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Richard H Osborne - One of the best experts on this subject based on the ideXlab platform.
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Health Literacy of recently hospitalised patients a cross sectional survey using the Health Literacy questionnaire hlq
BMC Health Services Research, 2017Co-Authors: Rebecca L Jessup, Richard H Osborne, Alison Beauchamp, Allison Bourne, Rachelle BuchbinderAbstract:Health Literacy is simply defined as an individual’s ability to access, understand and use information in ways that promote and maintain good Health. Lower Health Literacy has been found to be associated with increased emergency department presentations and potentially avoidable hospitalisations. This study aimed to determine the Health Literacy of hospital inpatients, and to examine if associations exist between different dimensions of their Health Literacy, sociodemographic characteristics and hospital services use. A written survey was sent to 3,252 people aged ≥18 years in English, Arabic, Chinese, Vietnamese, Italian or Greek. The survey included demographic and Health questions, and the Health Literacy Questionnaire (HLQ). The HLQ is a multidimensional instrument comprising nine independent scales. Use of hospital services was measured by length of stay, number of admissions in 12 months and number of emergency department presentations. Effect size (ES) for standardised differences in means described the magnitude of differences in HLQ scale scores between demographic and socioeconomic groups. 385 questionnaires were returned (13%); mean age 64 years (SD 17), 49% female. Aged ≥65 years (55%), using the Internet < once a month (37%), failure to complete high school (67%), low household income (39%), receiving means-tested government benefits (61%) and being from a culturally and linguistically diverse (CALD) background (24%), were all associated with lower scores in some Health Literacy scales. Being aged ≥65 years, not currently employed, receiving government benefits, and being from a CALD background were also associated with increased use of some hospital services. There was no association between lower scores on any HLQ scale and greater use of hospital services. We found no association between lower Health Literacy and greater use of hospital Health services. However increased age, having a CALD background and not speaking English at home were all associated with having the most Health Literacy challenges Strategies to address these are needed to reduce Health inequalities.
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distribution of Health Literacy strengths and weaknesses across socio demographic groups a cross sectional survey using the Health Literacy questionnaire hlq
BMC Public Health, 2015Co-Authors: Alison Beauchamp, Rachelle Buchbinder, Roy Batterham, Sarity Dodson, Gerald R Elsworth, Crystal Mcphee, Louise Margaret Sparkes, Melanie Hawkins, Richard H OsborneAbstract:Recent advances in the measurement of Health Literacy allow description of a broad range of personal and social dimensions of the concept. Identifying differences in patterns of Health Literacy between population sub-groups will increase understanding of how Health Literacy contributes to Health inequities and inform intervention development. The aim of this study was to use a multi-dimensional measurement tool to describe the Health Literacy of adults in urban and rural Victoria, Australia. Data were collected from clients (n = 813) of 8 Health and community care organisations, using the Health Literacy Questionnaire (HLQ). Demographic and Health service data were also collected. Data were analysed using descriptive statistics. Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between demographic sub-groups. Mean age of respondents was 72.1 (range 19–99) years. Females comprised 63 % of the sample, 48 % had not completed secondary education, and 96 % reported at least one existing Health condition. Small to large ES were seen for mean differences in HLQ scales between most demographic groups. Compared with participants who spoke English at home, those not speaking English at home had much lower scores for most HLQ scales including the scales ‘Understanding Health information well enough to know what to do’ (ES −1.09 [95 % confidence interval (CI) -1.33 to −0.84]), ‘Ability to actively engage with Healthcare providers’ (ES −1.00 [95 % CI −1.24, −0.75]), and ‘Navigating the Healthcare system’ (ES −0.72 [95 % CI −0.97, −0.48]). Similar patterns and ES were seen for participants born overseas compared with those born in Australia. Smaller ES were seen for sex, age group, private Health insurance status, number of chronic conditions, and living alone. This study has revealed some large Health Literacy differences across nine domains of Health Literacy in adults using Health services in Victoria. These findings provide insights into the relationship between Health Literacy and socioeconomic position in vulnerable groups and, given the focus of the HLQ, provide guidance for the development of equitable interventions.
