Health literacy and body mass index: a population-based study in a South-Eastern European country.

BACKGROUND: The relationship of health literacy (HL) with objective measures including anthropometric measurements remains an under-researched topic to date. OBJECTIVE: To assess the association between body mass index (BMI) and HL among Albanian adults. METHODS: A cross-sectional study was conducted in Tirana, Albania, in 2012-2014 including a population-based sample of 1154 individuals aged ≥18 years. HL was assessed by the use of HLS-EU-Q instrument. Anthropometrics included measurement of weight and height based on which BMI was calculated. Information on socio-demographic characteristics was also collected. Logistic regression was employed to assess the independent association of BMI and HL controlling all socio-demographic factors. RESULTS: One-fifth of the participants reported an inadequate HL level, whereas almost one-third (31%) reported an excellent HL level. About 41% of study participants were overweight and further 22% were obese. In multivariate analysis, there was evidence of a strong and significant association between BMI and HL: the odds of overweight/obesity were two times higher (OR = 2.0, 95% CI = 1.3-3.1) among inadequate HL individuals compared with excellent HL participants. CONCLUSION: Our findings, pertinent to a transitional country in the South East Europe, point to a strong, consistent and highly significant association between BMI and HL, irrespective of a wide array of socio-demographic characteristics.

Ability to Maintain and Improve Health and Socio-Demographic Correlates among Children in Albania.

Objective: Our aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans. Methods: A cross-sectional study was conducted in Albania in September 2022. The study population consisted of a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12-15 years. A structured self-administered and anonymous questionnaire inquired about the children's attitudes toward health promotion (ability to maintain and improve health) and a range of key dimensions on knowledge and practices regarding healthcare services. Socio-demographic data were also collected. Binary logistic regression was used to assess the socio-demographic correlates of children's ability to maintain health. Results: Overall, about 71% of schoolchildren exhibited the best attitudes toward health promotion (ability to maintain and improve health). In the multivariable adjusted logistic regression models, poorer attitudes toward health promotion (ability to maintain and improve health) were significantly related to older age (OR=1.2, 95% CI=1.0-1.3), middle/low maternal education (OR=1.2, 95%CI=1.1-1.3), poor/very poor economic situation (OR=1.5, 95%CI=1.2-1.8), lack of appropriate knowledge about rights to healthcare (OR=1.3, 95% CI=1.1-1.5), lack of knowledge about obtaining healthcare services (OR=1.7, 95%CI=1.4-2.2), and lack of consultations/visits with health professionals excluding vaccinations (OR=1.2, 95%CI=1.1-1.4). Conclusions: Almost 1/3rd of Albanian schoolchildren included in this study did not exhibit the best attitudes toward health promotion (ability to maintain and improve health). The best attitudes were related to a higher socioeconomic level and adequate knowledge and practices regarding healthcare services. There is thus a need to increase health literacy levels among children in order to ultimately induce sustainable healthy behavioural/lifestyle practices.

Young Queer Community Members Faced Higher Discrimination in Albania During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has hit vulnerable populations harder. In this context, the aim of this study was to assess the negative personal impacts and discrimination experienced by the LGBTQ+ community in Albania during the COVID-19 pandemic. METHODS: This cross-sectional study was carried out in Albania in 2021, as a part of a larger multicenter study conducted by the International Planned Parenthood Federation European Network (IPPF EN). Binary logistic regression was used to assess the likelihood of feeling discriminated, ashamed, or afraid due to sexual orientation, adjusting for main confounding factors. RESULTS: In total, 279 youngsters aged 14-30 years were included in this study. Of these, 55 participants or 19.7% self-declared as LGBTQ+. Significantly higher proportions of LGBTQ+ were older and of Albanian ethnicity, whereas lower proportions were not married/cohabiting compared to non-LGBTQ+ participants. Significantly higher proportions of LGBTQ+ members have felt discriminated (32.7%), ashamed to discuss about sexual and reproductive health (SRH) issues of concern (32.7%), afraid to express their sexual orientation (45.5%), and lacked privacy to discuss SRH issues with people of trust (36.4%) compared to non-LGBTQ+ participants (5.4%, 15.2%, 4%, and 17.4%, respectively). LGBTQ+ participants were 19.57 times more likely to feel discriminated because of their sexual orientation and 25.05 times more likely to be afraid to express their sexual orientation compared to non-LGBTQ+ participants. CONCLUSION: The LGBTQ+ community in Albania was more negatively impacted by the COVID-19 pandemic compared to non-LGBTQ+ participants. The findings should guide future interventions for addressing the needs of the LGBTQ+ community in emergency situations.

