Search Results (50)

Inflammatory bowel disease (IBD) requires sustained patient engagement in complex therapeutic and self-management processes, making health literacy (HL) a key determinant of effective care. This cross-sectional study assessed HL levels among adults with IBD attending a public day-hospital service in Lisbon, Portugal, and examined associations with sociodemographic, lifestyle, and selected clinical variables. A convenience sample of 280 participants completed a self-administered questionnaire, including the Portuguese version of the European Health Literacy Survey Questionnaire (HLS-EU-PT-Q16). Descriptive statistics, bivariate analyses, and multiple linear regression were used. HL indices were computed and categorized into proficiency levels; domain- and competency-specific indices were also analyzed. Overall, 48.3% of participants had inadequate or problematic HL, whereas 42.5% had sufficient HL. Healthcare-related HL showed the most favourable profile, whereas health promotion emerged as the weakest domain, with domain-specific mean indices ranging from 31.8 ± 8.3 to 34.4 ± 7.4 on a 0–50 scale. Competency-specific indices indicated that appraisal and, particularly in disease prevention, application were the lowest, and item-level analyses highlighted difficulties with mental health information-seeking and evaluating or acting on media-based health information. In multivariable linear regression analysis, higher educational attainment was positively associated with HL (B = 0.89; 95% CI: 0.05 to 1.73; p = 0.039), whereas female sex was independently associated with slightly lower HL scores (B = −1.72; 95% CI: −3.33 to −0.11; p = 0.036). These findings indicate that nearly half of patients with IBD in a day-hospital setting experience HL-related vulnerabilities, especially beyond clinician-mediated care. Targeted, HL-sensitive interventions focusing on critical appraisal and decision-to-action support may enhance self-management and equity in IBD care. Full article

Inadequate health literacy (HL) is a critical factor contributing to fall risk among older adults. However, evidence on how HL relates to home environment and fall prevention behaviors in Asian community settings remains limited. This study aimed to assess HL levels and examine their associations with sociodemographic characteristics, home environment, and fall prevention behaviors. A community-based cross-sectional study was conducted among 177 community-dwelling older adults aged 60 to 79 years. Data were collected through structured questionnaires assessing sociodemographic characteristics, home environment, fall prevention behaviors, and HL using the European Health Literacy Survey Questionnaire (HLS-EU-Q47), which cover three subdomains: healthcare, disease prevention, and health promotion. Multiple linear regression analysis was performed to examine the associations between sociodemographic factors, home environment, fall prevention behaviors, and HL. The HL score among older adults was 34.50 ± 7.50 (54.2% limited HL). A total HL score was positively associated with regular exercise (β = 2.73, 95% CI: 0.71, 4.74) and a sitting toilet (β = 6.38; 95% CI: 3.83, 8.92) and marginally associated with wearing properly fitting shoes (β = 2.54; 95% CI: 0.22, 4.86). Therefore, the health promotion aimed at improving HL in this population may benefit from concurrently promoting regular exercise, home safety modifications, and safe footwear practices. Full article

Background and Objectives: AI- and extended reality (XR)-enabled telemedicine is increasingly relevant to clinical training, yet evidence from Central and Eastern Europe is limited. We assessed Romanian medical students’ acceptance of AI/XR-enabled telemedicine and examined whether health literacy moderates the association between AI/XR knowledge and acceptance. Methods: We conducted an anonymous cross-sectional online survey of 212 medical students (years 1–6) at a single Romanian university (March 2024–June 2025). Acceptance was measured using a study-specific Acceptance Index (mean of three 4-point items: trust in AI-assisted recommendations, perceived improvement in telemedicine quality with AI/XR, and willingness to participate in AI/XR-enabled teleconsultations; internal consistency acceptable, Cronbach’s α ≈ 0.8). Health literacy was assessed with the validated Romanian version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). We performed group comparisons, Spearman correlations, multivariable and hierarchical regression with a Knowledge × Health Literacy interaction, and k-means clustering. Results: Participants had a mean age of 22.5 ± 1.9 years; 66.0% were female. Overall acceptance was high (2.9 ± 0.6). Acceptance was higher in clinical vs. preclinical years (3.1 ± 0.6 vs. 2.8 ± 0.5; p < 0.001; Cohen’s d ≈ 0.55) and in prior AI/XR users vs. non-users (3.2 ± 0.5 vs. 2.7 ± 0.6; p < 0.001; d ≈ 0.89). Knowledge correlated strongly with acceptance (ρ = 0.68; p < 0.001). In multivariable models (R² = 0.61), knowledge, perceived educational value, prior AI/XR use, and clinical stage independently predicted acceptance, whereas privacy concern and gender did not. Health literacy was sufficient in 64.2% and significantly moderated the knowledge–acceptance link (interaction p = 0.012). Conclusions: Romanian medical students report favorable acceptance of AI/XR-enabled telemedicine. Findings support curriculum integration that combines structured AI/XR teaching with literacy-sensitive scaffolding to ensure knowledge translates into informed, critical acceptance across student subgroups. Full article