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the optimising Health Literacy ophelia process study protocol for using Health Literacy profiling and community engagement to create and implement Health reform
BMC Public Health, 2014Co-Authors: Roy Batterham, Alison Beauchamp, Rachelle Buchbinder, Sarity Dodson, Gerald R Elsworth, Richard H OsborneAbstract:Health Literacy is a multi-dimensional concept comprising a range of cognitive, affective, social, and personal skills and attributes. This paper describes the research and development protocol for a large communities-based collaborative project in Victoria, Australia that aims to identify and respond to Health Literacy issues for people with chronic conditions. The project, called Ophelia (OPtimising Health Literacy) Victoria, is a partnership between two universities, eight service organisations and the Victorian Government. Based on the identified issues, it will develop and pilot Health Literacy interventions across eight disparate Health services to inform the creation of a Health Literacy response framework to improve Health outcomes and reduce Health inequalities.
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measuring Health Literacy in populations illuminating the design and development process of the european Health Literacy survey questionnaire hls eu q
BMC Public Health, 2013Co-Authors: Kristine Sorensen, Zofia Slonska, Gerardine Doyle, James Fullam, Barbara Kondilis, Stephan Van Den Broucke, Richard H Osborne, J Pelikan, Vivian Stoffels, Helmut BrandAbstract:Several measurement tools have been developed to measure Health Literacy. The tools vary in their approach and design, but few have focused on comprehensive Health Literacy in populations. This paper describes the design and development of the European Health Literacy Survey Questionnaire (HLS-EU-Q), an innovative, comprehensive tool to measure Health Literacy in populations. Based on a conceptual model and definition, the process involved item development, pre-testing, field-testing, external consultation, plain language check, and translation from English to Bulgarian, Dutch, German, Greek, Polish, and Spanish. The development process resulted in the HLS-EU-Q, which entailed two sections, a core Health Literacy section and a section on determinants and outcomes associated to Health Literacy. The Health Literacy section included 47 items addressing self-reported difficulties in accessing, understanding, appraising and applying information in tasks concerning decisions making in Healthcare, disease prevention, and Health promotion. The second section included items related to, Health behaviour, Health status, Health service use, community participation, socio-demographic and socio-economic factors. By illuminating the detailed steps in the design and development process of the HLS-EU-Q, it is the aim to provide a deeper understanding of its purpose, its capability and its limitations for others using the tool. By stimulating a wide application it is the vision that HLS-EU-Q will be validated in more countries to enhance the understanding of Health Literacy in different populations.
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conceptualising Health Literacy from the patient perspective
Patient Education and Counseling, 2010Co-Authors: Joanne E Jordan, Richard H Osborne, Rachelle BuchbinderAbstract:Abstract Objective A person's Health Literacy, i.e., their ability to seek, understand and use Health information, is a critical determinant of whether they are able to actively participate in their Healthcare. The objective of this study was to conceptualise Health Literacy from the patient perspective. Methods Using comprehensive qualitative methods 48 individuals were interviewed across three distinct groups in Australia: those with a chronic condition, the general community and individuals who had recently presented to a metropolitan public hospital emergency department. Purposeful sampling was employed to ensure a range of experiences was captured. Results Seven key abilities were identified: knowing when to seek Health information; knowing where to seek Health information; verbal communication skills; assertiveness; Literacy skills; capacity to process and retain information; application skills. Conclusion This study identifies key abilities patients identified as critical to seek, understand and utilise information in the Healthcare setting. These abilities are not reflected in existing measures for Health Literacy. Future measures of Health Literacy could consider incorporating abilities identified in this study and may provide guidance in developing Health interventions to assist patients to participate effectively in their Health. Practice implications More comprehensive measures to assess patient's Health Literacy are needed.
Michael S Wolf - One of the best experts on this subject based on the ideXlab platform.
