The European Health Literacy Survey Pilot results Kristine Sørensen on behalf of the HLS-EU consortium

Transcription

1 The European Health Literacy Survey Pilot results Kristine Sørensen on behalf of the HLS-EU consortium

2 Rationale for the HLS-EU project Recognizing health literacy as a public health goal Measuring health literacy in Europe Advocates of advancing health literacy in Europe

3 The HLS-EU consortium Austria Bulgaria Germany Greece Ireland Netherlands Poland Spain + collaborating partners HLS EU

4 Milestones in the HLS-EU survey Literature review Conceptual model Questionnaire development (HLS-EU-Q) Pilot Focus groups (Ireland, Greece and the Netherlands) Face to face interviews (Ireland and the Netherlands) Survey in eight countries (Autumn 2010) Results and report (Primo 2011)

5 Examples of existing measures Realm: List of words to be read aloud TOFHLA: Recognition test Newest Vital Sign: Ice cream label Screening tools

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7 The HLS-EU all inclusive working definition Health literacy entails people s capacities, skills, knowledge, motivation and confidence to access, understand, appraise and apply health information to form judgments and take decisions in everyday life in terms of healthcare, disease prevention and health promotion to improve quality of life during the life course. Sørensen et al. 2010

8 A more literacy friendly version: - people s abilities to access, understand, appraise and apply information to make health decisions in everyday life throughout the life course.

9 HLS-EU Conceptual model Lif e course Psycosocial, physical and material factors Resources, opportunities & structures Literacies Access Health information Know ledge, skills, motivation & confidence Apply Understand Appraise Cure and care Disease prev ention Health promotion Health serv ice use Health behav ior Participa -tion Equity Health costs Health outcome s Empowe rment Sustainability Indiv idual level Population lev el Sorensen et al submitted to BMC Public Health HLS EU C

10 HLS-EU Questionnaire development Matrix HL core Delphi Item review Focus groups Expert views Pilot interviews Item analysis Translation

11 HLS-EU health literacy dimensions Accessing Understanding Appraising Applying information in terms of Cure and care Disease prevention Health promotion to make decisions in everyday life throughout the life course

12 Health literacy matrix Access/ obtain Understand Appraise Apply Cure & Care How easily do you find information on the following medical issues?... Cancers, resp. diseases etc. How easily do you understand the content of the leaflets that come with medications? Do you consider advantages and disadvantages of treatment options? How often do you follow your doctor's advice? Disease prevention How easily do you find information on the following risk factors? tobacco, alcohol etc. Health promotion How easily do you find information on the following health enhancing factors?... Nutrition and diet, exercise etc.

13 Pilot Questionnaire Chapters Health literacy Literacy Health outcomes (health status, service use, life style, empowerment) Personal information 86 items - Perceived health literacy (Likert scales) - Skills (Test)

14 Pilot analysis Item analysis Items that did not discriminate well were eliminated (95%) Factor analysis Separate principal component analysis for the three areas of health: CC; DP; HP Number of factors: 4 loadings analyzed Reliability analysis Internal consistency: Cronbach alpha

15 12 scales measuring health literacy The factor analysis confirm the four steps of the process for the three areas (the matrix) For each cell a valid and internal consistent measure

16 Pilot sample description (I) 99 persons interviewed 57 female (57.6%) 42 male (42.4%) Mean age 43.8 years (SD=16.6) Range years Nationality Ireland (n=48) The Netherlands (n=47) Other countries (Belgium, Denmark, Philippines, UK)

17 Pilot sample description (II) 96% (n=96) rate their life good to excellent Marital status: single married 31% (n=31) 42% (n=42) 61% (n=60) have children Work status: working 62% (n=61) student 15% (n=15) retired 10% (n=10)

18 Accessing or obtaining information

19 How well informed about (very well/fairly well) (question 6) physical activity nutrition and diet tobacco sun burns unsafe sex alcohol obesity dental hygiene healthy work environments drugs cancer stress respiratory disease cardiovascular disease social deprivation STD mental disease water and air pollution HIV/AIDS env. issues neighborhood healthy school setting noise government health policy %

20 Information about preventive measures Participants were mostly very well/fairly well informed about (50-80%) Vaccination Screening Contraception Smoking cessation Sun protection Weight control

