Search Results (4)

Background: Health literacy (HL) is a key determinant of health outcomes and equity. The European Health Literacy Survey 2019 (HLS₁₉) introduced three domain-specific instruments—HLS₁₉-NAV, HLS₁₉-COM-P-Q11, and HLS₁₉-VAC. We present the translation, cultural adaptation, field testing, and descriptive pilot evaluation of their Greek versions (HLS₁₉-NAV-GR, HLS₁₉-COM-GR, HLS₁₉-VAC-GR). Methods: Dual forward/back-translation and expert review (11 health professionals/academics) produced the final versions. A purposive, quota-guided field test (N = 71) approximated population distributions by sex, age, education, and geographical region. Test–retest stability (n = 16; ~12 days) was summarized primarily with intraclass correlation ICC (2,1), with Pearson/Spearman correlations reported secondarily. Internal consistency was assessed using ordinal alpha computed from polychoric (polytomous) and tetrachoric (dichotomous) correlations. We report item- and scale-level descriptive statistics for both the original polytomous (four-category, 1–4) responses and a dichotomous difficulty–ease scheme (1–2 vs. 3–4). Given the non-probability sampling in this pilot, the results are descriptive, not statistically representative. Results: Instruments were well accepted, requiring only minor revisions. Scales demonstrated high short-term stability and good internal consistency; inter-scale correlations were moderate, interpreted as associations among related but distinct constructs. Item distributions skewed toward Easy/Very Easy; several HLS₁₉-VAC-GR items showed a clear ceiling, suggesting the need to consider harder items or a larger item pool in future validation. By scale, scores followed the descending order NAV, COM, and VAC. Distributions and ranking patterns broadly mirrored population-level findings from other countries. Conclusions: The adapted HLS₁₉-NAV/COM/VAC-GR instruments are linguistically and culturally appropriate and prepared for large-scale validation, while items NAV9, COM4, and the VAC ceiling are flagged for further assessment. Full article

This secondary analysis explores differences and correlations between handwriting anticipatory awareness (time estimation, expected performance, and expected difficulty) before a paragraph copying task and actual performance time and legibility among adolescents with executive function deficits (EFD) versus neurotypical adolescents. Eighty-one adolescents (10–18 years old; 41 with EFD and daily functioning difficulties as per parent reports) estimated their time, expected performance, and expected difficulty before the paragraph copying task using the Self-Awareness of Performance Questionnaire (SAP-Q). Time duration was assessed using the Computerized Penmanship Evaluation Tool (ComPET) software, and legibility was scored using the Handwriting Legibility Scale (HLS). Significant between-group differences were found in actual time duration (ComPET), HLS total score and legibility components, and three SAP-Q questions. Both groups estimated significantly more performance time than their actual performance duration. The adolescents with EFD underestimated their performance before the handwriting task. Significant correlations were found between actual performance, anticipatory awareness, and Executive Function (EF) in both groups. Their performance predictions were significantly correlated with their EF and product’s legibility. The results highlight the potential relationships between anticipatory awareness and actual handwriting performance (time duration and legibility) of adolescents with and without EFD. Further studies may analyze the benefits of focusing on both EF and anticipatory awareness for handwriting improvement among populations with EF deficits. Full article

Background: Sufficient communicative health literacy (COM-HL) is important for patients actively participating in dialogue with physicians, expressing their needs and desires for treatment, and asking clarifying questions. There is a lack of instruments combining communication and HL proficiency. Hence, the aim was to establish an instrument with sufficient psychometric properties for measuring COM-HL. Methods: The HLS₁₉-COM-P instrument was developed based on a conceptual framework integrating HL with central communicative tasks. Data were collected using different data collection modes in nine countries from December 2019 to January 2021 (n = 18,674). Psychometric properties were assessed using Rasch analysis and confirmatory factor analysis. Cronbach’s alpha and Person separation index were considered for reliability. Results: The 11-item version (HLS₁₉-COM-P-Q11) and its short version of six items (HLS₁₉-COM-P-Q6) fit sufficiently the unidimensional partial credit Rasch model, obtained acceptable goodness-of-fit indices and high reliability. Two items tend to under-discriminate. Few items displayed differential item functioning (DIF) across person factors, and there was no consistent pattern in DIF across countries. All items had ordered response categories. Conclusions: The HLS₁₉-COM-P instrument was well accepted in nine countries, in different data collection modes, and could be used to measure COM-HL. Full article

Health literacy-sensitive communication has been found to be an important dimension of organizational health literacy measured from the patients’ perspective. Little is known about the role of health literacy-sensitive communication in complex care structures. Therefore, our aim was to assess which hospital characteristics (in terms of process organization) and patient characteristics (e.g., age, chronic illness, etc.) contribute to better perceptions of health literacy-sensitive communication, as well as whether better health literacy-sensitive communication is associated with better patient reported experiences. Data were derived from a patient survey conducted in 2020 in four clinical departments of a university hospital in Germany. Health literacy-sensitive communication was measured with the HL-COM scale. Data from 209 patients (response rate 24.2%) were analyzed with a structural equation model (SEM). Results revealed that no patient characteristics were associated with HL-COM scores. Better process organization as perceived by patients was associated with significantly better HL-COM scores, and, in turn, better HL-COM scores were associated with more patient-reported social support provided by physicians and nurses as well as fewer unmet information needs. Investing into good process organization might improve health literacy-sensitive communication, which in turn has the potential to foster the patient–provider relationship as well as to reduce unmet information needs of patients. Full article