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aging and functional Health Literacy a systematic review and meta analysis
Journals of Gerontology Series B-psychological Sciences and Social Sciences, 2016Co-Authors: Lindsay C Kobayashi, Michael S Wolf, Jane Wardle, Christian Von WagnerAbstract:Limited functional Health Literacy among adults is a major public Health problem. Functional Health Literacy is defined as an individual’s capacity to obtain, process, and understand basic Health information and services sufficiently to make appropriate Health decisions and will be used interchangeably with the term “Health Literacy” in this review (Institute of Medicine, 2004). Limited Health Literacy is of particular concern among older adults, who often have increased needs for Health information and services to maintain their Health and well-being. National Literacy surveys indicate that more than 70% of adults aged older than 65 years in North America lack the basic Health Literacy skills required for successful interactions with Health systems (Canadian Council on Learning, 2008; Kutner, Greenberg, Jin, & Paulsen, 2006). Outcomes of limited Health Literacy among older adults include incorrect taking of prescription medication, poor chronic disease management, low use of preventive Health services, and increased risk of overall mortality (Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011; Sudore et al., 2006b). The nature of the association between aging and Health Literacy is unclear. Functional Health Literacy skills reflect, at least in part, the cognitive abilities used to manage Health (Federman, Sano, Wolf, Siu, & Halm, 2009; Reeve & Basalik, 2014; Wolf et al., 2012). “Fluid” cognitive abilities such as verbal fluency, working memory, and reasoning are essential to Health Literacy skills and undergo mild decline during aging in the absence of dementia as early as mid-adulthood, whereas “crystallized” abilities such as generalized knowledge and vocabulary are more stable with age (O’Carroll, 1995; Singh-Manoux et al., 2012). Therefore, performance on Health Literacy tests that require the use of fluid cognitive abilities in the context of medical and Health-related information may decline with age (e.g., the Test of Functional Health Literacy in Adults [TOFHLA] or the Newest Vital Sign [NVS]; Parker, Baker, Williams, & Nurss, 1995; Weiss et al., 2005), whereas tests that assess Health Literacy as medical vocabulary may show little decline in performance with age (e.g., the Rapid Estimate of Adult Literacy in Medicine [REALM]; Davis et al., 1993). If Health Literacy skills represent the functional use of cognitive abilities in Health contexts, then certain Health Literacy skill sets, but not necessarily others, would be expected to decline with age. Furthermore, any association between age and Health Literacy would be expected to be at least partly explained by cognitive aging. We hypothesized that the functional Health Literacy skills assessed by TOFHLA and similar tests (representing fluid cognitive abilities) would be more likely to show an inverse association with age than Health Literacy skills assessed by the REALM and similar tests (representing crystallized cognitive abilities). We aimed to review the evidence on the association between age and Health Literacy, overall and by Health Literacy test, and to investigate the mediating role of cognitive function.
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addressing Health Literacy in patient decision aids
BMC Medical Informatics and Decision Making, 2013Co-Authors: Kirsten Mccaffery, Margaret Holmesrovner, Sian K Smith, David R Rovner, Don Nutbeam, Marla L Clayman, Karen Kellyblake, Michael S Wolf, Stacey L. SheridanAbstract:Effective use of a patient decision aid (PtDA) can be affected by the user’s Health Literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the Health Literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of Health Literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower Health Literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for Health Literacy, and b) are tested in lower Health Literacy populations. We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Aim 1: In an existing systematic review of PtDA trials, lower Health Literacy was associated with lower patient Health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower Health Literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower Health Literacy was related to higher decisional uncertainty and regret. Lower Health Literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a Health Literacy intervention on outcomes; it showed that using video to improve the salience of Health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower Health Literacy users. In 90% of trials, user Health Literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies in which Health Literacy needs were addressed. Lower Health Literacy affects key decision-making outcomes, but few existing PtDAs have addressed the needs of lower Health Literacy users. The specific effects of PtDAs designed to mitigate the influence of low Health Literacy are unknown. More attention to the needs of patients with lower Health Literacy is indicated, to ensure that PtDAs are appropriate for lower as well as higher Health Literacy patients.
