Search Results (43)

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

Backgrounds/Objectives: Modern technology and educational activities, such as antenatal classes (ACs), increase patient informedness in medicine and improve collaboration between physicians and patients. The present study aimed to evaluate and compare the impact of maternal health literacy (HL) on delivery outcomes between nulliparous and multiparous women who attended antenatal classes. Methods: This prospective study recruited 281 pregnant women who regularly attended ACs, but only 188 who gave birth at our academic tertiary hospital were included in the final analysis. Socio-demographic characteristics, peripartum data (cervical dilatation at the time of admission to the hospital, duration of labor, and mode of delivery), and obstetric interventions (cesarean section (C/S) rate and rate of instrumental vaginal birth and episiotomy) were recorded, and the level of HL was assessed using the European Health Literacy Survey Questionnaire (HLS-EU-Q16). HL levels did not significantly affect peripartum and postpartum outcomes. Results: The study results showed that HL levels did not impact labor duration and newborn Apgar scores (p > 0.05). Patient education levels and employment status affected the peripartum duration of labor (p = 0.048 and p = 0.001, respectively). There were no differences in the HL total score and subscale scores (p > 0.05) between nulliparous and multiparous patients, and the rate of primary C/S was similar in both groups. Conclusions: HL levels did not impact delivery (peripartum) outcomes in pregnant women who attended antenatal classes. However, the primary C/S rate was similar between the nulliparous and multiparous groups, which may indicate that antenatal education services can correct the negative impact of low HL levels on the primary C/S rate. Full article

In early childhood, children are extremely susceptible to the acquisition of habits and the establishment of health-promoting habits. Therefore, the patterns, routines, and rules transmitted and expected by the adults surrounding the child are of paramount importance and can correlate with the level of their health literacy. Our cross-sectional, quantitative, exploratory study aimed to examine the relationships between parental health literacy and preschool children’s health-related habits, using simple, non-random sampling (n = 598). In addition to the sociodemographic characteristics, the measuring tool we compiled included the standardized European Health Literacy Survey Questionnaire (HLS-EU-Q16), as well as a set of questions containing 30 statements suitable for exploring children’s habit systems. The health literacy of the parents involved in our study proved to be more favorable than that of the general population. Regarding children’s habit systems, we found significant differences in several areas by age group (p < 0.05) and gender (p < 0.05). The levels of parental health literacy (0.003 ≤ p ≤ 0.048) and parents’ education (p < 0.05) show a correlation with the children’s health-related habit systems: the indicators of children with parents who have a higher level of health literacy and a higher level of education are more favorable in terms of established habits. In the long term, the formation of health-promoting habits may facilitate the internalization of favorable health behavior motives for the future, contributing to the establishment of positive physical, mental, and social health in adulthood. Full article

Rationale and aim: Health literacy (HL) is pivotal for the successful self-management of chronic diseases. Little HL information is currently available in SSc patients; therefore, the present study aims at evaluating the HL levels in an Italian cohort of SSc patients. Methods: SSc patients were enrolled with the support of Italian patient associations, from September 2022 to March 2023. Health literacy characteristics were derived from the Health Literacy Scale European Questionnaire-16 (HLS-EU-Q16), consisting of 16 items designed on a four-point Likert scale ranging from “very difficult” to “very easy”, and three HL levels were identified: inadequate HL (0–8 score); problematic HL (9–12 score); and sufficient HL (13–16 score). Results: Enrolled patients (n = 57, mean age = 59 years, SD = 13.2) were mostly female (98.2%), partnered (73.7%), and unemployed or retired (67.9%). Almost half of SSc patients were diagnosed more than 10 years ago, with first symptoms appearing on average 19 years ago (SD 10.5). In 63% of the participants, the overall health literacy skills were inadequate, or problematic, especially in the health care and disease prevention domains. Indeed, 49.2% of the patients declared difficulty in finding information on treatments for illnesses and where to get professional help (42.1%), 47.6% found difficulty in retrieving information on how to manage mental health problems, and 40.4% declared difficulties in judging whether the information on health risks in the media was reliable. Conclusions: Our findings show that SSc patients have inadequate or problematic levels of HL, suggesting the need for periodic screenings to uncover poor health literacy skills and to provide tailored and understandable educational material. This study was not registered. Full article

