Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS19-Q12 Instrument in Seventeen Countries.

BACKGROUND: For improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS19-Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region. METHODS: For factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out. RESULTS: The Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS19-Q12 score with social determinants and selected consequences of HL. The HLS19-Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS19-Q47 long form. CONCLUSIONS: The HLS19-Q12, based on a comprehensive understanding of HL, shows acceptable psychometric and validity characteristics for different languages, country contexts, and methods of data collection, and is suitable for measuring HL in general, national, adult populations. There are also indications for further improvement of the instrument.

Adaptation of the Health Literacy Survey Questionnaire (HLS19-Q) for Russian-Speaking Populations-International Collaboration across Germany, Israel, Kazakhstan, Russia, and the USA.

The Russian language is the eighth most spoken language in the world. Russian speakers reside in Russia, across the former Soviet Union republics, and comprise one of the largest populations of international migrants. However, little is known about their health literacy (HL) and there is limited research on HL instruments in the Russian language. The purpose of this study was to adapt the Health Literacy Questionnaire (HLS19-Q) developed within the Health Literacy Survey 2019-2021 (HLS19) to the Russian language to study HL in Russian-speaking populations in Germany, Israel, Kazakhstan, Russia, and the USA. The HLS19-Q was translated either from English or from a national language to Russian in four countries first and then critically reviewed by three Russian-speaking experts for consensus. The HLS19 protocol and "team approach" method were used for linguistic and cultural adaptation. The most challenging was the adaptation of HLS19-Q questions to each country's healthcare system while general HL questions were flexible and adaptable to specific contexts across all countries. This study provides recommendations for the linguistic and cultural adaptation of HLS19-Q into different languages and can serve as an example of international collaboration towards this end.

International Perspective on Health Literacy and Health Equity: Factors That Influence the Former Soviet Union Immigrants.

Among the world's 272 million international migrants, more than 25 million are from the former Soviet Union (FSU), yet there is a paucity of literature available about FSU immigrants' health literacy. Besides linguistic and cultural differences, FSU immigrants often come from a distinct healthcare system affecting their ability to find, evaluate, process, and use health information in the host countries. In this scoping review and commentary, we describe the health literacy issues of FSU immigrants and provide an overview of FSU immigrants' health literacy based on the integrated health literacy model. We purposefully consider the three most common locations where FSU immigrants have settled: the USA, Germany, and Israel. For context, we describe the healthcare systems of the three host countries and the two post-Soviet countries to illustrate the contribution of system-level factors on FSU immigrants' health literacy. We identify research gaps and set a future research agenda to help understand FSU immigrants' health literacy across countries. Amidst the ongoing global population changes related to international migration, this article contributes to a broad-scope understanding of health literacy among FSU immigrants related to the system-level factors that may also apply to other immigrants, migrants, and refugees.

Welche Erkenntnisse gibt es zu den Methoden, Rahmen und Indikatoren für die Evaluation von Handlungskonzepten, Programmen und Interventionen zur Gesundheitskompetenz auf Landes-, Regions- und Organisationsebene?

Auch wenn Gesundheitskompetenz in der Europäischen Region der WHO schon seit Langem Beachtung findet, so ergab doch eine Erhebung aus dem Jahr 2011, dass mehr als 47% der erwachsenen Bevölkerung in den acht teilnehmenden Mitgliedstaaten über eine suboptimale persönliche Gesundheitskompetenz verfügen. Zu den Initiativen zur Priorisierung der Gesundheitskompetenz im öffentlichen Gesundheitswesen zählen die Erklärung der WHO von Shanghai, das Aktionsnetzwerk der WHO zur Messung der Gesundheitskompetenz von Bevölkerung und Organisationen und der Bericht des Health Evidence Network zu Handlungskonzepten für Gesundheitskompetenz in der Europäischen Region der WHO. Der vorliegende Bericht enthält Evidenz über die Methoden, Rahmenkonzepte, Messinstrumente, Bereiche und Indikatoren, die auf allen Ebenen zur Evaluation von Handlungskonzepten, Programmen und Interventionen für Gesundheitskompetenz angewandt werden. Zwar gibt es nur begrenzte Erkenntnisse zur Evaluation nationaler Handlungskonzepte und Programme, jedoch wurden kommunale Programme und Interventionen unter Anwendung quantitativer, qualitativer und methodisch gemischter Ansätze analysiert. Grundsätzliche Überlegungen betreffen unter anderem die Entwicklung von Rahmenkonzepten und Indikatoren für eine Vielzahl von Bereichen, die eine in sich stimmige und vergleichbare Überwachung und Evaluation auf Ebene der Bevölkerung ermöglichen und so Rückschlüsse auf die Wirkung und Effektivität nationaler Handlungskonzepte und Programme zulassen.

Que sait-on des méthodes, des cadres et des indicateurs utilisés pour évaluer les politiques, les programmes et les interventions en matière de littératie en santé aux niveaux régional, national et organisationnel ?

