Journal of Health Literacy
Volume:9 Issue: 1, Spring 2024

The COVID-19 pandemic raises a concern about the urgent issue of low levels of digital health literacy (DHL). Adequate DHL may mitigate the negative impacts of proliferating misinformation. This study was aimed at examining the COVID-19 related DHL levels and social media use as digital health information sources among high school students in East Java, Indonesia. The differences in DHL levels across sociodemographic factors, medical history, and social media preferences were also analyzed. This was a cross-sectional study, conducted in 2021, and enrolled high school students aged 15-18. The subjects were selected for convenience, with a minimum sample size of 384. An online questionnaire was shared through a survey platform. The sociodemographic variables and medical history were collected. The DHL measuring items were adapted from the validated DHL instrument developed in the COVID-19 context.  Data were analyzed with SPSS 17.0. We collected 432 responses. More than half of respondents (56.5%) have adequate DHL. Although 81.7 percent of respondents reported that searching for online information was easy, only 53.5 percent reported ease in appraising the reliability aspect. Fathers’ education varied by DHL. Students whose fathers hold post-graduate degrees showed a significantly higher level of DHL than those of lower educational backgrounds. Students experiencing COVID-19 infection of their own or close relatives showed higher total DHL and information search scores. Instagram and TikTok were the most frequently chosen social media as digital health information sources, but no significant difference in DHL across the preference for social media. Even though the information can be obtained easily, there are still difficulties in evaluating its reliability. Considering the proportion of respondents with inadequate DHL, stakeholders in the health and education sectors need to develop DHL-promoting strategies for adolescents. Improvement in evaluating reliability should be the target of focus.

The proactive activities of professional organizations have significantly contributed to improving nurses’ knowledge related-specialty in order to improve health care services quality offered by nurses. Since the palliative care improvement and development in Indonesia remain still in their infancy, and the organization of palliative care for Indonesian nurses has not been established yet, it is imperative to investigate the Indonesian nurses’ viewpoints concerning the importance of establishing a palliative nursing organization in fostering palliative care services in Indonesia. This study aimed to identify what kind of palliative care related activities are carried out by Indonesian nurses and what are the perspectives of nurses regarding the importance of establishing palliative nursing organizations in Indonesia. A national study was conducted using an embedded mixed-methods design, for which the quantitative and qualitative data were collected and analyzed in the same time period from October – December 2020. There were a total of 552 (92%) respondents who participated through WhatsApp, and Telegram platforms, and completed our online survey. There were four themes and nine sub themes found in this study: namely, services improvement (quality improvement, and literacy improvement sub themes), human resource development (knowledge development, individual nurse development, and professional development sub-themes), boarding and information source (boarding, and information source sub themes), and policy and legality (policy, and legality sub themes). While barriers exist, respondents confirmed the importance of establishing an Indonesian palliative nursing organization. Establishing a palliative nursing organization could be an important step in developing palliative care in Indonesia.

Adolescents living with HIV on medication have an additional duty to ensure adherence to antiretroviral therapy. There have been documented challenges in retaining adolescents in care and treatment programs, loss to follow-up, and poor adherence that have led to continued deaths. Adolescents on second-line antiretroviral therapy have reduced therapeutic options as they have resisted first-line drugs, and the third-line is not available in this resource-poor setting. Ensuring and upscaling adherence support is crucial. This study sought to find out the level of basic health literacy in terms of knowledge of one’s drugs, HIV re-infection, and HIV drug resistance and how this knowledge influenced adherence. This was a longitudinal ethnographic research coupled with a mixed methods approach. Semi-structured questionnaires were administered to 37 participants. The study conducted ten in-depth and 13 key informant interviews, participant observation, and three focus group discussions. Quantitative data was analyzed using SPSS, and cross-tabulations were done to identify appropriate relationships. Qualitative data was analyzed thematically and presented using descriptive reports and verbatim quotations. Participants who had basic knowledge of the ARVs they were taking exhibited good adherence compared to those who did not know their ARVs. Among the participants, 72% knew what HIV re-infection was, yet 43% still had poor adherence. This was similar to basic knowledge of HIV Drug Resistance.  There was sufficient health knowledge. However, the study observed a lack of ability to translate knowledge into practice. Other factors alongside health knowledge in determining health-promotive behaviour could be explored.

Health and safety literacy is an essential aspect of the employees’ awareness level. Since an estimate of the literacy level can be effective in increasing the level of personnel awareness of safe and health behavior, the purpose of this study is to provide a tool in the form of a valid and reliable questionnaire in the field of occupational health and safety literacy. The current research was conducted to examine feasibility of the Persian version of the occupational health and safety literacy assessment questionnaire in employees in 2023. After translating the tool using the translation-retranslation, quantitative and qualitative validity of the questionnaire were assessed by 10 experts. Repeatability and internal consistency were examined by 30 employees, and item analysis as well as construct validity by 410 employees. The impact score, CVR and CVI of the questionnaire were 3.51, 0.96 and 0.91, respectively. The construct validity confirmed the final version of the questionnaire contains 34 questions in 4 dimensions including access, review, evaluation, and use of health and job information. The ratio of the chi-square test to the degree of freedom (χ2⁄df) was equal to 3.71. and the RMSEA index was 0.08. The internal consistency of the questionnaire was (⍺=0.923), and repeatability (ICC= 0.98) which were within the acceptable range.  The Persian version of occupational safety and health literacy questionnaire with 34 items and 4 dimensions was confirmed by the concept of Iranian occupational safety and health literacy. Iranian occupational health and safety specialists can use this valid and reliable tool to assess the occupational health and safety literacy and the findings can be applied for occupational health and safety interventions.

