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. 2024 Dec 19;25(1):428.
doi: 10.1186/s12875-024-02684-y.

Factors associated with functional health literacy and the quality of life of riverside residents served by the primary care network in the Brazilian amazon: a cross-sectional study

Ana Kedma Correa Pinheiro  1 , Carlos Eduardo Raymundo  2 , Eliene do Socorro da Silva Santos  3 , Marcio Yrochy Saldanha Dos Santos  4 , Adriana de Oliveira Sarefino  3 , Maria Helena do Nascimento Souza  3 , Ingrid Bentes Lima  4 , Raquel Gomes da Silva  4 , Laura Maria Vidal Nogueira  4
Affiliations

Factors associated with functional health literacy and the quality of life of riverside residents served by the primary care network in the Brazilian amazon: a cross-sectional study

Ana Kedma Correa Pinheiro et al. BMC Prim Care. .

Abstract

Background: the riverside population lives in a vulnerable social situation, shaped by geographical, economic, social, and educational aspects that have repercussions on health literacy, the limitations of which can compromise Quality of Life. These specificities influence the actions of Primary Health Care, especially in the rural context. This study aimed to assess the factors associated with Functional Health Literacy and Quality of Life among riverside residents of the Brazilian Amazon who use Primary Health Care.

Methods: a cross-sectional study with 312 users of a riverside Family Health Team, using the Health Literacy Test, classified as adequate, limited, and inadequate, and the Study Short Form 12 Health Survey questionnaire, analyzing the physical and mental components in isolation. A theoretical model was built to assess the associations between sociodemographic and environmental variables and the Functional Health Literacy and Quality of Life outcomes. The Functional Health Literacy outcome was considered as two dichotomous variables (inadequate versus adequate; limited versus adequate), while the Quality of Life outcomes were considered as counts, with a Poisson distribution. Thus, a structural equation model was used to adjust the proposed theoretical model.

Results: there was a worsening in inadequate Functional Health Literacy, associated with females, aged over 40, elementary school education, living close to the health service, and using only a cell phone for communication. Factors that compromised physical Quality of Life: livelihood problems; inadequate literacy; age range 40-59; and having two children or more. And those that worsened mental Quality of Life: age over 40; having a family allowance; and being in control of their medication.

Conclusions: sociodemographic, environmental, and economic factors and adherence to medication by river communities have been shown to be associated with Health Literacy and Quality of Life. Knowing these implications is fundamental for health provision. These findings can support the formulation of strategies in health services to improve Health Literacy and Quality of Life.

Keywords: Health Literacy; Primary Health Care; Quality of Life; Rural Population Health; Socioeconomic Factors.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: The study followed the guidelines of Resolution 466/2012 of the National Health Council/Ministry of Health, which regulates research with human beings in Brazil. Thus, it obtained institutional authorization from the Municipal Health Department of Abaetetuba and was approved by the Research Ethics Committee of the Undergraduate Nursing Course at the State University of Pará, under Opinion No. 4.517.829 of February 1, 2021. All participants signed the Free and Informed Consent Term (FICT), formally declaring their voluntary acceptance. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Spatial location of the study area in Abaetetuba (PA), Brazil
Fig. 2
Fig. 2
Theoretical model health literacy. Note: SEX: Sex; AGE: Age group; SCH: Schooling; SKC: Skin color/race; FIL: Number of children; PLC: Proximity to health service; INC: Income; RIG: Defense of rights; CME: Means of communication; SWK: Start of work activities; DWK: Daily working hours; SSB: Social Security benefit; FAM: Family Allowance (Bolsa Família); SEW: Sanitary sewage; GAR: Destination of garbage; WAT: Water supply; MEU: Medication use; MEC: Medication control; PFE: Problems with feeding; PED: Problems with education; PDR: Problems with drugs; PVI: Problems with violence; PHO: Problems with housing; PTR: Problems with transportation: PFA: Family problems; PBS: Basic sanitation problems; PEC: Economic problems; PHE: Health problems; PWK: Work problems; PLE: Leisure problems; PME: Media problems; PLO: Loneliness problems; HLI: Inadequate FHL; HLL: Limited FHL; MCS: Mental Component Summary; PCS: Physical Component Summary
Fig. 3
Fig. 3
Final SEM diagram. Note: SEX: Sex; AGE: Age group; SCH: Schooling; FIL: Number of children; PLC: Proximity to health service; CME: Means of communication; FAM: Bolsa Família; GAR: Garbage disposal; MEC: Medication control; PED: Problems with education; PVI: Problems with violence; PHO: Problems with housing; PTR: Problems with transportation; PBS: Problems with basic sanitation; HLI: Inadequate FHL; HLL: Limited FHL; MCS: Mental Component Summary; PCS: Physical Component Summary
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