21 Understanding information

22 Understanding information Leaflets of medications are understood easily/very easy by 68% (n=66) 12% have difficulties/great difficulties (n=12) 89% find the information from the doctor easy or very easy to understand (n=88)

23 The content of labels of packaged food is understood Easily/very easily 57% (n=55) Neutral 26% (n=25) Difficulty/great difficulty 17% (n=16) The rational of preventive measures like smoking ban or wearing seat belts is well understood by 84% (n=82) (easily/very easily)

24 Knowledge of the national health system % Very bad Bad Fair Good Very good No answer

25 Disease prevention and risks Vaccination guidelines/age Easily/very easily 59% (n=57) Difficulty/great difficulty 18% (n=17) Sun protection (sun screen factor) Easily/very easily 81% (n=80) Difficulty 3% (n=3) Consideration of advantages/disadvantages of preventive services are always/often taken into account by 45-60%

26 Appraising information

27 Considering ; discussing cure and care issues follow doctor's advice c omfortable talking with doctor consider advantages/disadvantages of treatment options dis cuss different treatments often/alway s sometimes never/rarely as k if issue is unclear %

28 How reliable do you think health information from is? (reliable/very reliable) family doctor pharmacist family local gov. Institutions friends schools/colleagues school/occup. health service scientific institut. and organizations nat. department or ministry of health NGO other resp. ministries mass media celebrities political parties valid %

29 Applying information

30 What do you do if you believe to have received insufficient info from the doctor. I seek advice from valid % second opinion family members people suffering the same condition continue treatment

31 Managing information and navigating the system Arrange appointment with a specialist Easily/very easily 77% (n=76) Neutral 17% (n=17) Difficult 6% (n=6) Confidence in using nat. health system Confident/very confident 54% (n=54) Neutral 29% (n=29) Not confident/not confident at all 15% (n=15) Signing of not understood medical documents Never 74% (n=73) Rarely 18% (n=18) Sometimes 7% (n=7)

32 Medicine label Identification of the sentence that indicates how often medication should be administered: Correct 83% (n=82) Wrong/no answer 7% (n=17) How much Tempra syrop is recommended for a child (10 years, 50 pounds)? Correct 64% (n=63) Wrong/no answer 36% (n=36) Identification of correct medication according to a chart for a child (11 years, 85 pounds) Correct 22% (n=22) Wrong/no answer 76% (n=76) n2 n3 n4

33 Folie 32 n2 n3 Or should we handle no answer here as MV? wrong n=7 no answer n=10 nicole.rosenkoetter; same as previous comment wrong n=28 no answer n=8 nicole.rosenkoetter; n4 Same as comment 2 wrong n=69 no answer n=7 ATTENTION answer 30 is typed in ones (i have graded this as MV)! nicole.rosenkoetter;

34 Health Behaviour Smoking: yes 31%(n=31) former smoker 25% (n=25) non-smoker 43% (n=43) Nutrition 73% (n=72) eat 1-3 servings fruits and vegetables per day Alcohol: never 12% (n=12) monthly or less 21% (n=21) 2-4 times/month 26% (n=26) 2-3 times/week 28% (n=28) Sport/exercise 70% (n=69) every day to once a week

35 How do you feel about you re health good health is a matter of luck health is sth. you are born with I can manage my own health I'm in control of my own health I can change my own lifestyle to become healthier I know where to ask for help if I get ill %

36 Conclusions Qualitative aspects Differences among younger and older generations Ability to access, understand, appraise and apply information is related to life events Confidence in terms of managing own health and navigating the system; lower trust in authorities as health advisors

37 Conclusions quantitative aspects The core health literacy dimensions have been confirmed Sample too small to show country differences the full survey will reveal similarities and differences on socioeconomic and cultural aspects of health literacy

38 Special acknowledgements National school of public health; Athens Barbara Kondilis & Elizabeth Ionnides UCD Business Schools; Dublin James Fullam & Gerardine Doyle Maastricht University Helmut Brand, Stephan van den Broucke, Vivian Stoffels & Nicole Rosenkötter Associated partners

39 Thank you for your attention HLS EU