Determinants of Inadequate Health Literacy Among Faculty of Medical Technical Sciences Students in Albania: Cross-Sectional Survey.

BACKGROUND: Health literacy (HL) refers to people's ability to find, understand, and use health information in order to make appropriate health decisions. Health literacy among students is important so that tomorrow's health professionals can deliver high-quality health care and enhance patient education and communication. OBJECTIVE: In this context, the aim of this study was to assess the HL level of Faculty of Medical Technical Sciences (FMTS) students in order to shed light on this underresearched topic in Albanian settings. METHODS: A cross-sectional study involving 193 FMTS students of various study branches (nursing, midwifery, physiotherapy, and laboratory technician) was carried out during June 22-29, 2022, on the premises of the FMTS Faculty in Tirana, Albania. The international European Health Literacy Survey Questionnaire (HLS-EU-Q) standardized questionnaire, validated in Albanian, was used to collect information about FMTS students' general HL through a face-to-face interview. Basic sociodemographic information was collected as well. Binary logistic regression was used to assess the factors associated with inadequate, problematic, or limited HL. RESULTS: The mean level of general HL was 37.2 (on a scale from 0 [minimum HL] to 50 [maximal HL]). About one-quarter of FMTS students had inadequate (9/193, 4.7%) or problematic (38/193, 19.7%) HL, 51.3% (99/193) had sufficient HL, and 24.4% (47/193) had excellent HL. The prevalence of limited HL (inadequate and problematic HL) was higher among male than female students (6/12, 50% vs 41/181, 22.6%, respectively) and those with lower social and economic status. Upon adjusting for confounding effects, the only factor significantly increasing the likelihood of limited HL was male gender (odds ratio 8.13, 95% CI 1.68-39.39). Findings suggested that low social and economic status also increased the likelihood of limited HL, but such associations did not reach statistical significance. CONCLUSIONS: To our knowledge, this is the first study exploring the level of HL and its associated factors among FMTS students in Albania. The prevalence of limited HL was relatively high among FMTS students. There is a need for targeted interventions to increase the HL of nursing and midwifery students, such as the inclusion of HL subjects in the nursing curriculum.

Health Literacy and Blood Glucose Level in Transitional Albania.

Aim: Our aim was to assess the independent association between blood glucose level and health literacy (HL) adjusting for many socio-demographic characteristics and body mass index (BMI) in an adult population in Albania, a transitional country in the South Eastern Europe. Methods: A cross-sectional study was carried out in Tirana in 2012-2014 including a population-based sample of 1,154 individuals aged ≥18 years (57% women; mean age: 45.5 ± 16.4 years; response rate: 88.6%). HL was assessed by use of HLS-EU-Q instrument. Blood glucose level was measured in a fasting state by use of rapid finger stick method. Information on socio-demographic characteristics was collected, and BMI was calculated based on measurement of height and weight in all participants. General Linear Model (GLM) and binary logistic regression were used to assess the independent association of blood glucose level and HL adjusting for all socio-demographic factors and BMI. Results: One-third of participants had pre-diabetes (100-125.9 mg/dl) and further 11% had diabetes (≥126 mg/dl) based on the measured blood glucose level. In fully-adjusted GLM, mean blood glucose level was significantly lower among individuals with excellent HL compared with their counterparts with inadequate HL (99.3 vs. 106.0, respectively). Furthermore, the odds for the presence of diabetes in the group of study participants whose HL was "inadequate" were 2.6 times higher (95% CI = 1.3-5.4) compared to those whose HL was "excellent." Conclusion: We obtained evidence of a strong and significant inverse relationship between measured blood glucose level and HL, independent of many socio-demographic characteristics and measured BMI in a population-based study in a country of the Western Balkans.