Vaccinations against COVID-19 are of the utmost importance in long-term care facilities. During the pandemic, mental health issues increased significantly. This cross-sectional analysis aimed to assess the associations of depression and anxiety with health literacy in people in need of care and the association of depression and burnout with vaccination readiness against COVID-19 in health care workers (HCWs). Within our cross-sectional study, people in need of care were assessed for symptoms of depression (PHQ-9), anxiety (GAD-7), and health literacy (HLS-EU-Q16). Among HCWs, we assessed symptoms of depression (PHQ-9) and burnout (MBI-HSS), as well as psychological antecedents of vaccination (5C) to measure vaccination readiness against COVID-19. A multivariate regression analysis was performed. Symptoms of a major depression were significantly associated with reduced health literacy (p = 0.010) in people in need of care. Among HCWs, symptoms of depression and burnout reduced vaccination readiness against COVID-19 significantly. In particular, collective responsibility was reduced in HCWs suffering from burnout symptoms (p = 0.001). People in need of care and their HCWs could benefit from intensified target group-specific vaccination counseling. Additionally, more attention should be paid to the protection of mental health in long-term care facilities. Full article

The improvement of health literacy (HL) is a critical issue for college students who are in the transitional period to adulthood and are establishing their subsequent lifestyles. The present study aimed to evaluate the current state of HL among college students and to explore the factors that influence HL. Moreover, it investigated the relationship between HL and health conditions. For this study, the researchers conducted an online survey of college students. The questionnaire consisted of the Japanese version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47), which is a self-assessment tool for HL that covers the major health issues of college students and health-related quality of life. The study analyzed 1049 valid responses. Based on the HLS-EU-Q47 total score, 85% of the participants exhibited problematic or unsatisfactory HL levels. Participants who reported high levels of healthy lifestyles obtained high HL scores. High levels of HL were associated with high levels of subjective health. Results from quantitative text analysis suggested that specific mindsets were correlated with high levels of competency in appraising health information among male students. In the future, educational intervention programs for college students need to be established to improve HL levels. Full article

Health literacy refers to the competencies of individuals and the general population to navigate all the areas of health care, making health decisions. Health professionals need a set of skills and information to adapt to people’s health literacy. To succeed, it is crucial to determine the health literacy level of a population, in this case, the Portuguese. This study aims to measure the psychometric properties of the Portuguese version of HLS-EU-Q16 and HLS-EU-Q6 from the long form of HLS-EU-Q47, already validated for Portugal. To analyse these results, a comparison was made with the HLS-EU-PT index. Spearman correlation analysis was performed between the single items and scale scores. Cronbach’s alphas for all the indexes were calculated. For the statistical analysis, SPSS (version 28.0) was used. Cronbach’s alpha coefficient for HLS-EU-PT-Q16 internal consistency was 0.89 overall, and for HLS-EU-PT-Q6 was 0.78 overall. Indexes were not normally distributed, and the Spearman correlation was computed. The correlation between G HL47 and G HL16 indexes was ρ = 0.95 (p < 0.001), and between G HL6 and HLS-EU-PT-Q6 was perfect. The HLS-EU-PT-Q16 and HLS-EU-PT-Q6 are concise and present adequate psychometric properties to measure the HL level of the Portuguese population. However, more similarities are found between the 47-item and the 16-item forms. Full article

(1) Background: Health literacy (HL) is one of the key determinants of health and healthcare outcomes. The objectives of this study are to measure and validate Sørensen et al.’s integrated model of health literacy (IMHL) in a developing country’s youth population, as well as to assess the impact of family affluence and social and family support on healthcare domains. (2) Methods: A cross-sectional survey was carried out of undergraduate university students in 19 public and private sector universities in Pakistan during June–August 2022. A nine-factor measurement model was tested using confirmatory factor analysis (CFA), and structural equation modeling (SEM) based on the 56 valid items obtained from three different validated scales, such as the family affluence scale (FAS-II), the multidimensional scale of perceived social support (MSPSS), and the European Health Literacy Questionnaire (the HLS-EU-Q). (3) Results: The data were collected from 1590 participants with a mean age of 21.16 (±2.027) years. The model fit indices indicate that the model partially fitted the data: χ² = 4.435, df = 1448, p = 0.000, RMSEA = 0.048, TLI = 0.906, CFI = 0.912, IFI = 0.912, GFI = 0.872, NFI = 0.889, RFI = 0.882, PGFI = 0.791. The structural equation model showed acceptable goodness of fit indices, indicating a significant direct influence of social and family support on healthcare and disease prevention. (4) Conclusions: Social and family support are the most influential factors, with regard to HL dimensions, in improving healthcare, disease prevention, and health promotion in low-income settings and among non-English-speaking communities. Full article