BACKGROUND & AIMS: :Healthcare providers can enhance the effectiveness and efficiency of the care they provide by recognizing their patients' health literacy. Health literacy is defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." It is a measure of the clarity of the communication between the healthcare system and the patient. The consequences that can occur when the patients' health literacy is not addressed include: poorer health status, high rates of health services use, compromised patient safety, and increased health care costs. The mnemonic SPEAK (Speech, Perception, Education, Access, and Knowledge) provides a simple framework that healthcare providers can use to enhance their own awareness of health literacy components during patient care. Case examples show how the mnemonic can be used in everyday practice.

背景与目标： : 医疗保健提供者可以通过识别患者的健康素养来提高他们提供的护理的有效性和效率。健康素养的定义是 “个人有能力获得，处理和理解做出适当健康决策所需的基本健康信息和服务的程度。”这是衡量医疗保健系统与患者之间通信清晰度的一种度量。当患者的健康素养得不到解决时，可能发生的后果包括: 健康状况较差，医疗服务使用率高，患者安全受损以及医疗保健成本增加。助记符SPEAK (语音，感知，教育，访问和知识) 提供了一个简单的框架，医疗保健提供者可以使用该框架在患者护理期间增强自己对健康素养的认识。案例示例显示了如何在日常实践中使用助记符。

BACKGROUND & AIMS: Background:The present systematic review and meta-analysis were conducted to find the degree by which the Iranian diabetic patients were informed about their disease in term of health literacy. Methods:The search was carried out in databases including the PubMed, MEDLINE (PubMed), Scopus, Embase, Cochrane Library, ProQuest, Web of Science, Science Direct and Wiley and also domestic databases including the Iranian Academic Center for Education Culture and Research (sid.ir), the Iranian Research Institute for Information Science and Technology (IranDoc.ac.ir), Barakat Knowledge Network System (barakatkns.com), the national publications database (magiran.com) and also Google Scholar and Elmnet search engines. All the original studies published by Oct 20, 2018, in Persian or English, to assess the health literacy of adults with diabetes were included in the study. Ultimately, 17 articles were included in the meta-analysis. The meta-analysis was carried out using the fixed-effects method using Stata-11.2. Results:The pooled mean score of health literacy was 56.65 out of score of 100, and its 95% CI was estimated as 49.85 to 63.45. No significant heterogeneity could be reported for the articles included in the meta-analysis (I-squared=21.3%, P=0.177). The pooled mean scores with the CI of 95% by gender based on the study population in women and men were estimated as 47.97and 50.06 respectively. Conclusion:Health literacy is not high in Iranian diabetic patients and is rather inadequate in most of them in both genders. Diabetic women have somewhat lower health literacy compared to diabetic men.

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BACKGROUND & AIMS: :Successful early reading and spelling acquisition depends on a number of different skills. Of considerable importance is phonological processing, which is the processing of acoustic signals with linguistic content. Three areas of phonological processing have been found to be most important for reading and writing competence: phonological awareness, naming speed, and phonological working memory. Research on these components suggests that specific interventions tailored to individual phonological processing deficits may prevent later dyslexia. Therefore, it appears mandatory that ear-nose-throat physicians have at least a basic knowledge of the theory of phonological processing. This will enable proper consultation with parents of affected children.

背景与目标： : 成功的早期阅读和拼写习得取决于许多不同的技能。语音处理非常重要，它是对具有语言内容的声音信号的处理。已发现语音处理的三个领域对于阅读和写作能力最重要: 语音意识，命名速度和语音工作记忆。对这些组成部分的研究表明，针对个人语音处理缺陷的特定干预措施可能会防止以后的阅读障碍。因此，似乎必须使耳鼻喉医师至少具有语音处理理论的基本知识。这将能够与受影响儿童的父母进行适当的协商。

BACKGROUND & AIMS: OBJECTIVE:The primary objective was to compare the efficacy of two eight-lesson programs, targeting perfectionism and media literacy compared to control classes in reducing eating disorder risk. METHOD:Students from six classes (N = 127, mean age 15.0 years, SD 0.4) and two schools participated. Linear mixed-model analyses were conducted by group (3: perfectionism, media literacy, control), time (2: postprogram, 3-month follow-up) and eating disorder risk status (2: high, low), with baseline observations included as a covariate. RESULTS:An interaction effect favoring the perfectionism program at 3-month follow-up was found for concern over mistakes (effect size 0.45). A main effect for group, also favoring the perfectionism program, was found for personal standards (effect size 0.44). High-risk participants (i.e., those with high levels of shape and weight concern at baseline) benefited most from the perfectionism program with reliable change indices indicating favorable rates of improvement beyond chance on all of the variables, whereas the media literacy and control participants experienced a comparable rate of change during the course of the study. CONCLUSIONS:Targeting perfectionism represents a promising prevention option that requires further investigation in children of mid-adolescence age, and further investigation is required to determine the demographic most likely to benefit from media literacy.