Background/Objectives: Health literacy represents the ability to access, understand, appraise, and apply health information for making appropriate health decisions. It is closely linked to education, income, employment, and overall health outcomes. Limited health literacy is associated with poor self-care, inadequate treatment adherence, and increased healthcare utilization. This study aimed to assess the level of health and medication adherence behaviors among primary health care users in Montenegro and examine its association with key demographic and socioeconomic factors. Methods: A cross-sectional, multicenter study was conducted among 202 primary health care users at the Primary Healthcare Center Danilovgrad, Plav and Ulcinj, Montenegro. Data were collected using a demographic questionnaire, the standardized European Health Literacy Questionnaire (HLS-EU-Q-47), and the Attitudes towards Medication Adherence Self-Reported Questionnaire (ADHERE-7). Statistical analyses included descriptive statistics, χ² tests, and univariate and multivariate regression. Results: The mean HLS-EU-Q Index was 33.55 ± 8.05. Significant differences in literacy levels were observed by age (p = 0.022), material status (p = 0.043), and self-rated health (p = 0.020). In multivariate ordinal regression analysis, lower income (<400 €) was associated with lower odds of belonging to a higher health literacy category (OR = 0.22, 95% CI: 0.02–0.92, p = 0.039), while no statistically significant associations were observed for gender, education level, or employment status after adjustment. The mean ADHERE-7 score of the study population was 21.78 ± 5.19. When analyzed in relation to the level of health literacy, the highest mean ADHERE-7 score was observed among participants with excellent health literacy (24.28 ± 4.90). Lower levels of health literacy were associated with lower odds of belonging to higher health literacy categories among participants reporting selected non-adherence behaviors, including missing therapy 3–4 times per week (OR = 0.30), frequently skipping prescribed medication when feeling well (OR = 0.03), and reducing or omitting therapy due to perceived lack of benefit or high costs (OR range: 0.10–0.31). Conclusions: Health literacy among primary care users in Montenegro is moderate, with a substantial proportion exhibiting limited literacy. Low income is a key determinant of limited literacy, and limited health literacy was associated with poorer medication adherence. Targeted educational and policy interventions are needed to improve health literacy and reduce health inequalities. Full article

Background/Objectives: Health literacy (HL) plays a fundamental role in maternal and neonatal outcomes by influencing women’s ability to access, understand, and apply health information during pregnancy. However, evidence regarding the determinants of HL among pregnant women remains limited, particularly within the Spanish context. This study aimed to assess HL levels among pregnant women and to examine their association with personal, socioeconomic, and health-related factors. Methods: A cross-sectional study was conducted between January 2023 and February 2024 across nine primary care centres within the Vigo Health Area (Spain), including 182 pregnant women receiving prenatal care. HL was measured using the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16). Sociodemographic, obstetric, and health-related variables were collected through structured interviews. Descriptive and inferential analyses were performed to explore associations between HL and the selected variables. Results: Limited HL was observed in 35.7% of participants. A significant association was found between HL and family income (p = 0.037), with limited HL being more frequent among women with a monthly family income below €2000. No associations were identified with other sociodemographic or health-related variables. Thirty-nine per cent of participants visited hospital emergency services on two or more occasions, mostly without admission. The main source of information was healthcare professionals, although Internet use was also relevant. Conclusions: The prevalence of limited HL was lower than that reported in other national studies, although inequalities related to family income persisted. These findings highlight the need to incorporate systematic, HL-tailored strategies into prenatal care, based on prior HL assessment, to promote informed decision-making and improve maternal and neonatal outcomes. Full article