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the causal pathways linking Health Literacy to Health outcomes
American Journal of Health Behavior, 2007Co-Authors: Michael K Paascheorlow, Michael S WolfAbstract:OBJECTIVE: To provide an evidence-based review of plausible causal pathways that could best explain well-established associations between limited Health Literacy and Health outcomes. METHODS: Through analysis of current findings in medical and public Health literature on Health Literacy we derived a conceptual causal model. RESULTS: Health Literacy should be viewed as both a patient and a system phenomenon. Three distinct points along a continuum of Health care are suggested to be influenced by Health Literacy: (1) access and utilization of Health care, (2) patient-provider relationship, and (3) self-care. CONCLUSIONS: The conceptual model organizes what has been learned to date and underscores promising areas of future inquiry and intervention.
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Health Literacy and mortality among elderly persons
JAMA Internal Medicine, 2007Co-Authors: David W Baker, Michael S Wolf, Julie A Gazmararian, Joe Feinglass, Jason A Thompson, Jenny HuangAbstract:Background Individuals with low levels of Health Literacy have less Health knowledge, worse self-management of chronic disease, lower use of preventive services, and worse Health in cross-sectional studies. We sought to determine whether low Health Literacy levels independently predict overall and cause-specific mortality. Methods We designed a prospective cohort study of 3260 Medicare managed-care enrollees in 4 US metropolitan areas who were interviewed in 1997 to determine their demographic characteristics, chronic conditions, self-reported physical and mental Health, and Health behaviors. Participants also completed the shortened version of the Test of Functional Health Literacy in Adults. Main outcome measures included all-cause and cause-specific (cardiovascular, cancer, and other) mortality using data from the National Death Index through 2003. Results The crude mortality rates for participants with adequate (n = 2094), marginal (n = 366), and inadequate (n = 800) Health Literacy were 18.9%, 28.7%, and 39.4%, respectively ( P Conclusions Inadequate Health Literacy, as measured by reading fluency, independently predicts all-cause mortality and cardiovascular death among community-dwelling elderly persons. Reading fluency is a more powerful variable than education for examining the association between socioeconomic status and Health.
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Health Literacy and functional Health status among older adults
JAMA Internal Medicine, 2005Co-Authors: Michael S Wolf, Julie A Gazmararian, David W BakerAbstract:Background Individuals with limited Health Literacy have less Health knowledge, worse self-management skills, lower use of preventive services, and higher hospitalization rates. We evaluated the association between Health Literacy, self-reported physical and mental Health functioning, and Health-related activity limitations among new Medicare managed care enrollees. Methods A cross-sectional survey of 2923 enrollees was conducted in Cleveland, Ohio; Houston, Tex; Tampa, Fla; and Fort Lauderdale–Miami, Fla. Health Literacy was measured using the short form of the Test of Functional Health Literacy in Adults. We used outcome measures that included scores on the physical and mental Health functioning subscales of the Medical Outcomes Study 36-Item Short-Form Health Survey, difficulties with instrumental activities of daily living and activities of daily living, and limitations because of physical Health and pain. Results After adjusting for the prevalence of chronic conditions, Health risk behaviors, and sociodemographic characteristics, individuals with inadequate Health Literacy had worse physical function (67.7 vs 78.0, P P Conclusion Among community-dwelling older adults, inadequate Health Literacy was independently associated with poorer physical and mental Health.
David W Baker - One of the best experts on this subject based on the ideXlab platform.
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Health Literacy and mortality among elderly persons
JAMA Internal Medicine, 2007Co-Authors: David W Baker, Michael S Wolf, Julie A Gazmararian, Joe Feinglass, Jason A Thompson, Jenny HuangAbstract:Background Individuals with low levels of Health Literacy have less Health knowledge, worse self-management of chronic disease, lower use of preventive services, and worse Health in cross-sectional studies. We sought to determine whether low Health Literacy levels independently predict overall and cause-specific mortality. Methods We designed a prospective cohort study of 3260 Medicare managed-care enrollees in 4 US metropolitan areas who were interviewed in 1997 to determine their demographic characteristics, chronic conditions, self-reported physical and mental Health, and Health behaviors. Participants also completed the shortened version of the Test of Functional Health Literacy in Adults. Main outcome measures included all-cause and cause-specific (cardiovascular, cancer, and other) mortality using data from the National Death Index through 2003. Results The crude mortality rates for participants with adequate (n = 2094), marginal (n = 366), and inadequate (n = 800) Health Literacy were 18.9%, 28.7%, and 39.4%, respectively ( P Conclusions Inadequate Health Literacy, as measured by reading fluency, independently predicts all-cause mortality and cardiovascular death among community-dwelling elderly persons. Reading fluency is a more powerful variable than education for examining the association between socioeconomic status and Health.