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BACKGROUND & AIMS: :The intent of this exploratory descriptive study was to examine mental health literacy (MHL) with 28 African American elders who reside in Kentucky. Collectively, all elders were partially literate of mental disorders and familiar with self-help and professional interventions and Alzheimer's and depression were the most recognized mental disorders. An awareness of MHL is an essential first step to understanding African American elders' views about mental health which then can facilitate the design and development of culturally relevant psychoeducational programs geared to this subset of the aging population.

背景与目标： : 这项探索性描述性研究的目的是检查居住在肯塔基州的28名非洲裔美国老年人的精神卫生素养 (MHL)。总的来说，所有老年人都部分了解精神障碍，并且熟悉自助和专业干预措施，而阿尔茨海默氏病和抑郁症是公认的精神障碍。对MHL的认识是了解非裔美国老年人对精神卫生的看法的重要第一步，然后可以促进针对这一老龄化人口的文化相关心理教育计划的设计和开发。

BACKGROUND & AIMS: PURPOSE OF REVIEW:The following review summarizes contributions from rheumatology to the growing field of health literacy. RECENT FINDINGS:Arthritis related publications have primarily contributed to one strand of research in health literacy: assessments of print materials and considerations of the match between the reading grade level of materials and the reading skills of intended audiences. Unlike researchers addressing other chronic diseases such as diabetes, however, researchers and practitioners in rheumatology have yet to examine links between patients' literacy skills and health outcomes. In addition, only one early study reports on evaluation findings of an education program designed for audiences with low literacy skills. No other studies report on efforts to increase health literacy in arthritis, reduce the demands of print materials for education or research purposes, or on efforts to ameliorate the effects of limited literacy skills among patients. SUMMARY:Health literacy may well influence arthritis outcomes as well as recruitment efforts in arthritis research. The 2004 report on health literacy from the Institute of Medicine calls for additional studies focused on the links between health literacy and health outcomes.

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BACKGROUND & AIMS: BACKGROUND:We explored the association between health literacy and self-care behaviors among low-income patients with chronic kidney disease (CKD). METHODS:We used baseline data from the Kidney Awareness Registry and Education trial (n = 137 patients with CKD) and multivariable logistic regressions to cross-sectionally examine the association between health literacy, defined by a validated questionnaire, and healthy behaviors. RESULTS:Study participants had a mean age of 55 years, were racially diverse (6% White, 36% Hispanic, 43% Black, 15% Asian) and 26% had low health literacy. Over one-third (38%) had hypertension, 51% had diabetes, and 67% had CKD stage 3 or 4. Compared to individuals with adequate health literacy, those with low health literacy had non-statistically significant higher tobacco use (adjusted odds ratio [aOR] = 2.33; 95% CI 0.90-6.06) and lower consumption of sugary beverages (aOR = 0.50; 0.20-1.23) and statistically significant decreased fast food intake (aOR = 0.38; 0.16-0.93). Health literacy was not associated with differences in medication adherence (0.84; 0.38-1.89) or physical activity (aOR = 2.39; 0.54-10.53). CONCLUSIONS:Health literacy was not uniformly associated with all self-care behaviors important for CKD management. A more nuanced understanding of the association of health literacy and self-care may be necessary to promote participation in behaviors known to slow CKD progression.

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BACKGROUND & AIMS: ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION:Oral health literacy and associated oral conditions: A systematic review. Firmino RT, Ferreira FM, Palva SM, Granvlle-Garcia AF, Fraiz FC, Martins CC. JADA 2017; 148(8):604-13. SOURCE OF FUNDING:Government and foundation. This study was supported by the Brazilian Ministry of Education Coordination for the Improvement of Higher Education Personnel, the Minas Gerais State Research Foundation, and the Brazilian National Council for Scientific and Technological Development. TYPE OF STUDY/DESIGN:Systematic review.

