Impact of health literacy, social support, and socioeconomic position on the serum uric acid level in asymptomatic hyperuricaemia patients in China: a structural equation model.

BACKGROUND: Hyperuricaemia (HUA) poses a significant public health challenge on a global scale. It is mostly asymptomatic hyperuricemia (AHU) with unsatisfactory recognition and control rates. The role of health literacy in influencing health outcomes is of utmost importance, and enhancing health literacy is helpful for patients in managing risk factors. Additionally, social support and socioeconomic position (SEP) have been identified as potential factors influencing health. However, the exact relationships between these factors and AHU remain unclear. This study aimed to investigate the status of health literacy among patients with AHU and explore the relationships between health literacy, social support, SEP, and serum uric acid (SUA) levels. METHODS: A cross-sectional study was conducted among 349 participants with AHU in Luzhou, China. The research instruments included a sociodemographic characteristics questionnaire, the Health Literacy Scale for Chronic Patients (HLSCP), and the Social Support Scale (SSRS). The construction of the SEP index was achieved through the application of principal component analysis. Univariate and hierarchical regression analyses were used to evaluate the associations between SEP, social support, health literacy, and SUA levels. Furthermore, structural equation modelling (SEM) was utilized to examine these associations. RESULTS: (1) Most patients exhibited low health literacy (90.18 ± 15.11), and only 44.4% possessed basic health literacy. (2) SEP was positively correlated with SUA levels (ß = 4.086, P < 0.001), and health literacy was negatively related to SUA levels (ß = -0.399, P < 0.001). There was no significant relationship between social support and SUA levels (ß = 0.051, t = 1.085). (3) Health literacy mediated the association between SEP and SUA levels (ß = -0.490, 95% CI: -0.620 to -0.382). SEP had a direct positive effect on SUA levels (ß = 0.723) and health literacy (ß = 0.696), and the total effect of SEP on SUA levels was 0.233. CONCLUSIONS: The findings indicate a low level of health literacy among patients with AHU and suggest that health literacy might play a mediating role in the relationship between SEP and SUA levels. Consequently, future initiatives are recommended to prioritize health literacy and devise appropriate intervention strategies to enhance the self-management capabilities of patients with AHU.

Cancer literacy differences of basic knowledge, prevention, early detection, treatment and recovery: a cross-sectional study of urban and rural residents in Northeast China.

Background: Cancer literacy as a potential health intervention tool directly impacted the success of cancer prevention and treatment initiatives. This study aimed to evaluate the cancer literacy in Northeast China, and explore the factors contributing to urban-rural disparities. Methods: A cross-sectional survey was conducted in 14 cities across Liaoning Province, China, from August to October 2021, using the multistage probability proportional to size sampling (PPS) method. The survey comprised 4,325 participants aged 15-69 and encompassed 37 core knowledge-based questions spanning five dimensions. Associations between sociodemographic factors and the cancer literacy rate were evaluated using chi-square tests and multivariate logistic regression model. Results: The overall cancer literacy rate was 66.9% (95% CI: 65.6-68.2%). In the primary indicators, cancer literacy were highest in treatment (75.8, 95% CI: 74.2-77.4%) and early detection (68.2, 95% CI: 66.8-69.6%), followed by basic knowledge (67.2, 95% CI: 65.8-68.6%), recovery (62.6, 95% CI: 60.7-64.5%) and prevention (59.7, 95% CI: 58.2-61.3%). Regarding secondary indicators, the awareness rates regarding cancer-related risk factors (54.7, 95% CI: 52.8-56.5%) and early diagnosis of cancer (54.6, 95% CI: 52.7-56.6%) were notably inadequate. Rural participates exhibited lower cancer literacy across all dimensions compared to urban. Multi-factor analysis showed that factors such as advanced age, limited education or low household income were barriers to health literacy in rural areas. Conclusion: Strengthening awareness concerning prevention and early detection, particularly among key populations, and bridging the urban-rural cancer literacy gap are imperative steps toward achieving the Healthy China 2030 target.

Associations between GoSmart Channel, health literacy and health behaviours in adolescents: A population-based study.

