Validity and reliability of the Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale in patients undergoing bariatric surgery in Sweden: a prospective psychometric evaluation study

ObjectivesThe aim was to psychometrically test and evaluate the Swedish functional health literacy scale and the Swedish communicative and critical health literacy scale in patients undergoing bariatric surgery.DesignA prospective cross-sectional psychometric study.SettingPatients from three bariatric centres in Sweden were consecutively included in this study.ParticipantsA total of 704 patients undergoing bariatric surgery filled in the questionnaires preoperatively. Inclusion criteria were scheduled for primary bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) and greater than 17 years, proficiency in Swedish.Primary and secondary measuresPsychometric outcomes of the Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale.ResultsThere was a higher proportion of females (74.4%, n=523) to males (25.6%, n=180). The mean age was 42 years (SD 11.5). Limited functional health literacy and limited communicative and critical health literacy (including both inadequate and problematic health literacy) was reported in 55% (n=390) and 40% (n=285), respectively. Cronbach alpha for the Swedish Functional Health Literacy scale was α=0.86 and for the Swedish Communicative and Critical Health Literacy scale, α=0.87. Construct validity showed weak to negative correlations between the Swedish Functional Health Literacy scale and income, education and SF-36/RAND36 summary scores. Confirmatory factor analysis showed a one-factor solution for the Swedish Functional Health Literacy scale and a two-factor solution for the Swedish Communicative and Critical Health Literacy scale.ConclusionsThe Swedish Functional Health Literacy scale and the Swedish Communicative and Critical Health Literacy scale are valid and reliable to use for patients undergoing bariatric surgery in a Swedish context. Measuring dimensions of health literacy can be used as a guide for the development of health literacy friendly patient information in patients undergoing bariatric surgery.

Critical Health Literacy in a Pandemic: A Cluster Analysis Among German University Students

Objectives: In the COVID-19 pandemic, critical health literacy (CHL-P) has been proposed as a means of addressing issues of complexity, uncertainty, and urgency. Our study aimed to identify CHL-P clusters among university students in Germany and to analyze associations with potential determinants.Methods: In May 2020, students at four German universities participated in the COVID-19 International Student Well-Being Study, an online survey that yielded a non-probabilistic sample of N = 5,021. CHL-P, COVID-19-related knowledge, worries, risk perception, and adherence to protective measures were measured in an online questionnaire with self-constructed items. We conducted a cluster analysis of the five CHL-P items and performed logistic regression analyses.Results: Two CHL-P clusters were identified: high vs. moderate CHL-P. Belonging to the high-CHL-P cluster (31.2% of students) was significantly associated with older age, female/other gender, advanced education, higher levels of parental education, and moderate importance placed on education. In addition, higher levels of knowledge, risk perception and worries, and adherence to protective measures were associated with high CHL-P cluster membership.Conclusion: Students would benefit from educational measures that promote CHL-P at German universities.

The Norwegian public’s ability to assess treatment claims: results of a cross-sectional study of critical health literacy

Background: Few studies have evaluated the ability of the general public to assess the trustworthiness of claims about the effects of healthcare. For the most part, those studies have used self-reported measures of critical health literacy. Methods: We mailed 4500 invitations to Norwegian adults. Respondents were randomly assigned to one of four online questionnaires that included multiple-choice questions that test understanding of Key Concepts people need to understand to assess healthcare claims. They also included questions about intended behaviours and self-efficacy. One of the four questionnaires was identical to one previously used in two randomised trials of educational interventions in Uganda, facilitating comparisons to Ugandan children, parents, and teachers. We adjusted the results using demographic data to reflect the population. Results: A total of 771 people responded. The adjusted proportion of Norwegian adults who answered correctly was > 50% for 17 of the 30 Key Concepts. On the other hand, less than half answered correctly for 13 concepts. The results for Norwegian adults were better than the results for Ugandan children in the intervention arm of the trial and parents, and similar to those of Ugandan teachers in the intervention arm of the trial. Based on self-report, most Norwegians are likely to find out the basis of treatment claims, but few consider it easy to assess whether claims are based on research and to assess the trustworthiness of research. Conclusions: Norwegian adults do not understand many concepts that are essential for assessing healthcare claims and making informed choices.Future interventions should be tailored to address Key Concepts for which there appears to be a lack of understanding.

The level of health literacy of secondary school students in Slovenia

Introduction: Health literacy of secondary school students is particularly important as they are exposed to higher health risk. Therefore, the aim of the study is to determine the level of basic health literacy, critical and mental health literacy, and numeracy of Slovenian secondary school nursing students using a cross-sectional comparative method.Methods: The questionnaire measuring the level of basic numerical, critical, and mental health literacy was completed by 249 secondary school students, divided into a group of secondary school students attending a nursing program and students of others similar secondary schools such as economic technician, chemical technician and preschool education.Results: Secondary nursing students were found to have statistically significantly higher levels of basic and mental health literacy than their peers, rather than numerical and critical health literacy. In addition, the results show that there is no statistically significant difference in the level of health literacy between the groups of secondary school students in relation to the environment (rural/urban area).Conclusion: Numerical and critical health literacy should be systematically developed in nursing schools, and at least the basic aspects of health literacy should be introduced in all secondary school curricula.

Strenghtening Critical Health Literacy for Health Information Appraisal. An Approach from Argumentation Theory

The overload of health information has been a major challenge during the COVID-19 pandemic. Public health authorities play a primary role in managing this information. However, individuals have to apply critical health literacy to evaluate it. The objective of this paper is to identify targets for strengthening critical health literacy by focusing on the field of argumentation theory. This paper is based on the textual analysis of instances of health information through the lens of argumentation theory. The results show that critical health literacy benefits from: (1) understanding the concept of argument and the supporting reasons, (2) identifying the main argument schemes, and (3) the knowledge and use of the main critical questions to check the soundness of arguments. This study operationalizes the main aspects of critical health literacy. It calls for specific educational and training initiatives in the field. Moreover, it argues in favor of broadening the current educational curricula to empower individuals to engage in informed and quality decision making. Strenghtening individuals' critical health literacy involves interventions to empower in argument evaluation. For this purpose, argumentation theory has analytical and normative frameworks that can be adapted within a lay-audience education concept.

Case Study on Patient Groups on Facebook in Turkey

Increasing prevalence of chronic diseases and ageing population necessitate access to accurate health information for better health. The internet and social media affect and transform the communication of health-related information. Online platforms are enabling patients and patient groups to find common ground to discuss their health and diseases. Focusing on disease/patient group sites, this chapter investigates these sites through analyzing their features, inclusion of social and economic determinants of health in their contents, and level of critical health literacy calling for decision and action. Furthermore, these sites and their organization structures are analyzed by netnography. The findings show that disease/patient sites on Facebook are highly benefitted as an information and experience sharing platform. However, the critical health literacy level of the contents is quite low. Therefore, the role of social media as an improvement area for critical health literacy in health communication is getting more important.

Critical health literacy in pandemics: the special case of COVID-19

Summary In the current COVID-19 pandemic the active participation of the public is of central importance, however, certain factors found in this new pandemic disease complicates the participation. Addressing these complications needs public health and health promotion experts to understand the role of critical health literacy in a pandemic. We present the case for a definition of critical health literacy in a pandemic, CHL-P. We suggest that CHL-P can help professionals to support individuals and communities as agents for effectively dealing with the unique features of this pandemic.