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BACKGROUND & AIMS: OBJECTIVE:Non-adherence to pediatric regimens is a common concern. Low health literacy is correlated with poor outcomes in adults but is understudied in pediatrics. The current project aimed to determine the relationship between health literacy, adherence, and outcomes in pediatric liver transplant recipients. Hypotheses included a) parent and patient health literacy would be positively correlated; and b) low patient and/or parent health literacy would be negatively correlated with adherence and health outcomes. PATIENTS AND METHODS:Eligible participants were recruited during routine follow-up visits in a pediatric liver transplant clinic. Parents and patients (>13 years old) completed 2 measures of health literacy. Patients ≥18 years completed health literacy measures without corresponding parent surveys. Adherence variables and health outcomes were obtained from medical records. RESULTS:Seventy-nine patients across two sites completed the study. Variance in classification of health literacy between measures was observed; however, most parents (82%-100%) scored within an "adequate literacy" range. More adolescents scored in lower health literacy ranges relative to the parents. Markers of SES were positively correlated with health literacy. Parent health literacy was negatively associated with biopsy-proven rejection episodes and the number of hospitalizations; however, it was not associated with measures of tacrolimus adherence. There were no relationships observed between parent and adolescent health literacy. CONCLUSIONS:Health literacy is an important consideration in managing patient care; however, available measures demonstrate variability in capturing the skills of patients. Effective communication strategies may ameliorate admittedly small, but negative, impacts of limited health literacy on outcomes.

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BACKGROUND & AIMS: BACKGROUND:Patients with low health literacy experience difficulty in understanding their medications leading to worse health outcomes. Pharmacists need to use formal assessment tools to be able to identify these patients, so they can better tailor their patient education. The objective of the study was to characterize hospital pharmacists understanding of health literacy and their use of screening and counselling strategies before and after completion of an educational module and to identify barriers that hospital pharmacists perceive to exist that prevent them from using health literacy tools. METHODS:Pharmacists in three health authorities were administered a pre-survey and then given access to an online 11 min educational video. The post-survey was distributed 1 month later. Descriptive statistics were used to quantify survey responses with comparisons made between pre and post responses. The main outcome measure was pharmacists' understanding of health literacy and their current practice related to health literacy. RESULTS:There were 131 respondents for the pre-survey and 39 for the post-survey. In the pre-module survey, 84% of pharmacists felt they understood what health literacy was, but only 53% currently assessed patients for their health literacy status and 40% were aware of what strategies to use in low health literacy patients. Lack of time (74%) was the biggest barrier in assessing patients' health literacy. In the post-module survey, 87% felt they understood what health literacy was and 64% incorporated health literacy status evaluation into their clinical practice. The educational module was helpful to the clinical practice of 74% of respondents. CONCLUSION:As health literacy can affect a patient's ability to adhere to their medications it is important for pharmacists to assess this in their patients. While pharmacists self-reported a high degree of understanding of health literacy, they are not regularly assessing their patients' health literacy status and are unaware of what strategies to use for low literacy patients.

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BACKGROUND & AIMS: BACKGROUND:The role of one's social network in the process of becoming health literate is not well understood. We aim to explain the 'distributed' nature of health literacy and how people living with a long-term condition draw on their social network for support with health literacy-related tasks such as managing their condition, interacting with health professionals and making decisions about their health. DESIGN:This paper reports a longitudinal qualitative interview and observation study of the development and practice of health literacy in people with long-term health conditions, living in South Wales, UK. Participants were recruited from health education groups (n = 14) and community education venues (n = 4). The 44 interview transcripts were analysed using the 'Framework' approach. RESULTS:Health literacy was distributed through family and social networks, and participants often drew on the health literacy skills of others to seek, understand and use health information. Those who passed on their health literacy skills acted as health literacy mediators and supported participants in becoming more health literate about their condition. The distribution of health literacy supported participants to manage their health, become more active in health-care decision-making processes, communicate with health professionals and come to terms with living with a long-term condition. Participants accessed health literacy mediators through personal and community networks. CONCLUSION:Distributed health literacy is a potential resource for managing one's health, communicating with health professionals and making health decisions.

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BACKGROUND & AIMS: BACKGROUND:Maternal mental health including postpartum mental health is essential to women's health. This study aimed to develop a specific measure for assessing postpartum depression literacy and consequently evaluate its psychometric properties among a sample of perinatal women. METHODS:This investigation was composed of two studies: developing the measure, and evaluating of psychometric properties of the developed questionnaire. In development stage an item pool was created. Then, based on definition of mental health literacy and preliminary screening, an initial questionnaire was developed. The content and face validity of the questionnaire were then assessed. In the second study psychometric properties of the questionnaire were examined. Overall 692 perinatal women with the mean age of 27.63 years (ranging from 17 to 43) participated in the study. RESULTS:In all an item pool of 86 items was generated. Of these, 31 items were removed and the remaining 55 items subjected to content and face validity and further 16 items removed. In the second stage a 39-item questionnaire namely the Postpartum Depression Literacy Scale (PoDLis) was evaluated. In principal component factor analysis, 31 items were loaded indicating a 7-factor solution for the questionnaire. The factors designated the following constructs: ability to recognize postpartum depression, knowledge of risk factors and causes, knowledge and belief of self-care activities, knowledge about professional help available, beliefs about professional help available, attitudes which facilitate recognition of postpartum depression and appropriate help-seeking, and knowledge of how to seek information related to postpartum depression. Finally performing the confirmatory factor analysis, the Postpartum Depression Literacy Scale with 31 items was supported for the structures suggested by theoretical model and findings from the exploratory factor analysis. The Cronbach's alpha coefficient for the scale was .78 and it ranged from .70 to .83 for each factor lending support to the internal consistency of the questionnaire. CONCLUSION:The findings suggest that the Postpartum Depression Literacy Scale (PoDLiS) is a reliable and valid instrument for measuring the postpartum depression literacy and now can be used in studies of mental health literacy in women.