Background: As part of the research project ‘Seigungo–Gungo’s Health, Education, and Maternal and Child Quality of Life: An Action-Research Project’, a study was conducted in the Gungo community in Angola, a region facing significant challenges in terms of access to healthcare and health literacy. The primary aim of the study was to evaluate the effectiveness of an intervention training model designed to improve the health literacy of the participants. Methods: The sample consisted of 30 trainees, 60% of whom were male, with an average age of 45.6 years. Most participants were single (53.3%) and had completed 6 years of formal education (26.7%). Health literacy levels were assessed using the HLS-EU-PT-Q16, a short 16-item questionnaire designed to assess three key domains: healthcare, disease prevention, and health promotion. These domains are related to the focus of the training programme. Data collection took place throughout the year 2024. Results: According to the data obtained, prior to attending the training program, 60% of the participants demonstrated an inadequate level of health literacy. Following the intervention, this percentage dropped significantly to 20%. In contrast, the proportion of participants with sufficient to excellent health literacy rose from 16.7% to approximately 40%. The results indicate that the training program had a positive and statistically significant impact on improving health literacy in the Gungo community. Conclusions: These findings highlight the importance of targeted training and sustained intervention efforts to address the specific health education needs currently affecting this community. Full article

Health literacy is crucial for effectively navigating health systems and promoting equitable health outcomes. Multilingual and culturally dual regions present unique challenges for health communication; however, disparities in health literacy within such contexts remain insufficiently explored. This study constitutes the first population-based assessment of health literacy in Alto Adige/South Tyrol, a bilingual province in northern Italy, utilizing the validated HLS-EU-Q16 instrument. A stratified random sample of 2090 residents aged 18 and older was surveyed in 2024. Weighted analyses ensured population representativeness, and scores were analyzed overall, by domain (health care, disease prevention, health promotion), and by language group (German, Italian, multilingual). Regression models incorporating sociodemographic and health-related covariates were employed to identify predictors of health literacy. Half of the population (50.0%) exhibited problematic or inadequate health literacy, with significant differences observed across language groups. Italian speakers demonstrated the highest scores, whereas German speakers scored lowest overall. These differences remained significant after adjustment for age, education, chronic illness, and professional background. Domain-specific analyses revealed distinct patterns: German-speaking respondents scored particularly low in the health promotion domain, while multilingual individuals achieved the highest scores in the prevention and promotion domains. Education level and language background emerged as the strongest predictors of health literacy, while most other covariates exhibited limited explanatory power. The findings underscore the necessity for language-sensitive and domain-specific interventions, highlighting health literacy as both a personal skill and a structural responsibility. Full article

Health literacy improves informal caregivers’ knowledge and ability to provide care. The aim of this study is to analyze the impact of a group-based intervention on the health literacy of informal caregivers of children with special health needs (SHNs). The intervention focuses on movement, hydrotherapy, walking, and relaxation, with three evaluation stages. Participants included 34 informal caregivers of children with SHNs, recruited at a Physical Medicine and Rehabilitation Service. We collected sociodemographic data of the participants and measured their health literacy through the short-form version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Around 70% of the participants were female, with a mean age of 41.06 ± 4.98 years, and nearly 85% were married or in a de facto union. About 26% were unemployed, and more than 65% had completed secondary education or higher. The mean scores of the HLS-EU-Q16 were statistically significantly higher throughout the intervention, with differences over the evaluation stages [F(2,56) = 75.55; p < 0.05]. A structured, dynamic, and group-based intervention plan showed improvements in the health literacy of the participants, with an increase in the percentage of participants with sufficient and excellent levels of health literacy at the end of the intervention. Full article

Grounded in health behavior theory, this study examined patterns of preventive health behavior in a culturally diverse, multilingual region of northern Italy using data from a representative population survey (n = 2090). Preventive behaviors were assessed using the 16-item Good Health Practices (GHP-16) scale. Latent profile analysis (LPA) identified five behavioral profiles, ranging from ‘Globally Low Engagers’ to ‘Comprehensive High Engagers’. Binary logistic regression compared ‘Globally Low Engagers’ to ‘Broadly Moderate Preventers’, examining predictors including gender, age, education, language, chronic disease status, health literacy (HLS-EU-Q16), patient activation (PAM-10), mistrust of health information, living situation, and healthcare employment. The results showed that men, younger adults, individuals with low patient activation, those living alone, and respondents with high mistrust of health information had higher odds of belonging to the low engagement group. Health literacy and language group membership were not significantly associated with the profile membership. Item-level comparisons revealed gender differences in information-seeking, oral hygiene, and dietary behaviors, with men reporting lower engagement. These findings support a segmentation-based understanding of preventive health behavior and highlight the need to address personal capacities and contextual barriers in interventions while challenging assumptions of uniformly higher female health vigilance. Full article