Bien que la Région européenne de l’OMS accorde de longue date son attention à la littératie en santé, une étude réalisée en 2011 dans huit États membres a montré que chez plus de 47 % de la population adulte, le niveau de littératie en santé n’était pas optimal. Les initiatives qui visent à accorder la priorité à la littératie en santé dans les politiques publiques comprennent la Déclaration de Shanghai de l’OMS, Santé 2020, le cadre politique européen qui soutient les interventions pangouvernementales et pansociétales pour la santé et le bien-être, et le rapport de synthèse du Réseau des bases factuelles en santé sur les politiques de littératie en santé dans la Région européenne de l’OMS. Le présent rapport répertorie les informations factuelles portant sur les méthodes, les cadres, les instruments de mesure, les domaines et les indicateurs utilisés pour évaluer les politiques, les programmes et les interventions en matière de littératie en santé à tous les niveaux. Les bases factuelles recueillies sur l’évaluation des politiques et des programmes nationaux ont été limitées, mais des programmes et des interventions locales ont été mesurés à l’aide de méthodes quantitatives, qualitatives et mixtes. Parmi les options politiques figurent la mise au point de cadres et d’indicateurs couvrant un ensemble de domaines susceptibles de permettre un suivi de la population et des évaluations cohérentes et comparables sur les effets et l’efficacité des politiques et des programmes nationaux.

Обзор имеющихся фактических данных о методах, механизмах и показателях, используемых для оценки стратегий, программ и мероприятий в сфере развития грамотности в вопросах здоровья на региональном, национальном и организационном уровнях

Хотя в Европейском регионе ВОЗ грамотности в вопросах здоровья давно уделяется большое внимание, данные проведенного в 2011 г. опросного исследования, в котором участвовали восемь государств-членов, показали, что более 47% взрослого населения этих стран обладают недостаточным уровнем личной грамотности в вопросах здоровья. К числу ключевых инициатив ВОЗ, призванных сделать развитие грамотности в вопросах здоровья приоритетным направлением государственной политики, относятся Шанхайская декларация ВОЗ, Сеть действий по оценке грамотности в вопросах здоровья среди населения и на уровне организаций, а также доклад Сети фактических данных по вопросам здоровья, посвященный мерам политики в области развития грамотности в вопросах здоровья в Европейском регионе ВОЗ. В настоящем обзоре приводятся данные о методах, рамочных механизмах, инструментах оценки, сферах и показателях, используемых для оценки эффективности стратегий, программ и мероприятий по развитию грамотности в вопросах здоровья на всех уровнях. Авторы доклада обнаружили, что объем данных об оценке национальных стратегий и программ весьма ограничен, однако при этом они установили, что в ходе оценки местных программ и мероприятий использовались количественные, качественные и смешанные методы. К числу предлагаемых к рассмотрению мер политики относится разработка рамочных механизмов и показателей, охватывающих целый ряд областей. Такие механизмы и показатели позволяют проводить последовательный мониторинг и оценку ситуации среди населения с использованием сопоставимых данных, чтобы определить уровень воздействия на ситуацию национальных стратегий и программ и оценить их эффективность.

What is the evidence on the methods, frameworks and indicators used to evaluate health literacy policies, programmes and interventions at the regional, national and organizational levels?

Although health literacy has long been a focus of attention in the WHO European Region, survey evidence in 2011 of eight Member States indicated that more than 47% of the adult population had suboptimal personal health literacy. Initiatives to prioritize health literacy in public policies include the WHO Shanghai Declaration, Health 2020, the European policy framework that supports action across government and society for health and well-being, and the Health Evidence Network report on health literacy policies in the WHO European Region. This review identifies evidence on the methods, frameworks, measurement instruments, domains and indicators used to evaluate health literacy policies, programmes and interventions at all levels. Limited evidence was found on evaluation of national policies and programmes, but local programmes and interventions have been measured using quantitative, qualitative and mixed-methods approaches. Policy considerations include the development of frameworks and indicators covering a range of domains to enable consistent and comparable population monitoring and evaluations to determine the impact and effectiveness of national policies and programmes.

What is the evidence on the methods, frameworks and indicators used to evaluate health literacy policies, programmes and interventions at the regional, national and organizational levels?

The Health Evidence Network (HEN) is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional Office for Europe under the umbrella of the European Health Information Initiative (a multipartner network coordinating all health information activities in the WHO European Region). HEN supports public health decision-makers to use the best available evidence in their own decision-making and aims to ensure links between evidence, health policies and improvements in public health. The HEN synthesis report series provides summaries of what is known about the policy issue, the gaps in the evidence and the areas of debate. Based on the synthesized evidence, HEN proposes policy options, not recommendations, for further consideration of policy-makers to formulate their own recommendations and policies within their national context.