Health literacy among university students in Greece: determinants and association with self-perceived health, health behaviours and health risks
Tóm tắt
Health literacy is widely considered as a key determinant of health and a priority in the public health policy agenda. Low health literacy has been associated with poorer health states, broader inequalities and higher health systems’ costs. In the present study we bring into focus the functional health literacy among university students in Greece, researching and assessing mainly their ability to apply basic knowledge in a health context. The study was carried out during the period 15–30 April 2013, among a random sample of 1,526 students of 14 Higher Tertiary Public universities and Technological Educational Institutes in Greece. The objective of the study was to assess the functional health literacy among university students in Greece, adopting the short four-item comprehension test of Bostock and Steptoe. Summary statistics, correlations and regressions were used to assess the determinants of health literacy and the association with self-perceived health, health behaviours and health risks. Economic factors, such as family income, demographic factors, such as gender, and health behaviours and risks, namely consumption of alcohol, smoking and physical workout are associated with the level of health literacy and health status of the participant. While the results of the study are consistent with previous work in this area, several findings worth further research. Though, health promotion interventions in Greece include health literacy as one of the basic pillars of the public health policy agenda, it is clear, that health literacy needs to become a key policy issue in Greece, mainly focusing in young ages, where healthy (or unhealthy) behaviours are established affecting the health through the life span.
Tài liệu tham khảo
Coulter A, Parsons S, Askham J: Where are the patients in decision-making about their own care? Policy Paper. 2008, Copenhagen: World Health Organization, on behalf of the European Observatory on Health Systems and Policies 2008
Ratzan SC, Parker R: National Library of Medicine current bibliographies in medicine: health literacy (introduction). 2000, Maryland, US: National Institutes of Health
Health literacy: a prescription to end confusion. Edited by: Nielsen-Bohlman L, Panzer AM, Kindig DA. 2004, Washington, DC: National Academies Press
HLS-EU Consortium: Comparative report on health literacy in eight EU member states. The European Health Literacy Project 2009–2012. 2012, Maastricht, http://www.health-literacy.eu, accessed 1 September 2013
World Health Organization: Health literacy and health behaviour. 2011, http://www.who.int/healthpromotion/conferences/7gchp/track2/en/, accessed 2 February 2013
World Health Organization Regional Office for Europe: Health literacy: The solid facts. Edited by: Ilona K, Pelikan JM, Franklin A, Tsouros AD. 2013, Copenhagen: WHO Regional Office for Europe
Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H: Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012, 12: 80-10.1186/1471-2458-12-80.
Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G: Priority actions for the non-communicable disease crisis. Lancet. 2011, 377 (9775): 1438-1447. 10.1016/S0140-6736(11)60393-0.
Department of Health: Healthy lives, healthy people: our strategy for public health in England. 2010, London: DoH
Eichler K, Wieser S, Brugger U: The costs of limited health literacy: a systematic review. Int J Public Health. 2009, 54: 313-324. 10.1007/s00038-009-0058-2.
Weiss BD: Health literacy and patient safety: help patients understand. Manual for clinicians. 2007, Chicago: American Medical Association Foundation and American Medical Association, http://www.ama-assn.org/ama1/pub/upload/mm/367/healthlitclinicians.pdf, accessed 1 September 2013, 2
Berkman ND: Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011, 155: 97-107. 10.7326/0003-4819-155-2-201107190-00005.
Marmot M, Allen J, Goldblatt P, Boyce T, McNeish D, Grady M, Geddes I: Fair society, healthy lives. 2008, London: Marmot Review, http://www.hospitaldr.co.uk/features/marmot-review-reducing-health-inequalities-in-england, accessed 1 September 2013
Levin-Zamir D, Wills J: Health literacy, culture and community. Health literacy in context: international perspectives. Edited by: Begoray D, Gillis DE, Rowlands G. 2012, Hauppauge: NY, Nova Science Publishers, 99-123.
Nutbeam D: The evolving concept of health literacy. Soc Sci Med. 2008, 67: 2072-2078. 10.1016/j.socscimed.2008.09.050.
Nutbeam D: Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st Century. Health Promot Int. 2000, 15 (3): 9-17.
Zaza S, Briss P, Harris K: The Guide to Community Preventive Services: What Works to Promote Health?. 2005, New York: Oxford University Press
Feinstein L: Inequality in the early cognitive development of British children in the 1970 cohort. Economica. 2003, 70: 73-97. 10.1111/1468-0335.t01-1-00272.
Leger St L: Schools, health literacy and public health: possibilities and challenges. Health Promot Int. 2000, 15 (4): 46-54.
Robert SA, Booske BC, Rigby E, Rohan AM: Public views on determinants of health, interventions to improve health, and priorities for government. Wis Med J. 2008, 107 (3): 124-130.
Kickbusch I: Health literacy: Skilling students for better health. Children, Youth and Women’s Health Service, Volume 41. 2006, Government of South Australia: Virtually Health newsletter, 2-3.
