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Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire

BACKGROUND: Health literacy (HL) is defined as necessary competencies to make well-informed decisions. As patients’ decision making is a key element of patient-centered health care, insight in patients’ HL might help healthcare professionals to organize their care accordingly. This is particularly t...

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Autores principales: Storms, Hannelore, Claes, Neree, Aertgeerts, Bert, Van den Broucke, Stephan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438531/
https://www.ncbi.nlm.nih.gov/pubmed/28526009
http://dx.doi.org/10.1186/s12889-017-4391-8
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author Storms, Hannelore
Claes, Neree
Aertgeerts, Bert
Van den Broucke, Stephan
author_facet Storms, Hannelore
Claes, Neree
Aertgeerts, Bert
Van den Broucke, Stephan
author_sort Storms, Hannelore
collection PubMed
description BACKGROUND: Health literacy (HL) is defined as necessary competencies to make well-informed decisions. As patients’ decision making is a key element of patient-centered health care, insight in patients’ HL might help healthcare professionals to organize their care accordingly. This is particularly true for people in a vulnerable situation, potentially with limited HL, who are, for instance, at greater risk of having limited access to care [1, 2]. As HL correlates with education, instruments should allow inclusion of low literate people. To that end, the relatively new instrument, HLS-EU-Q47, was subjected to a comprehensibility test, its shorter version, HLS-EU-Q16, was not. Therefore, the goal of this study was to examine feasibility of HLS-EU-Q16 (in Dutch) for use in a population of people with low literacy. METHODS: Purposive sampling of adults with low (yearly) income (< €16,965.47) and limited education (maximum high school), with Dutch language proficiency. Exclusion criteria were: psychiatric, neurodegenerative diseases or impairments. To determine suitability (length, comprehension and layout) participants were randomly distributed either HLS-EU-Q16 or a modified version and were interviewed directly afterwards by one researcher. To determine feasibility a qualitative approach was chosen: cognitive interviews were carried out using the verbal probing technique. RESULTS: Thirteen participants completed HLS-EU-Q16 (n = 7) or the modified version (n = 6). Questions about ‘disease prevention’ or ‘appraisal’ of information are frequently reported to be incomprehensible. Difficulties are attributed to vocabulary, sentence structure and the decision process (abstraction, distinguishing ‘appraising’ from ‘applying’ information, indecisive on the appropriate response). CONCLUSIONS: HLS-EU-Q16 is a suitable instrument to determine HL in people with limited literacy. However, to facilitate the use and interpretation, some questions would benefit from minor adjustments: by simplifying wording or providing explanatory, contextual information. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-017-4391-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-54385312017-05-22 Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire Storms, Hannelore Claes, Neree Aertgeerts, Bert Van den Broucke, Stephan BMC Public Health Research Article BACKGROUND: Health literacy (HL) is defined as necessary competencies to make well-informed decisions. As patients’ decision making is a key element of patient-centered health care, insight in patients’ HL might help healthcare professionals to organize their care accordingly. This is particularly true for people in a vulnerable situation, potentially with limited HL, who are, for instance, at greater risk of having limited access to care [1, 2]. As HL correlates with education, instruments should allow inclusion of low literate people. To that end, the relatively new instrument, HLS-EU-Q47, was subjected to a comprehensibility test, its shorter version, HLS-EU-Q16, was not. Therefore, the goal of this study was to examine feasibility of HLS-EU-Q16 (in Dutch) for use in a population of people with low literacy. METHODS: Purposive sampling of adults with low (yearly) income (< €16,965.47) and limited education (maximum high school), with Dutch language proficiency. Exclusion criteria were: psychiatric, neurodegenerative diseases or impairments. To determine suitability (length, comprehension and layout) participants were randomly distributed either HLS-EU-Q16 or a modified version and were interviewed directly afterwards by one researcher. To determine feasibility a qualitative approach was chosen: cognitive interviews were carried out using the verbal probing technique. RESULTS: Thirteen participants completed HLS-EU-Q16 (n = 7) or the modified version (n = 6). Questions about ‘disease prevention’ or ‘appraisal’ of information are frequently reported to be incomprehensible. Difficulties are attributed to vocabulary, sentence structure and the decision process (abstraction, distinguishing ‘appraising’ from ‘applying’ information, indecisive on the appropriate response). CONCLUSIONS: HLS-EU-Q16 is a suitable instrument to determine HL in people with limited literacy. However, to facilitate the use and interpretation, some questions would benefit from minor adjustments: by simplifying wording or providing explanatory, contextual information. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-017-4391-8) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-19 /pmc/articles/PMC5438531/ /pubmed/28526009 http://dx.doi.org/10.1186/s12889-017-4391-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Storms, Hannelore
Claes, Neree
Aertgeerts, Bert
Van den Broucke, Stephan
Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire
title Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire
title_full Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire
title_fullStr Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire
title_full_unstemmed Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire
title_short Measuring health literacy among low literate people: an exploratory feasibility study with the HLS-EU questionnaire
title_sort measuring health literacy among low literate people: an exploratory feasibility study with the hls-eu questionnaire
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438531/
https://www.ncbi.nlm.nih.gov/pubmed/28526009
http://dx.doi.org/10.1186/s12889-017-4391-8
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