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Health Literacy and functional Health status among older adults
JAMA Internal Medicine, 2005Co-Authors: Michael S Wolf, Julie A Gazmararian, David W BakerAbstract:Background Individuals with limited Health Literacy have less Health knowledge, worse self-management skills, lower use of preventive services, and higher hospitalization rates. We evaluated the association between Health Literacy, self-reported physical and mental Health functioning, and Health-related activity limitations among new Medicare managed care enrollees. Methods A cross-sectional survey of 2923 enrollees was conducted in Cleveland, Ohio; Houston, Tex; Tampa, Fla; and Fort Lauderdale–Miami, Fla. Health Literacy was measured using the short form of the Test of Functional Health Literacy in Adults. We used outcome measures that included scores on the physical and mental Health functioning subscales of the Medical Outcomes Study 36-Item Short-Form Health Survey, difficulties with instrumental activities of daily living and activities of daily living, and limitations because of physical Health and pain. Results After adjusting for the prevalence of chronic conditions, Health risk behaviors, and sociodemographic characteristics, individuals with inadequate Health Literacy had worse physical function (67.7 vs 78.0, P P Conclusion Among community-dwelling older adults, inadequate Health Literacy was independently associated with poorer physical and mental Health.
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Health Literacy and knowledge of chronic disease
Patient Education and Counseling, 2003Co-Authors: Julie A Gazmararian, Mark V Williams, Jennifer L Peel, David W BakerAbstract:Abstract We sought to examine the relationship between Health Literacy and knowledge of disease among patients with a chronic disease. A total of 653 new Medicare enrollees aged 65 years or older who had at least one chronic disease (115 asthma, 266 diabetes, 166 congestive heart failure, 214 hypertension), completed both the in-person and telephone survey. Health Literacy measured by the short test of functional Health Literacy in adults (S-TOFHLA) and demographic information were collected during the in-person survey. Knowledge of disease was assessed by questions based on key elements in educational materials during a telephone survey. Overall, 24% of patients had inadequate and 12% had marginal Health Literacy skills. Respondents with inadequate Health Literacy knew significantly less about their disease than those with adequate Literacy. Multivariate analysis indicated that Health Literacy was independently related to disease knowledge. There are many opportunities to improve patients’ knowledge of their chronic disease(s), and efforts need to consider their Health Literacy skills.
Karen Crotty - One of the best experts on this subject based on the ideXlab platform.
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low Health Literacy and Health outcomes an updated systematic review
Annals of Internal Medicine, 2011Co-Authors: Nancy D Berkman, David J Halpern, Stacey L. Sheridan, Katrina E Donahue, Karen CrottyAbstract:BACKGROUND: Approximately 80 million Americans have limited Health Literacy, which puts them at greater risk for poorer access to care and poorer Health outcomes. PURPOSE: To update a 2004 systematic review and determine whether low Health Literacy is related to poorer use of Health care, outcomes, costs, and disparities in Health outcomes among persons of all ages. DATA SOURCES: English-language articles identified through MEDLINE, CINAHL, PsycINFO, ERIC, and Cochrane Library databases and hand-searching (search dates for articles on Health Literacy, 2003 to 22 February 2011; for articles on numeracy, 1966 to 22 February 2011). STUDY SELECTION: Two reviewers independently selected studies that compared outcomes by differences in directly measured Health Literacy or numeracy levels. DATA EXTRACTION: One reviewer abstracted article information into evidence tables; a second reviewer checked information for accuracy. Two reviewers independently rated study quality by using predefined criteria, and the investigative team jointly graded the overall strength of evidence. DATA SYNTHESIS: 96 relevant good- or fair-quality studies in 111 articles were identified: 98 articles on Health Literacy, 22 on numeracy, and 9 on both. Low Health Literacy was consistently associated