BACKGROUND: Health literacy is essential in the promotion of healthy lifestyle habits and chronic disease prevention. OBJECTIVE: To assess the health literacy level among Hong Kong adolescents; to evaluate the association between access of an online health information platform (GoSmart Channel) and health literacy level; and to examine the association between health literacy level and various unhealthy behaviours. DESIGN: This study recruited students from 10 local secondary schools in Hong Kong to assess the health literacy level among adolescents. SETTINGS AND PARTICIPANTS: Participants were required to complete a self-administered questionnaire on health behaviours and health literacy using the Health Literacy Measure for Adolescents (HELMA). MAIN OUTCOME MEASURE: Data were analysed using descriptive statistics and multivariate regression modelling. RESULTS: A total of 777 responses were collected. Overall, most (74.4%) of the adolescents in Hong Kong have limited health literacy (HELMA score <66). The majority (63.7%) of adolescents relied on their parents for health information, while 11.4% of the respondents sought information from the GoSmart Channel. The intervention of GoSmart Channel was significantly associated with better health literacy in almost all aspects among adolescents. Desired levels of health literacy were significantly associated with better perceived health (adjusted odds ratio: 2.04, p = .001) and negatively associated with a range of unhealthy and risky behaviours including unhealthy dietary habits, poor hygienic measures and physical inactivity. DISCUSSION AND CONCLUSION: This study highlights the importance of improving health literacy among Hong Kong adolescents and the potential of technology-based interventions. The findings suggest the need for continued efforts to promote health literacy and healthy behaviours among adolescents, especially given the limited health literacy levels observed in the study. PATIENT OR PUBLIC CONTRIBUTION: Members of the GoSmart.Net Built-on Project patient and public involvement and engagement group advised about survey development.

High nutrition literacy linked with low frequency of take-out food consumption in chinese college students.

BACKGROUND: The excessive consumption of take-out food has increased the risk of nutrition-related chronic diseases. Nutrition literacy (NL) is an important influencing factor of food choice. This study aimed to explore the relationship between nutrition literacy and take-out food consumption. METHODS: A cross-sectional study was conducted on 2130 college students in Bengbu, China. A self-reported questionnaire that included demographic information, lifestyle behavior, take-out food consumption, and nutrition literacy scale was used. Ordinal logistic regression models were used to analyze the association between nutrition literacy and take-out food consumption. RESULTS: Of the students surveyed, 61.5% consumed take-out food at least once a week. NL was significantly associated with the frequency of take-out food consumption ≥ 4 times/week (OR = 0.995, 95% CI = 0.990-1.000); the difference specifically was discovered for applying skills, interactive skills, and critical skills. Moreover, students with high level NL ate less (Spicy) hot pot (OR = 0.996, 95% CI = 0.992-1.000), but more vegetable and fruit salad (OR = 1.009, 95% CI = 1.002-1.015). CONCLUSIONS: NL, especially in applying skills, interactive skills, and critical skills, is not only associated with consumption frequency of take-out food among college students, but also links with types of take-out food consumption. Our findings emphasize that targeted interventions on nutritional skills literacy should be needed to improve dietary behaviors for student's good health.

Knowledge of bidirectional relationship between diabetes and periodontal disease among diabetes patients: A systematic review.

INTRODUCTION: The bidirectional relationship between diabetes mellitus and periodontal disease has been reported in the literature, suggesting that poor glycemic control is strongly associated with increased risk of developing periodontal disease. Therefore, this systematic review evaluated the level of knowledge of this bidirectional relationship among patients with diabetes. METHODS: This systematic review (protocol CRD42018117902) was conducted according to PRISMA guidelines. The following databases were considered: Medline/PubMed, Scopus, and Web of Science. Search strategy (April 05th , 2021) considered proper combination of keywords and eligibility criteria. The quality of studies was evaluated using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS: Among the 328 records identified in the initial search, 24 studies were selected, considering a total of 8,693 patients. All studies used a cross-sectional design. Among the included studies, only five showed prevalence of knowledge higher than 50%, ranging from 5.8% to 75.9%. Interestingly, 58.0% of patients reported that they brush their teeth at least 1x/day, but only four studies reported that the dentist was the main source of information. In terms of methodology and result quality, just one study clearly showed all information evaluated by the AXIS tool. Most of studies did not report sample size calculations and did not used validated questionnaires to assess patient knowledge. CONCLUSION: The results show that less than half of people with diabetes have knowledge about their increased risk for periodontal disease, and often the dentist is not the main source of information to motivate them.

Sickle cell disease and social determinants of health: A scoping review.

Social determinants of health (SDoH) may impact outcomes in sickle cell disease (SCD). We conducted a comprehensive literature review of five electronic databases to elucidate the relationship between SDoH and SCD, and identify gaps in the literature. Our search yielded 59 articles, which we organized into five SDoH areas: Neighborhood and Built Environment, Health and Healthcare, Social and Community Context, Education, and Economic Stability. We found that social determinants, such as access to healthcare, were inconsistently evaluated. Improved recognition and understanding of SDoH should enhance the development of programs that directly address its detrimental effects on patients with SCD.

Revisit the Effects of Health Literacy on Health Behaviors in the Context of COVID-19: The Mediation Pathways Based on the Health Belief Model.

