Explaining variance in health literacy among people with type 2 diabetes : the association between health literacy and health behaviour and empowerment

Background To reflect the health literacy (HL) skills needed for managing type 2 diabetes (T2DM) in everyday life, HL in people with T2DM should be measured from a broader perspective than basic skills, such as proficiency in reading and writing. The HLS-Q12, based on the European Health Literacy Survey Questionnaire (HLS-EU-Q47), assesses four cognitive domains across three health domains. International studies on people with T2DM show inconsistent results regarding the association between HL and general health and the association between HL and glycaemic control. Moreover, knowledge is needed related to the link between HL and empowerment for those with T2DM. The aims of this study were to examine the association between i) HL and general health and diabetes outcomes, ii) HL and health behaviours and iii) HL and empowerment in people with T2DM. Methods During March and April 2015, 388 adults with T2DM responded to a paper-and-pencil self-administered questionnaire. A sequential multiple regression analysis was applied to explore the association between HL, as measured by the HLS-Q12, and health conditions, HbA1c, health behaviours and empowerment. Results For people with T2DM, higher levels of HL were associated with higher levels of education, better overall health conditions and higher self-perceived empowerment. No empirical evidence strengthening either the link between HL and glycaemic control or the link between HL and health behaviours was found. Conclusions The independent variables education level, overall health condition and empowerment explained about one-third of the total observed variance in HL

Health literacy in former Soviet Union immigrants in the US: A mixed methods study

Kostareva U, Albright CL, Berens E-M, et al. Health literacy in former Soviet Union immigrants in the US: A mixed methods study. Applied nursing research : ANR. 2022: 151598.BACKGROUND: People with limited health literacy may have trouble finding, understanding, and using health-related information and services and navigating the healthcare system.; PURPOSE: The purpose of this study was to assess the health literacy of immigrants from the former Soviet Union (FSU) using the Health Literacy Survey (HLS19-Q12 in Russian) and explore associated socio-demographic factors.; METHOD: This mixed methods study recruited adult immigrants through social networks and social media and included data from online survey and follow-up interviews. Variance in health literacy was explained using multiple linear regression. Qualitative data were analyzed through modified Grounded Theory approach.; FINDINGS: Survey respondents (n=318) were primarily female college-educated FSU immigrants aged 20-74 from 14 of the 15 FSU countries and distributed across 33 US states. Forty percent scored at or below predefined cut-offs for inadequate or problematic health literacy levels. Social status, social support, and English proficiency were significant variables in explaining variance in health literacy scores while controlling for age, gender, and education. Interviews (n=24) identified eight themes: English proficiency, social support, health insurance, experience with health care, complexity of the US healthcare system, relevant health information, health beliefs/practices, and trust.; DISCUSSION: There is a need to distribute health-related information in the native language (e.g., Russian), potentially through social media and immigrants' social networks. Health providers should be aware of the prevalence of inadequate and problematic health literacy among FSU immigrants and consider associated social factors. Copyright © 2022 Elsevier Inc. All rights reserved