with more hospitalizations; greater use of emergency care; lower receipt of mammography screening and influenza vaccine; poorer ability to demonstrate taking medications appropriately; poorer ability to interpret labels and Health messages; and, among elderly persons, poorer overall Health status and higher mortality rates. Poor Health Literacy partially explains racial disparities in some outcomes. Reviewers could not reach firm conclusions about the relationship between numeracy and Health outcomes because of few studies or inconsistent results among studies. LIMITATIONS: Searches were limited to articles published in English. No Medical Subject Heading terms exist for identifying relevant studies. No evidence concerning oral Health Literacy (speaking and listening skills) and outcomes was found. CONCLUSION: Low Health Literacy is associated with poorer Health outcomes and poorer use of Health care services. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
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Health Literacy interventions and outcomes an updated systematic review
Evidence report technology assessment, 2011Co-Authors: Nancy D Berkman, David J Halpern, Karen Crotty, Stacey L. Sheridan, Katrina E Donahue, Anthony J Viera, Audrey Holland, Michelle Brasure, Kathleen N Lohr, Elizabeth HardenAbstract:Objectives To update a 2004 systematic review of Health care service use and Health outcomes related to differences in Health Literacy level and interventions designed to improve these outcomes for individuals with low Health Literacy. Disparities in Health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. Data sources We searched MEDLINE®, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For Health Literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. Review methods We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of Health Literacy to include numeracy and oral (spoken) Health Literacy. We excluded intervention studies that did not measure Health Literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. Results We included good- and fair-quality studies: 81 studies addressing Health outcomes (reported in 95 articles including 86 measuring Health Literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in Health Literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and Health messages, and, among seniors, poorer overall Health status and higher mortality. Health Literacy level potentially mediates disparities between blacks and whites. The strength of evidence of numeracy studies was insufficient to low, limiting conclusions about the influence of numeracy on Health care service use or Health outcomes. Two studies suggested numeracy may mediate the effect of disparities on Health outcomes. We found no evidence concerning oral Health Literacy and outcomes. Among intervention studies (27 randomized controlled trials [RCTs], 2 cluster RCTs, and 13 quasi-experimental designs), the strength of evidence for specific design features was low or insufficient. However, several specific features seemed to improve comprehension in one or a few studies. The strength of evidence was moderate for the effect of mixed interventions on Health care service use; the effect of intensive self-management inventions on behavior; and the effect of disease-management interventions on disease prevalence/severity. The effects of other mixed interventions on other Health outcomes, including knowledge, self-efficacy, adherence, and quality of life, and costs were mixed; thus, the strength of evidence was insufficient. Conclusions The field of Health Literacy has advanced since the 2004 report. Future research priorities include justifying appropriate cutoffs for Health Literacy levels prior to conducting studies; developing tools that measure additional related skills, particularly oral (spoken) Health Literacy; and examining mediators and moderators of the effect of Health Literacy. Priorities in advancing the design features of interventions include testing novel approaches to increase motivation, techniques for delivering information orally or numerically, "work around" interventions such as patient advocates; determining the effective components of already-tested interventions; determining the cost-effectiveness of programs; and determining the effect of policy and practice interventions.
Alison Beauchamp - One of the best experts on this subject based on the ideXlab platform.
