Is Adherence to a Gluten-Free Diet by Adult Patients With Celiac Disease Influenced by Their Knowledge of the Gluten Content of Foods?

The aim of this study was to investigate adherence to a gluten-free diet and potentially associated factors, focusing on the relationship between adherence and knowledge of the gluten content of foods and of celiac disease in general. A questionnaire was completed by adult patients diagnosed with celiac disease including demographics, dietary practices, sources of information, and attitude to the disease. Their knowledge of disease and gluten-free diet was assessed using a newly developed scale comprising 31 statements on celiac disease in general and foods appropriate in a gluten-free diet. A validated questionnaire was used to measure adherence to diet. One hundred four patients with celiac disease took part in the study, 65% of them reported strictly adhering to a gluten-free diet. Factors associated with adherence were membership of the Italian Celiac Association and receiving support from this association, Internet, and social media. Patients' knowledge regarding celiac disease and gluten-free diet was generally poor: one patient answered all questions correctly. Knowledge of celiac disease and gluten-free diet was strongly and significantly associated with adherence to a gluten-free diet. The association between knowledge of celiac disease and gluten-free diet in patients with celiac disease and their adherence to the diet suggests the promotion of education and behavioral programs.

Correlation Between eHealth Literacy and Health Literacy Using the eHealth Literacy Scale and Real-Life Experiences in the Health Sector as a Proxy Measure of Functional Health Literacy: Cross-Sectional Web-Based Survey.

BACKGROUND: The eHealth Literacy Scale (eHEALS) is a tool for the self-assessment of perceived comfort and skills in using the internet as a source for health-related information. Although evidence exists of the reliability and construct and structural validity of the scale, there is a lack of evidence in relation to what is proposed by Norman and Skinner in their theoretical lily model of eHealth literacy; in particular it is not clear whether having a higher level of health literacy can positively influence electronic health (eHealth) literacy as measured by the eHEALS. OBJECTIVE: Our study aim was to assess whether real-life experiences from studying or working in the health field, as a proxy of higher functional health literacy, correlate with self-referred eHealth literacy as measured by the eHEALS. METHODS: A Web-based survey was conducted among adults living in Northeast Italy using an Italian version of the eHEALS (IT-eHEALS). In order to be able to measure the effect of higher functional health literacy on eHealth literacy, we divided our sample into two groups, respectively characterized by studying or working experience in the health sector and by lack thereof. Mean differences between eHEALS were calculated using t test and effect size evaluated using Cohen d. To ensure the validity of the IT-eHEALS, we evaluated its psychometric properties (internal consistency and dimensionality) and construct validity (by evaluating its correlation with respondents age, gender, educational attainment, self-rated health, use of internet for health-related purposes, and working status). RESULTS: A total of 868 respondents that completed the IT-eHEALS were included for analysis, of which 259 had working or studying experience in the health field. Mean (SD) eHEALS total score was 28.2 (6.2) for the whole sample, with statistically significant differences (P<.001) between the two groups, with the higher health literate group scoring significantly better (31.9 (5.9) vs 26.7 (5.6), respectively), with a standardized mean difference (Cohen d) of 0.9. Interestingly, we found a weak, yet significant, correlation between eHealth literacy and respondent characteristics for the higher health literate group only, as measured by positive Spearman correlation coefficients for age (0.11, P=.001), educational attainment (0.19, P=.002) and self-rated health (0.14, P=.024). Also, in line with current literature, correlation of eHEALS score with frequency of internet use for health-related purposes was significant for both groups (0.32, P<.001 and 0.15, P<.001 for higher and lower health literacy group, respectively). In our study we could not find any difference related to gender, while a significant difference for working status was only present when considering the sample as a whole (P=.03). CONCLUSIONS: Our study demonstrates a sizeable effect of higher levels of functional health literacy on the eHEALS score, corroborating what was initially proposed by Norman and Skinner in the lily model of eHealth literacy.

Sexual and reproductive health-related knowledge, attitudes and support network of Italian adolescents.

Objectives: What is the state of sexual and reproductive health (SRH) knowledge among teens? What about adolescents' attitudes toward SRH and the available supporting network? Study design: A cross-sectional study conducted between April and May 2018. Methods: An anonymous 36-item questionnaire on SRH knowledge, behaviors, and networks was developed, revised and validated by a multidisciplinary health professional team, then distributed to high school students in Udine (Italy). Results: 747 questionnaires were collected in five high schools; respondents were predominantly male, mean age 14.8 years; 48% of students have sufficient SRH knowledge (considered as above the mean value). Factors associated with higher knowledge levels were female sex, age, SES according to father's profession, first SRH information at age 11-13, Italy as country of origin, and attendance at a technical school. Conclusions: Students' knowledge on SHR resulted relatively poor. Sex, school type and previous experience of sexuality education were the most important factor associated with SRH knowledge.

Beliefs about HPV vaccination and awareness of vaccination status: Gender differences among Northern Italy adolescents.

Human papillomavirus (HPV) is one of the most frequent sexually transmitted infectious agents worldwide, and it is responsible for a significant burden of cancers. The aim of this study was to evaluate HPV knowledge and awareness in a sample of Northeastern Italian adolescents and parental support available to them, in order to highlight potential room for improvement towards optimal HPV vaccination adherence. Between April and May 2018 an observational questionnaire-based study was conducted in 1st year students of secondary upper schools in Udine (Italy). We quantitatively evaluated HPV knowledge, awareness and parental support level of male and female adolescents. The contribution of sociodemographic characteristics to HPV vaccination knowledge and uptake were explored using Chi-Square or Fisher test and multivariate logistic. Knowledge about HPV vaccine resulted to be mostly insufficient among enrolled adolescents, with a worrying proportion of them believing that HPV vaccine was expected to prevent HIV/AIDS. Awareness about their vaccination status was poor, and more than half of them were not involved in HPV vaccine uptake deliberation. Girls performed better than boys in relation to knowledge, awareness and engagement. Our results support the hypothesis that HPV vaccine knowledge and uptake can be affected by some gender bias. Improvements in adolescent health education and vaccination strategies are needed to engage and finally protect both genders from HPV.