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BACKGROUND & AIMS: BACKGROUND:The eHealth Literacy Scale (eHEALS) is the most widely used instrument in health studies to measure individual's electronic health literacy. Nonetheless, despite the rapid development of the online medical industry and increased rural-urban disparities in China, very few studies have examined the characteristics of the eHEALS among Chinese rural people by using modern psychometric methods. This study evaluated the psychometric properties of eHEALS in a Chinese rural population by using both the classical test theory and item response theory methods. OBJECTIVE:This study aimed to develop a simplified Chinese version of the eHEALS (C-eHEALS) and evaluate its psychometric properties in a rural population. METHODS:A cross-sectional survey was conducted with 543 rural internet users in West China. The internal reliability was assessed using the Cronbach alpha coefficient. A one-factor structure of the C-eHEALS was obtained via principal component analysis, and fit indices for this structure were calculated using confirmatory factory analysis. Subsequently, the item discrimination, difficulty, and test information were estimated via the graded response model. Additionally, the criterion validity was confirmed through hypothesis testing. RESULTS:The C-eHEALS has good reliability. Both principal component analysis and confirmatory factory analysis showed that the scale has a one-factor structure. The graded response model revealed that all items of the C-eHEALS have response options that allow for differentiation between latent trait levels and the capture of substantial information regarding participants' ability. CONCLUSIONS:The findings indicate the high reliability and validity of the C-eHEALS and thus recommend its use for measuring eHealth literacy among the Chinese rural population.

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BACKGROUND & AIMS: :The concept of information literacy may be new to some perioperative nurses; however, embracing this concept will help nurses identify situations that necessitate gaining more information, locate and access information sources, evaluate and analyze data, and cite information in compliance with copyright and fair use laws. The culture of health care is continually changing as a result of new technology and new methods to improve patient care, and this creates an information explosion. Perioperative educators should add information literacy as a strategic goal for obtaining Magnet status because it is foundational to evidence-based practice. Administrators also should advocate to obtain resources that will enable nurses to access information that addresses current patient care issues.

背景与目标： : 信息素养的概念对于一些围手术期护士来说可能是新的; 但是，接受这一概念将有助于护士识别需要获得更多信息的情况，定位和访问信息源，评估和分析数据，并引用符合版权和合理使用法律的信息。由于新技术和新方法改善了患者护理，医疗文化不断变化，这造成了信息爆炸。围手术期教育者应将信息素养作为获得磁铁状态的战略目标，因为它是循证实践的基础。管理员还应倡导获得资源，使护士能够访问解决当前患者护理问题的信息。

BACKGROUND & AIMS: OBJECTIVES:Low literacy is highly prevalent among UK adults. This study assessed functional health literacy among family planning clinic clients and whether this was associated with sexual health knowledge and behaviours. It also assessed the readability of patient leaflets. METHODS:505 female family planning clinic attendees aged 16-35 years were interviewed about their sexual behaviour and knowledge. Their reading age was assessed using a validated test (REALM). The readability of leaflets on contraception supplied to clinic users was measured. RESULTS:All respondents had a reading age of 12 years and above, 221 (43.8%) between 12 and 14 years and 284 (56.2%) greater than 14 years. Those in the lower literacy group were significantly more likely to have been aged under 16 years at time of first sexual intercourse, and significantly less likely to know the most fertile time of the menstrual cycle, to identify sexually transmitted infections and to know that sexual infections can be transmitted through oral and anal sex. The reading age of information leaflets in the clinics ranged from 11 to 17 years. Thus, clients with a reading level of 12-14 years would have difficulty in understanding some of the leaflets. CONCLUSIONS:Functional health literacy is related to sexual behaviour and knowledge. Written information should be prepared with this in mind and other routes of communication considered.

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