Community-Based Cardiovascular Health Programme

“…Findings in relation to anxiety provide further support of findings from time point 1 [ 22 ], which highlighted the impact of illness-related anxiety and fears on the ability to fully utilise health literacy capacities. In the current study, participants reported how their concerns had been alleviated and they were thus able to engage with and utilise health information more effectively.…”

“…This study makes an important contribution to the field of health literacy research as it is a qualitative in-depth and longitudinal study that follows individuals over time to examine developments in health literacy as they manage their health and illness in the context of their everyday lives. Findings from the first phase have been previously reported [ 22 ] and indicated a high level of limited health literacy for the population sample (65%). Both psychological factors, including perceptions of control and confidence in managing health, and structural factors such as access to health services and the impact of urban/rural environments, were found to impact on individuals’ use of health literacy capacities.…”

Fostering Health Literacy Responsiveness in a Remote Primary Health Care Setting: A Pilot Study

“…Whilst health literacy is partly determined by an individual's personal, literary, cognitive, communicative, and technology skills and capabilities, it is also affected by the demands placed on them by their increasingly complex healthcare systems [3]. Studies have shown that primary healthcare organisations are often the first point of access into the healthcare system and thus play a central role in facilitating or impeding the health literacy skills of individuals [16][17][18]. Clinical and non-clinical staff within healthcare organisations play a vital role in alleviating health literacy as a barrier to accessing healthcare by ensuring that across their services, policies, programs, and health information are all responsive to the diverse health literacy needs and preferences of the population [19].…”

A randomized controlled trial to evaluate utilization of physical activity recommendations among patients of cardiovascular healthcare centres in Eastern Slovakia: study design and rationale of the AWATAR study

“…Despite the strong emphasis on regular exercise during lifestyle counselling [ 38 ], in the EUROASPIRE IV (European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients), more than 59% of the interviewed patients reported little or no PA [ 39 ]. To clarify these conflicting observations, we need take to account the ecological factors [ 40 ], the quality of communication between care-providers and patients, [ 41 , 42 ] and the patient’s skills to access, understand and use of disease-specific instructions and recommendations [ 43 , 44 ]. The latter domain is also labelled as the patient’s health literacy (HL).…”

“…The latter domain is also labelled as the patient’s health literacy (HL). The HL level influences the patient’s use of healthcare, quality of disease management and health risk behaviours [ 45 ] and reflects patient’s proactivity in attempting to utilize health literacy skills [ 43 ]. Sufficient HL is significantly associated with improved health outcomes with a lower cost of care [ 45 ], while HL inadequacies can compromise patient safety, worsen management of a disease and increase the incidence of health conditions requiring intense medical assistance or hospitalization [ 46 ].…”