Hernandez L: Measures of Health Literacy: Workshop Summary Roundtable on Health Literacy. 2009, Institute of Medicine, http://www.nap.edu/catalog/12690.html, accessed 1 September 2013)
Baker DW: The meaning and the measure of health literacy. J Gen Intern Med. 2006, 21: 878-883. 10.1111/j.1525-1497.2006.00540.x.
Jordan J, Osborne R, Buchbinder R: A critical appraisal of the content and psychometric properties of 19 health literacy indices. J Clin Epidemiol. 2011, 64 (4): 366-379. 10.1016/j.jclinepi.2010.04.005.
Bostock S, Steptoe A: Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ. 2012, 344: e1602-10.1136/bmj.e1602.
Organisation for Economic Cooperation and Development and Statistics Canada: Literacy in the information age: final report of the International Adult Literacy Survey. 2000, Canada: OECD and Statistics
Statistics Canada and Organisation for Economic Cooperation and Development: Learning a living: first results of the adult literacy and life skills survey. 2005, Canada: Statistics Canada and Organisation for Economic Cooperation and Development
Kirsch I: The International Adult Literacy Survey: understanding what was measured. 2001, Princeton: Educational Testing Service
HLS-EU Consortium: The European Health Literacy Project 2009–2012. 2012, Maastricht: The European Health Literacy Survey–Greece, http://www.health-literacy.eu, accessed 1 September 2013
Harper R: Comprehensive health literacy assessment for college students. 2013, Colorado State University: Ph.D. Dissertation Thesis, Department of Journalism and Technical Communication
Ross PT, Lukela MP, Agbakwuru U, Lypson ML: Medical students’ recognition of health literacy in a single embedded curricular activity. Int J Med Educ. 2013, 4: 115-119.
Martin TL, Ruder T, Escarce JJ, Ghosh-Dastidar B, Sherman D, Elliott M, Bird CE, Fremont A, Gasper C, Culbert A, Lurie N: Developing Predictive Models of Health Literacy. J Gen Intern Med. 2009, 24 (11): 1211-1216. 10.1007/s11606-009-1105-7.
Berkman N, Sheridan S, Donahue K, Halpern D, Viera A, Crotty K, Holland A, Brasure M, Lohr K, Harden E, Tant E, Wallace I, Viswanathan M: Health Literacy Interventions and Outcomes: An Updated Systematic Review. 2011, Rockville, MD: Agency for Healthcare Research and Quality. Evidence Report/Technology Assesment No. 199. (Prepared by RTI International–University of North Carolina Evidence-based Practice Center under contract No. 290-2007-10056-I. AHRQ Publication Number 11-E006)
Vardavas C, Kondilis B, Patelarou E, Akrivos P, Falagas M: Health Literacy and sources of health education among adolescents in Greece. Int J Adolesc Med Health. 2009, 21 (2): 179-186.
John RB, Ronald MR: Adolescent mental health literacy: young people’s knowledge of depression and help seeking. J Adolesc. 2006, 29: 225-239. 10.1016/j.adolescence.2005.05.004.
Marks R: Health Literacy and School-based Education. 2012, Bingley, UK: Emerald Books
Potter L, Martin C: Health Literacy Fact Sheets. 2005, Hamilton, NJ: Center for Health Care Strategies
Chan K, Prendergast G, Gronhoj A, Bech-Larsen T: Adolescents’ perceptions of healthy eating and communication about healthy eating. Health Educ. 2009, 109 (6): 474-490. 10.1108/09654280911001158.
Leger St L: Schools, health literacy and public health: possibilities and challenges. Health Promot Int. 2001, 16 (2): 197-205. 10.1093/heapro/16.2.197.
Davis TC, Wolf MS, Bass PF, Middlebrooks M, Kennen E, Baker DW, Bennett CL, Durazo-Arvizu R, Bocchini A, Savory S, Parker RM: Low Literacy Impairs Comprehension of Prescription Drug Warning Labels. J Gen Intern Med. 2006, 21 (8): 847-851. 10.1111/j.1525-1497.2006.00529.x.
Wolf MS, Davis TC, Shrank W, Rapp DN, Bass PF, Connor UM, Clayman M, Parker RM: To err is human: Patient misinterpretations of prescription drug label instructions. Patient Educ Couns. 2007, 67: 293-300. 10.1016/j.pec.2007.03.024.
Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J: Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999, 38 (1): 33-42. 10.1016/S0738-3991(98)00116-5.
Ratzan SC: Health literacy: Communication for the public good. Health Promot Int. 2001, 16 (2): 207-214. 10.1093/heapro/16.2.207.
Parker RM, Ratzan SC, Lurie N: Health literacy: A policy challenge for advancing high-quality health care. Health Aff. 2003, 22 (4): 147-153. 10.1377/hlthaff.22.4.147.
Al Sayah F, Williams B, Johnson JA: Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures. Health Educ Behav. 2013, 40 (1): 42-55. 10.1177/1090198111436341.
MoE&RA: National Action Plan for Health Education Programs. 2008, Athens: Ministry of Education and Religious Affairs
MoH: National Action Plan for Public Health 2008–2012. 2008, Athens: Ministry of Health