Background/Objectives: Preventive health behaviors are key to disease prevention and health system sustainability; however, population-level factors remain understudied in multilingual regions. South Tyrol, an autonomous multilingual province in Northern Italy, provides a unique setting to examine how sociodemographic and linguistic factors shape preventive behaviors. Methods: A stratified, population-representative survey of 2090 adults (aged ≥18 years) was conducted in South Tyrol in 2024. Preventive behavior was assessed using the validated 16-item Good Health Practices Scale (GHP-16). Key predictors included age, sex, education, living situation, language group, employment in the health/social sector, health literacy (HLS-EU-Q16), patient activation (PAM-10), and the mistrust of professional health information. Weighted statistics and multivariable linear regression were used to identify associations. Results: The GHP-16 scores varied significantly across sociodemographic and psychosocial strata. Female sex, older age, higher education, higher patient activation, and sufficient health literacy were independently associated with greater engagement in preventive behaviors. Patient activation showed the strongest graded effect (β = 1.739). The mistrust of health professionals was inversely associated with behavior (β = –0.050, 95% CI: –0.090 to –0.009). Italian speakers reported higher GHP-16 scores than German speakers (β = 0.377), even after adjusting for covariates. Item-level analysis revealed small but consistent differences, particularly in information-seeking and vaccination behavior. Conclusions: Preventive behaviors in South Tyrol are shaped by demographic, psychosocial, and linguistic factors. Patient activation and health literacy are key modifiable predictors, whereas language group differences suggest structural and trust-related disparities that require tailored public health strategies in multilingual settings. Full article

Background/Objectives: Vaccination rates in South Tyrol, Northern Italy, remain among the lowest in the country. This study investigated whether health literacy is associated with vaccine uptake in this multilingual region. Methods: A representative cross-sectional survey (n = 2090) was conducted using the validated European Health Literacy Survey Questionnaire (HLS-EU-Q16) to assess health literacy. Vaccine uptake was evaluated on a 4-point Likert scale and analysed by age group (18–54 years; ≥55 years). Associations were explored using ANCOVA and multivariate logistic regression models. Results: Among younger adults (18–54 years), higher health literacy was significantly associated with greater vaccine uptake, particularly when compared with individuals with missing health literacy data. Health literacy was not a significant predictor for vaccine uptake in the older age group (≥55 years). Instead, vaccine uptake correlated with trust in healthcare providers, the presence of chronic diseases, and educational level. Differences in health literacy were notable across language groups, but these did not interact with vaccination behaviour. Conclusions: Building trust and targeting individuals with lower educational attainment are key strategies for improving vaccination rates across language groups. Although health literacy plays a secondary role, efforts to enhance it, especially among the German-speaking population, are still warranted. Younger individuals with missing health literacy scores, often with a migration background and low trust in healthcare, should be prioritised in vaccination and health literacy campaigns. Full article

Background/Objectives: Healthcare utilization is a behavioral phenomenon influenced by psychosocial factors. This study took place in South Tyrol, a culturally diverse autonomous province in northern Italy, and aimed to identify latent profiles of primary healthcare users based on health literacy, patient activation, sleep quality, and service use, and to examine the sociodemographic and health-related predictors of profile membership. Methods: A cross-sectional survey was conducted with a representative adult sample (n = 2090). The participants completed the questionnaire in German or Italian. Latent profiles were identified via model-based clustering using Gaussian mixture modeling and four z-standardized indicators: total primary healthcare contacts (general practice and emergency room visits), HLS-EU-Q16 (health literacy), PAM-10 (patient activation), and B-PSQI (sleep quality). The optimal cluster solution was selected using the Bayesian Information Criterion (BIC). Kruskal–Wallis and chi-square tests were used for between-cluster comparisons of the data. Multinomial logistic regression was used to examine the predictors of cluster membership. Results: Among the 1645 respondents with complete data, a three-cluster solution showed a good model fit (BIC = 19,518; silhouette = 0.130). The identified profiles included ‘Balanced Self-Regulators’ (72.8%), ‘Struggling Navigators’ (25.8%), and ‘Hyper-Engaged Users’ (1.4%). Sleep quality could be used to differentiate between different levels of service use (p < 0.001), while low health literacy and patient activation were key features of the high-utilization groups. Poor sleep and inadequate health literacy were associated with increased healthcare contact. Conclusions: The latent profiling revealed distinct patterns in health care engagement. Behavioral segmentation can inform more tailored and culturally sensitive public health interventions in diverse settings such as South Tyrol. Full article

