@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2018;5(1):19-26

Background
Health literacy is one of the main determinants of health [1]. .... [2, 3].
Previous Studies
... [4-8]. In general, the results of studies in Iran indicate that there is a low level of health literacy in different groups [9-13]; as the results of a national study on health literacy in the five provinces of Iran showed that only 28.1% of the participants had adequate health literacy and that the rest did not have a desirable level of health literacy [14]. People with low levels of health literacy seem to be less likely to understand the written and spoken information provided by the healthcare providers and act based on them, so they have a lower health status. The results of various studies show that people with higher levels of health literacy have more health promotion behaviors [15, 16]. ... [17, 18]. Health staff seem to be influential in promoting healthy behaviors in the community due to their daily engagement with people, and in addition to their duties, they can also promote health. It should be noted that despite the effective role of health literacy on the health status of the various groups of society, especially employees, few studies are available in this regard [12, 19].
Aim(s)
The present study was conducted to determine health literacy status and its associated factors in employees of Hamadan University of Medical Sciences.
Research type
This research is an analytical-descriptive (cross-sectional) study.
Research society, place and time
This study was performed on employees of the Hamadan University of Medical Sciences in 2016.
Sampling method and number
Stratified random sampling was performed for seven faculties (medicine, dentistry, pharmacy, health, nursing and midwifery, paramedics and rehabilitation). In order to determine the sample size, a preliminary study was carried out on 30 employees. According to the preliminary study, considering the 80% power and the 95% confidence coefficient in the following formula, the sample size was estimated 198 subjects: C=0.05×ln [(1+r)/(1-r)]=0.2, n=[(Zα+Zβ)/c]3+3=198 Of the 198 eligible staff members (including official and contract staff at the administrative departments of the Hamadan University of Medical Sciences campus), 188 subjects participated in the study. It is notable that the 95% of the subjects completed the questionnaire and 5% of the staff members did not answer the scale completely or they had no consent for participation in the study.
Used devices&materials
In order to observe ethical considerations, the verbal consent was obtained from the participants. The Health Literacy for Iranian Adults (HELIA) was used to collect information, which its validity and reliability have been investigated in Iran [20]. It consisted of two sections: demographic information and the main items of health literacy. Demographic information included age, gender, educational status, marital status, economic status, health status and sources of health information. The main items also comprised of 33 items that measure subjects in five dimensions of health literacy, including reading, access, understanding, evaluation, and decision-making, which are scored on a 5-point Likert scale. The raw score for each person in each dimension is based on the algebraic sum of the points for the dimension. The scores then are ranged from zero to 100, and to calculate the total score, the scores of all dimensions are summed together and divided by its number (five dimensions). For scoring, inadequate health literacy is scored 0 to 50, borderline health literacy is scored 50.1 to 66, adequate health literacy is scored 66.1 to 84 and 84.1 to 100 is considered as excellent health literacy. Data analysis was done by SPSS 22 software. Descriptive statistics were used to describe the data and independent t-test, one-way ANOVA and linear regression were used to determine the relationships between variables.
Findings by Text
The mean age of the staff members was 36.84±6.32 years and more than two thirds (71%) were women (Table 1). 74.5% of the staff members received health information through the Internet, 22.9% through doctors and healthcare providers and 3.6% by radio, TV, magazines and asking friends and relatives. Among the five dimensions of health literacy, understanding with 69.6% of the maximum achievable scores had the highest score and reading and evaluation skills with 61.2% of the maximum achievable scores had the lowest frequency. In other words, understanding was more favorable than other dimensions. In addition, there was a positive and significant correlation between different dimensions of health literacy with each other (p<0.05; Table 2). On the other hand, the mean of health literacy in the subjects was 64.34 ± 12.01. In other words, the health literacy of employees was on average at the borderline level. It should be noted that more than half (58.5%) of the employees had inadequate or borderline health literacy (Table 3). There was a significant difference between age groups in reading, understanding, evaluation, and decision-making skills (p<0.05). In other words, it can be said that in older age groups had more reading, understanding, evaluation and decision-making skills about health. Moreover, there was a significant difference among the educational groups in the dimensions of understanding, evaluation and decision making (P<0.05). There was also significant difference in reading, access and decision-making skills among single and married subjects (p<0.05); as the health literacy of married subjects was higher than that of single participants. On the other hand, among the five dimensions of health literacy, there was only a significant relationship between understanding and health information sources (p<0.05; Table 4). Except for gender, all demographic variables included in the regression model had a significant relationship with health literacy (p<0.05). Among these variables, marital status (β=5.53), education level (β=-2.38), health information sources (β=-1.57) and age (β=0.33) were the predictors of mean Health literacy in the staff. According to the standardized beta, health information source was the most powerful predictor compared with other demographic variables (Table 5).
Main comparison to the similar studies
The results showed that among dimensions of health literacy, understanding was more desirable than other dimensions, which is not consistent with the results of the Afshari study on the workers working in a car spare parts factory; as they did not found to have desirable understanding [19]. In Ghanbari research, all dimensions of health literacy were desirable, however decision-making was more favorable. [21]. In the present study, more than half (58.5%) of employees had inadequate or borderline health literacy, which is similar to the results of another study in Iran [12]. In general, health literacy level is varied among countries; for example, a study by Damman in the Netherlands showed that 78.3% of the staff had adequate health literacy [22]. However, the results of studies in Iran show that health literacy level is varied from 8.8 [23] to 45.4% [24]. On the other hand, the results indicated that there was a significant difference between age groups in reading, understanding, evaluation and decision-making skills, which has also been confirmed in other studies [19, 24], however it is not consistent with the results of two relevant studies in Brazil and the United States [25, 26]. ... [27]. Furthermore, there was no difference between men and women in different dimensions of health literacy. There is a contradiction in the effects of gender on health literacy and its different dimensions; as in some studies, women's health literacy is higher [23], whereas in some others, male subjects have higher health literacy [28]. ... [29, 30].
Suggestions
A study with a longer period is suggested in order to better understand the causal relationship between the variables.
Limitations
This research is a cross-sectional study, which can be considered as its limitations.
Conclusions
The staff members have a borderline mean health literacy level. It seems that interventions based on demographic characteristics are required to improve the health literacy status of employees.
Acknowledgments
The present study is a research project funded by the Deputy of Research and Technology of Hamedan University of Medical Sciences (Study ID: 9507134204), which is appreciated.
Conflict of interest
None declared.
Ethical Permissions
The present study (Code No.: IR.UMSHA.REC.1395.328) was approved by the Ethics Committee of Hamadan University of Medical Sciences.
Funding Sources
This study was supported the Deputy of Research and Technology of Hamedan University of Medical Sciences.

TABLES and CHARTS

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