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Health Literacy of recently hospitalised patients a cross sectional survey using the Health Literacy questionnaire hlq
BMC Health Services Research, 2017Co-Authors: Rebecca L Jessup, Richard H Osborne, Alison Beauchamp, Allison Bourne, Rachelle BuchbinderAbstract:Health Literacy is simply defined as an individual’s ability to access, understand and use information in ways that promote and maintain good Health. Lower Health Literacy has been found to be associated with increased emergency department presentations and potentially avoidable hospitalisations. This study aimed to determine the Health Literacy of hospital inpatients, and to examine if associations exist between different dimensions of their Health Literacy, sociodemographic characteristics and hospital services use. A written survey was sent to 3,252 people aged ≥18 years in English, Arabic, Chinese, Vietnamese, Italian or Greek. The survey included demographic and Health questions, and the Health Literacy Questionnaire (HLQ). The HLQ is a multidimensional instrument comprising nine independent scales. Use of hospital services was measured by length of stay, number of admissions in 12 months and number of emergency department presentations. Effect size (ES) for standardised differences in means described the magnitude of differences in HLQ scale scores between demographic and socioeconomic groups. 385 questionnaires were returned (13%); mean age 64 years (SD 17), 49% female. Aged ≥65 years (55%), using the Internet < once a month (37%), failure to complete high school (67%), low household income (39%), receiving means-tested government benefits (61%) and being from a culturally and linguistically diverse (CALD) background (24%), were all associated with lower scores in some Health Literacy scales. Being aged ≥65 years, not currently employed, receiving government benefits, and being from a CALD background were also associated with increased use of some hospital services. There was no association between lower scores on any HLQ scale and greater use of hospital services. We found no association between lower Health Literacy and greater use of hospital Health services. However increased age, having a CALD background and not speaking English at home were all associated with having the most Health Literacy challenges Strategies to address these are needed to reduce Health inequalities.
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distribution of Health Literacy strengths and weaknesses across socio demographic groups a cross sectional survey using the Health Literacy questionnaire hlq
BMC Public Health, 2015Co-Authors: Alison Beauchamp, Rachelle Buchbinder, Roy Batterham, Sarity Dodson, Gerald R Elsworth, Crystal Mcphee, Louise Margaret Sparkes, Melanie Hawkins, Richard H OsborneAbstract:Recent advances in the measurement of Health Literacy allow description of a broad range of personal and social dimensions of the concept. Identifying differences in patterns of Health Literacy between population sub-groups will increase understanding of how Health Literacy contributes to Health inequities and inform intervention development. The aim of this study was to use a multi-dimensional measurement tool to describe the Health Literacy of adults in urban and rural Victoria, Australia. Data were collected from clients (n = 813) of 8 Health and community care organisations, using the Health Literacy Questionnaire (HLQ). Demographic and Health service data were also collected. Data were analysed using descriptive statistics. Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between demographic sub-groups. Mean age of respondents was 72.1 (range 19–99) years. Females comprised 63 % of the sample, 48 % had not completed secondary education, and 96 % reported at least one existing Health condition. Small to large ES were seen for mean differences in HLQ scales between most demographic groups. Compared with participants who spoke English at home, those not speaking English at home had much lower scores for most HLQ scales including the scales ‘Understanding Health information well enough to know what to do’ (ES −1.09 [95 % confidence interval (CI) -1.33 to −0.84]), ‘Ability to actively engage with Healthcare providers’ (ES −1.00 [95 % CI −1.24, −0.75]), and ‘Navigating the Healthcare system’ (ES −0.72 [95 % CI −0.97, −0.48]). Similar patterns and ES were seen for participants born overseas compared with those born in Australia. Smaller ES were seen for sex, age group, private Health insurance status, number of chronic conditions, and living alone. This study has revealed some large Health Literacy differences across nine domains of Health Literacy in adults using Health services in Victoria. These findings provide insights into the relationship between Health Literacy and socioeconomic position in vulnerable groups and, given the focus of the HLQ, provide guidance for the development of equitable interventions.
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the optimising Health Literacy ophelia process study protocol for using Health Literacy profiling and community engagement to create and implement Health reform
BMC Public Health, 2014Co-Authors: Roy Batterham, Alison Beauchamp, Rachelle Buchbinder, Sarity Dodson, Gerald R Elsworth, Richard H OsborneAbstract:Health Literacy is a multi-dimensional concept comprising a range of cognitive, affective, social, and personal skills and attributes. This paper describes the research and development protocol for a large communities-based collaborative project in Victoria, Australia that aims to identify and respond to Health Literacy issues for people with chronic conditions. The project, called Ophelia (OPtimising Health Literacy) Victoria, is a partnership between two universities, eight service organisations and the Victorian Government. Based on the identified issues, it will develop and pilot Health Literacy interventions across eight disparate Health services to inform the creation of a Health Literacy response framework to improve Health outcomes and reduce Health inequalities.
