Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 5;10(10):e035987.
doi: 10.1136/bmjopen-2019-035987.

Measuring health literacy combining performance-based and self-assessed measures: the roles of age, educational level and financial resources in predicting health literacy skills. A cross-sectional study conducted in Florence (Italy)

Chiara Lorini  1 , Vieri Lastrucci  2 , Diana Paolini  1 , Guglielmo Bonaccorsi  1 ; Florence Health Literacy Research Group
Collaborators, Affiliations

Measuring health literacy combining performance-based and self-assessed measures: the roles of age, educational level and financial resources in predicting health literacy skills. A cross-sectional study conducted in Florence (Italy)

Chiara Lorini et al. BMJ Open. .

Abstract

Objective: The objective was to compare the results of performance-based and self-assessed measures of health literacy (HL) and to evaluate the contribution of their joint use in assessing some HL antecedents.

Design: This was a cross-sectional study.

Setting: The study was conducted on the general population in Florence (Italy).

Participants: This study is part of a larger one, where participants were randomly selected from the registries of 11 general practitioners working in the municipality of Florence. Inclusion criteria were the following: 18-69 years of age and Italian speaking. Exclusion criteria included cognitive impairment, severe psychiatric disease or end-stage disease. In this paper, 212 adults were included.

Outcome measures: HL was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the Newest Vital Sign (NVS). The HL levels obtained by means of the two measurement tools were combined into a new variable that described three different levels of HL skills: low HL skills, partial HL skills and high HL skills. Multivariate ordinal logistic regression analysis was performed to assess the predictive roles of age class, educational level and financial resources with respect to HL skills.

Results: Twenty-two per cent of the sample had high HL skills, 28.3% had low HL skills and 49.5% had partial HL skills. Educational level, age class and financial resources were significantly associated with HL skills, with OR values being higher than those obtained using the NVS or the HLS-EU-Q16 individually.

Conclusion: The combination of the results obtained using the NVS and the HLS-EU-Q16 improves the understanding of HL. The new variable generated by this combination could be considered as a different way to assess HL and its multidimensional contents.

Keywords: preventive medicine; public health; statistics & research methods.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Percentage of people with low HL by age class (A), educational level (B) and financial resources (C). HL, health literacy; HLS-EU-Q16, European Health Literacy Survey Questionnaire.
Figure 2
Figure 2
Percentage of people with regards to HLS (HLS-EU-Q16) and NVS by age class (A), educational level (B) and financial resources (C). For each graph, p<0.05 (Fisher’s exact test). HLS-EU-Q16, European Health Literacy Survey Questionnaire; NVS, Newest Vital Sign.
See this image and copyright information in PMC

References

    1. Kickbusch IS. Health literacy: addressing the health and education divide. Health Promot Int 2001;16:289–97. 10.1093/heapro/16.3.289 - DOI - PubMed
    1. Sørensen K, Van den Broucke S, Fullam J, et al. . Consortium health literacy project European. health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 2012;12:80. - PMC - PubMed
    1. Van den Broucke S. Health literacy: a critical concept for public health. Arch Public Health 2014;72:10. 10.1186/2049-3258-72-10 - DOI - PMC - PubMed
    1. Freebody P, Luke A. ‘Literacies’ programs: debates and demands in cultural context. Prospect:an Australian journal of TESOL 1990;5:7–16.
    1. Kickbusch I, Pelikan LM, Apfel F, et al. . Health literacy. The solid facts. Copenhagen: World Health Organisation Regional Office for Europe, 2013.