Background: Emerging research has identified health literacy as an important resource for individual health care and disease prevention. In the context of COVID-19, People with limited HL are less likely to follow preventive measures such as wearing masks, social isolation, or taking the vaccination. However, the pathways of how health literacy affects decision-making have remained unclear. Methods: With a cross-sectional study, a total of 613 responses (mean age is 25.64 ± 6.46 years) were collected. The relationship between health literacy and health behaviors under COVID-19 was examined, and the potential mediation pathways were assessed based on the health belief model. Results: With linear regression, it was found that health literacy has a direct effect on health behaviors and three constructs in the health belief model, i.e., perceived susceptibility, perceived severity, perceived barriers, as well as an indirect effect on health behaviors via increasing perceived barriers related with COVID-19 preventive measures. The results showed that health literacy only goes through the pathway of perceived barriers to influence health behaviors, and the indirect effects via other pathways were not significant. Conclusions: The research addressed the mediation model underlying the effects of health literacy on health behaviors and identified a partial mediation role of perceived barriers. Health literacy could promote individual health behavior by reducing the perceived barriers to forming a healthy lifestyle and making health decisions. Future health promotion interventions increasing people's health literacy should be advocated to promote health initiatives in the whole population.

Guidance on Providing Patient-Centered Care.

This article explores the clinical applications of Audiology Practice Standards Organization (APSO) Standards 2 and 13, both of which keep us fully focused on the patient-as-person. The topics within Standard 2 include audiologists' interpersonal communication skills, specifically clarity (ensuring patient comprehension) and empathy (understanding the patient's experiences). Standard 2 also addresses the topic of health literacy, which has been recently expanded to consider not only the degree to which individuals are able to find, understand, and use information and services to inform health-related decisions but also how organizations equitably support those necessary skills. The characteristics and benefits of services provided in patient- and family-centered care contexts are also described. Standard 13 addresses audiologists' support toward overall successful adjustment as defined by the patient, including both technical and personal adjustment to amplification, nontechnical communication issues, and rehabilitation support using readily available technologies. A new assessment protocol that includes goal setting and intervention is described, as well as a patient-centered intervention strategy involving discussion of personally meaningful photographs. Both standards provide a necessary balance to our technology-reliant profession.

Will the Effect of New Federal Breast Density Legislation Be Diminished by Currently Available Online Patient Educational Materials?

RATIONALE AND OBJECTIVES: To evaluate readability of commonly accessed online patient educational materials (OPEM) on breast density in setting of recently passed federal breast density legislation. MATERIALS AND METHODS: The term "breast density" was queried using an online search engine to identify the top 50 commonly accessed websites based on order of search results on December 15, 2018. Location, cookies, and user account information were disabled prior to our query. Only websites with OPEM, defined as any educational material on breast density targeted towards the general public, were evaluated in our study. Sponsored hits and research journal articles were excluded. Available patient-directed information from websites meeting inclusion criteria was then downloaded. Grade-level readability was then determined from formatted content using generalized estimating equations, with observations nested within readability metrics from each website. Results were compared to American Medical Association recommended readability parameters (sixth-grade reading level). All interval estimates were calculated for 95% confidence. RESULTS: Fouty-one websites met inclusion criteria representing patient-directed OPEM on breast density. Average grade-level readability of health information on breast density in our study ranged from 8.5-16.5 years with an average grade reading level of 11.1 years across all websites. Of websites fitting into a specific category, academic websites had the highest average grade reading level (12.0), while nonprofit websites had the lowest average grade reading level (10.4). Nearly half (19/41) of all websites in our study had diagrams to aid in patient comprehension, while few websites (2/41; 4.8%) displayed videos in addition to written content. The website with the lowest average grade reading level was WebMD, which had an average reading level of 8.5. No individual website in our study met American Medical Association recommended parameters of a sixth-grade reading level CONCLUSION: Readability of currently available OPEM on breast density may be written at a level too difficult for the general public to comprehend, which may represent a barrier to educational goals of newly passed federal breast density legislation.

Healthy lifestyle and behavior literacy of residents living in Xicheng District of Beijing in 2008 vs.2012 / 中华健康管理学杂志

Objective To learn healthy lifestyle and behavior literacy of residents living in Xicheng District of Beijing between 2008 and 2012 and to explore the influencing factors of healthy lifestyle and behavior literacy.Methods A total of 1 347 or 2 900 adults aged 18-60 years old were recurited from Xicheng District by using multistage stratified cluster sampling method in 2008 and 2012,respectively.Chisquare test and non-conditional logistic regression were used to analyze the effectiveness of 2-year intervention on healthy lifestyle and behavior literacy.Results The rate of healthy lifestyle and behavior literacy was 14.8％ vs.30.8％ in 2008 or 2012,respectively (x2=123.574,P＜0.05).For those with relatively lower education level (e.g.junior high school or below),the figure showed no statistically significant difference (x2=1.378,P＞0.05).In multivariate logistic regression analysis,female (odds ratio (OR)=1.350),education level (college/bachelor degree:OR=2.035,master degree or above:OR=2.554),monthly family income (＞5 000 RMB:OR=1.399) and investigation time (2012:OR=2.278) were influencing factors of healthy lifestyle and behavior literacy.Conclusion Remarkable improvement in healthy lifestyle and behavior literacy during 2012 as compared to 2008 could be attributed to the comprehensive interventions.In the future,those of low-literacy or low-income should be the mian target of modification of healthy lifestyle and behavior literacy.