Background/Objectives: Diabetes is a chronic metabolic disease affecting over 500 million adults worldwide, which is over 10% of the world’s population. Diabetes is associated with a high risk of complications, including cognitive impairment of varying severity. Effective treatment of diabetes requires the patients not only to follow medical recommendations, but also to have appropriate health literacy (HL). The aim of the study was to determine the level of health literacy in diabetes patients, taking into account their cognitive functions. Methods: the study design consists of an anonymous survey involving 312 patients with type 1 and 2 diabetes, treated at the Diabetology Clinic of the Institute of Rural Health in Lublin, Poland. The survey was based on two standardized research tools, the 47-item European Health Literacy Questionnaire (EU-HLS-Q47) and the Mini-Mental State Examination (MMSE), and an original questionnaire focusing on the patients’ health situation, metric questions, questions about self-assessment of knowledge, and educational needs. Results: The EU-HLS-Q47 and MMSE showed that diabetic patients mostly presented a sufficient level of health literacy. A limited level of health literacy was presented by 36.86% of the examined diabetic patients. A statistically significant relationship between the length of diabetes (in years) and the General Health Literacy, Health Care, and Health Promotion Indices was reported. The MMSE test showed that every third patient with diabetes had cognitive disorders of varying intensity. Conclusions: Patients with diabetes and their family members require coordinated care and targeted therapeutic education to prepare them for self-care and self-control so as to reduce the risk of complications. Full article

The acquisition of reliable health information plays a pivotal role in shaping informed decision-making and health-related behaviours. This investigation examined the factors influencing health information use and trust in health information sources among the adult population in South Tyrol, Italy, employing a population-based cross-sectional survey (n = 2090). Descriptive analyses revealed sociodemographic disparities, with younger individuals and those with higher educational attainment demonstrating increased engagement with digital sources, while older adults and those with lower educational levels exhibited a greater reliance on traditional media and healthcare professionals. Correlation analyses showed that elevated health literacy (HLS-EU-Q16) was linked to enhanced engagement with structured and professional health sources, whereas higher patient activation (PAM-10) exhibited a negative correlation with a dependence on healthcare professionals, indicating that more activated individuals are less reliant on medical consultations for health information. Individuals reporting a better health status were less inclined to use health information sources, such as media, healthcare professionals, or the internet, as opposed to relying on personal knowledge or experience. Ordinal regression models further identified age, education, and linguistic background as crucial predictors of health information use and trust in sources. These findings highlight the influence of health literacy and patient activation on information engagement and trust and emphasise the need for tailored public health initiatives to ensure equitable access to reliable health information across diverse demographic groups. Full article

Low health literacy (HL) is associated with numerous negative health behaviors and outcomes, making it crucial to understand its underlying determinants. While associations between sociodemographic variables and subjective HL have already been demonstrated, data on the association between HL and personality remain limited. This study aims to extend the current knowledge by exploring how personality traits influence HL, beyond the effects of sociodemographic variables on HL. A cross-sectional study was performed with a sample of 238 healthy participants aged 50 to 92 years. Personality was measured using the NEO Five-Factor Inventory and subjective health literacy using the HLS-EU-Q47 questionnaire. Descriptive and correlational analyses as well as a multiple linear regression analysis with the Big Five personality traits, sex, age, and education as predictors of subjective health literacy were performed. The General-HL index was 37.22 (SD 7.98), which corresponds to sufficient or non-limited health literacy. The Big Five personality traits accounted for 32.2% of the variance in health literacy. Of the traits, Conscientiousness emerged as the strongest predictor (β = 0.31, medium effect), followed by Neuroticism (β = −0.21, small effect) and Openness to experience (β = 0.15, small effect). Sex was also a significant predictor of health literacy (β = 0.14, small effect). These results suggest that personality plays a significant role in health literacy, with higher Conscientiousness, lower Neuroticism, and higher Openness to experience, as well as female sex, predicting better health literacy. These findings underscore the importance of considering personality traits in interventions aimed at improving health literacy, with potential implications for both theoretical understanding and practical application in healthcare settings. Full article