Nutrition literacy is a concept that improves individuals' diet quality, and quality of life and contributes to enhancing their general health by using and interpreting nutrition-related information correctly. This study purposed to determine the nutritional literacy and quality of life levels of university students and relate them with anthropometric measurements. This is a cross-sectional study and was conducted with 374 university students over the age of 18 at a state university. Nutrition literacy was assessed by using the Evaluation Instrument of Nutrition Literacy on Adults (EINLA), and quality of life was evaluated with the World Health Organization's Quality of Life Questionnaire (Turkish_WHOQOL-BREF). Waist, middle-upper arm, neck circumference, body weight, and height were measured in accordance with appropriate techniques by researchers. Independent t and One-Way ANOVA tests were used to determine differences between two and more than two mean values. Pearson correlation analysis was used to detect relationships between scores of total EINLA, its sections, total Turkish_WHOQOL-BREF and its dimensions, and other variables. The mean EINLA and WHOQOL-BREF scores of the participants were 25.3±4.7 (borderline) and 54.3±15.1, respectively. While the EINLA score varied according to gender, faculty (health sciences vs others), and degree (1 to 4), the WHOQOL-BREF score varied according to gender and living place (home vs dormitory). EINLA and WHOQOL-BREF scores of BMI (underweight to obese), waist circumference, and neck circumference (normal vs at risk) groups were not different. It was found positive significant relationships between the second section of EINLA (reading comprehension and interpretation) and psychological health, the third section of EINLA (food groups), and social relationships (p<0.05). Nutrition literacy, anthropometric measurements, and quality of life of university students are affected by a multifactorial situation.

It is important to note that Oral Health Literacy (OHL) not only pertains to dental health but also has a broader impact on overall quality of life. Therefore, this cross-sectional study aimed to assess the level of OHL in the adult population of Tehran, Iran.  A sample of 700 Iranian adults (Tehran), aged 18-64 years, participated in this study (October 2021 and March 2022). A researcher-developed questionnaire was used to collect data on demographic variables and OHL. The questionnaire consisted of four domains: cognitive, behavioral, media, and communication skills. The data was analyzed by software SPSS 19. Data analysis included descriptive statistics, independent-samples t-tests, one-way analysis of variance (ANOVA), chi-square tests, and multiple regression analysis. Statistical significance was set at P < 0.05. The average age of the subjects was 35.50±8.87 years, ranging from 18 to 61 years. The mean OHL score was 67.62±15.53, indicating a moderate level of OHL. Among the dimensions of the questionnaire, cognitive skills received the highest scores and Communicative skill lowest. The results revealed significant associations between OHL and demographic variables. Multiple regression analysis showed that income, education level (academic and below diploma), and marital status (married) significantly predicted OHL. This study highlights the need for improved OHL in the Iranian adult population. The findings suggest that educational interventions targeting low-educated individuals and specific demographic groups could help enhance OHL. Efforts should be directed towards improving communication skills in oral health settings.

Health literacy and cyberchondria are effective for pregnant women to make the right health decisions for themselves and their babies. The purpose of this study is to investigate the correlation between e-health literacy, cyberchondria, and the factors influencing them in pregnant women. The cross-sectional study was conducted on a population of pregnant women who were admitted to two public hospitals located in Samsun. A questionnaire form consisting of 3 sections was used as a data collection tool in the study.  Pregnancy information form, e-health literacy scale and cyberchondria scale. The study involved analysing 400 questionnaire forms. Data were analyzed by the frequency test, One Way ANOVA, correlation analysis and multiple regression. The study participants had a mean age of 28.53 ± 6.53. Among them, 60.3% were aged 19-29, 37.3% had an associate degree, 45.3% were pregnant for the first time, and 38.3% were in their second trimester. The mean pregnancy was 1.81 ± 10.63. In the study group, the mean e-health literacy was 3.27 ± 0.99, and the mean cyberchondria was 30.29 ± 9.78. The study found a statistically significant difference in e-health literacy and cyberchondria based on age, educational status, gestational week, and number of pregnancies. Additionally, there was a statistically significant positive relationship between health literacy and cyberchondria severity. The results of the study showed that the level of e-health literacy and cyberchondria of pregnant women was moderate, and that e-health literacy, age and education level would affect cyberchondria. Therefore, this problem can be prevented by providing digital health practices, e-health literacy and safe internet use training to pregnant women in health institutions and the media.

Health literacy organizations are doing a series of things in a health and healing environment to bring that environment to a level that makes it easier for people to understand and interpret health information. These items are designed in the checklist of Health Literacy Organization, so this study was conducted with the aim of validating the checklist of Health Literacy Organization in Iran. This research was a cross-sectional descriptive analytic study that was conducted on the tool of the Health Literacy Organization that was designed during previous studies. First, the face validity assessment of the checklist was checked by 22 experts. Then, the content validity was done using the relative coefficient of content validity rate and the content validity index by 22 experts in the field of health literacy who have favorable clinical and technical university experiences. In the third stage, in order to evaluate the calculation of the reliability coefficient, the instrument was performed by two evaluators in 12 environments, including three hospitals, two clinics, five comprehensive health service centers and two pharmacies. During the content validity phase, 6 questions were removed from the list of 67 questions, and 3 questions were structurally modified. The questionnaire had a CVI of 0.919 and a CVR of 0.781. The score of the reliability coefficient for the checklist was 0.94, and if this index is higher than 0.8, it indicates a very favorable reliability. Ultimately, the checklist of 10 attributes and 61 questions was approved. The evaluation checklist of Health Literacy Organization has the necessary psychometric features. Hence, it is suggested to use this tool, which is a native tool and has been prepared during various studies in Iran, to design and measure the organization of health literacy.