@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2014;1(2):48-55

Background
... [1-2]. Health Literacy means the individual capacity for accusation, interpretation, and understanding basic health information that is necessary for proper decision-making[3].
Previous Studies
... [4]. In a recent report, World Health Organization, has identified health literacy as one of the main health determinants [5].There is no single definition of health literacy, and this issue has faced its measurement with some problems [6-9].… [10-12]. Specialists in Medical Association have suggested dimension of health literacy in four groups including conceptual and cultural knowledge, oral literacy,writing literacy, and mathematical literacy. Because health literacy has a variety of definitions and structures, researchers have developed several tools to measure health literacy, each tool measures one of the dimensions [13-15]. … [16-18].
Aim(s)
This study was conducted to determine the health literacy of adults in Tuyserkan city.
Research type
This study is a descriptive – analytic in form of cross-sectional.
Research society, place and time
The study was done from the beginning of May to end of July 2014, over 285 people, aged 20-60 years old who had referred to health care centers under the supervision of Tuyserkan city health center.
Sampling method and number
Due to the relatively equal distribution of the population in urban and rural areas in the city, first through cluster sampling, two urban centers and two rural centers were selected. Numbers of samples in question were allocated in rural centers using stratified sampling according to sample size assigned to each center and covered health houses. Then, through convenience sampling, the questionnaires were filled by individuals who had referred to selected health centers and health house. Entry requirement for patients were ability to read and write. People who were suffering from acute sight and hearing, or cognitive and psychiatric disorders were excluded from the study.
Used devices&materials
For collecting data, Iranian Health Literacy Questionnaire (Iranian national research project to assess health literacy) was used. The reliability and validity of the questionnaire have been confirmed by experts. The questionnaire contains 71 questions for four dimensions of health literacy including access to and acquisition of health information with 11 questions (0-18 as weak, 18-36 as average, and more than 36 as good),understanding of information with 19 questions (0-25 as weak, 25-50 as average, over 50 as good) judgment and assessment with 8 items (0-11 as weak, 12-22 as average , 23-32 as good) and the use of information with 24 questions (0-32 as weak , 33-64 as average, and more than 64 as good). Scoring criteria was based on the Likert scale, and based on the four above-mentioned domains; the scores were classified in three categories: weak, moderate, and good. Statistical analysis: Using descriptive statistics including tables, frequencies and percentages as well as analytical statistics including chi-square test, independent t-test and ANOVA, meaningful difference of the mean of literacy health was compared in the studied groups. Significant levels in all phases of the study were considered less than 0.05. Data was analyzed by using Stata version 11 software.
Findings by Text
In this study of 285 studied individuals, 153 patients (53.7%) were male. 50.9% were rural residents and the rest lived in urban areas. Majority of them, i.e., the 55.8% of people had secondary education, and only 3.9% of them were educated in elementary level. In terms of age,52.3% of people were in the age group of 20-30 and only 14.8% were more than 40. From the aspect of their employment status,31.9% were students and 30.9 % of them were housewives. Demographic characteristics of the population study are shown in Table 1. Table 2 shows the educational level of subjects according to four dimensions of health literacy. As it is shown, in terms of access to health information, 42.1 % had weak access, 44.6 % had moderate access, and only 13.3% of people had appropriate access. About understanding health information, only 1.7% of people had a sufficient understanding of health. In case of judgments and assessment no one was in the appropriate level, and about use of health information, the situation was better i.e., 88.8% of people were at the state of average and 11.2% of them were in acceptable level of using health information.In Table 3, the mean of literacy scores of patients according to four dimensions of health literacy is shown. In terms of access to information about the health with a maximum score of 55, the mean scorewas 22.3 ± 0, 88. For understanding of the information with the maximum score of 76, the mean score was 24.2 ± 0.62, the mean score of judgment and assessment with the maximum score of 32 was 14.01± 0.25, and the mean for data usage with the maximum score of 96 was 52± 0.52. Table 4 shows that the mean score of women's access to health information had a better situation rather than those of men (25 to 19.93) that this difference was statistically significant (p=0.003). In terms of the use of health information, also,the mean score of women had better situation and was equal to 54.3, while it was 50.04 for men that this mean difference was, also, statistically significant (p˂0.001). Regarding understanding of health information as well as judgment and assessment, while women had better conditions, the mean difference was not significant between the two groups. Access to health information was better in the group aged 30-50 years, and the minimum score was belonged to the group aged 20-30 years that was 17.6. One-way ANOVA showed a significant difference between the mean score of access to health services and age group (p=0.09). No significant differences was observed in term of judgment and assessment (p=0.121). Regarding understanding of health information, the group aged 41-50 years, and the group aged 20-30 had the highest and lowest mean score with 36.6 and 19.8 respectively that this difference was statistically significant between groups with different ages (p<0.001). On the use of health information, (24 questions, maximum score 96), the mean score was 52. The results of this study, based on the Iranian health literacy questionnaire, showed that participants were moderate in terms of access to information; in case of understanding information, they were weak; they were moderate in judgment and assessment; and they were moderate in the use of information.
Main comparison to the similar studies
… [19-22]. In a study of adults in Isfahan that was carried out using two questionnaires, according to the questionnaire S-TOFHLA, 53.5% of people had insufficient health literacyand based on NVS questionnaire, 61.5% of the participants had inadequate health literacy [10]. ... [23].In present study, there was a meaningful statically relationship between health literacy level and age in the areas of understanding information and the use of information. Also, significant relation was observed between level of health literacy and the age in the domains of access, judgment and evaluation and the use of information .The average level of health literacy in women and in age group of 41 to 50 years was more than the other sex and age groups. These results are inconsistent with other studiesthat in the majority of those studies, men and younger age groups had higher health literacy [1, 24,25]. ... [26]. This study is the first study of adult health literacy which has examined the health literacy of adults in Tuyserkan city with Iranian health literacy questionnaire. This questionnaire having four sections of access, information understanding, judgment and assessment, and using information evaluates more levels of health education compared to other questionnaires, including NVS, S-TOFHLA and TOFHLA [10, 12, 15].
Suggestions
In health education programs and health promotion, there should be more attention to the health literacy of the society. First, training of health care staff should be considered. Accordingly, written training materials, along with other educational media should be used in patients referred to health centers.
Limitations
About the limitations of this study, ignorance of other skills, and cultural background of people related to health literacy in the questionnaire can be mentioned.
Conclusions
Health literacy in adults is undesirable.
Acknowledgments
The authors of this article appreciate the personnel of the Tuyserkan city health center that helped the researchers to collect data.
Conflict of interest
There is not a connection between authors’ personal interests and the results of this study.
Ethical Permissions
At the beginning of study, the purpose of the study was explained to the participants and their consent for completing the questionnaire was acquired.
Funding Sources
Non-declared

TABLES and CHARTS

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