Health Literacy and the Influencing Factors: A Study in Five Provinces of Iran

Tehrani Banihashemi, Seyed-Arash; Haghdoost, Ali Akbar; Amirkhani, Mohammed Amir; Haghdoost, Ali Akbar; Alavian, Seyed-Moayed; Asgharifard, Homa; Baradaran, Hamid; Barghamdi, Mozhgan; Parsinia, Saeid; Fathi Ranjbar, Sahar

Health Literacy and the Influencing Factors: A Study in Five Provinces of Iran

Document Type : Original Article

Authors

Seyed-Arash Tehrani Banihashemi ¹

Ali Akbar Haghdoost ²

Mohammed Amir Amirkhani ³

Ali Akbar Haghdoost

Seyed-Moayed Alavian ⁴

Homa Asgharifard ¹

Hamid Baradaran ⁵

Mozhgan Barghamdi ¹

Saeid Parsinia ⁶

Sahar Fathi Ranjbar ¹

¹ Frontier-less Researchers Institute, Tehran, Iran

² Head of Family Health & Population bureau, Ministry of Health and Medical Education, Tehran, Iran

³ Assistant Professor of Epidemiology and Biostatistics, Community Medicine Dept., Medical School, Physiology Research Center, kerman University of Medical Science, Kerman, Iran

⁴ Professor of Gastroenterology and Hepatology, Vice-Chancellor for Health, Ministry of Health and Medical Education, Tehran, Iran

⁵ Education Development Center, Iran University of Medical Sciences, Tehran, Iran

⁶ Health education & Communication, Dept. Ministry of Health and Medical Education, Tehran, Iran

Abstract

Background & Objective: Health literacy is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions The aim of this study was to estimate the level of health literacy and to determine the factors influencing it using valid instrument Methods: In a Populationbased household survey in 5 cities and 5 villages of Boushehr Mazandaran Kermanshah Ghazvin and Tehran provinces 1086 adults aged 18 and older were enrolled into the study Health literacy was measured by the questionnaire designed for test of Functional Health Literacy in Adults (TOFHLA) after validation Regression analysis was used to determine the association of demographic factors and level of health literacy Results: The average response rate was 708% in the studied clusters From all participants 614% were female and the rest were male Mean age of participants was 381 years Seventeen percent of the study population was illiterate and 36% had diploma or higher education The level of health literacy was adequate in 281% borderline in 15 3% and inadequate in 565% of the subjects Mean score of health literacy was 453 in males and 411 in females (P=0057) However after adjustment for educational level in the regression model health literacy was found to be higher in females (P=014) Limited health literacy was also associated with lower economic status (P=0004) Conclusion: This study indicates that the level of health literacy is low in Iran Educational level was the most important determinant of health literacy and the most increase was seen in subjects with more than 8 years education Lower health literacy in women older people and rural inhabitants was mainly due to lower educational levels in these groups

Keywords

Health literacy

Survey

influencing factors

Ratzan SC, Parker RM. Introduction. In: National Library of Medicine Current Bibliographies in Medicine: Health Literacy. Selden CR, Zorn M, Ratzan SC, Parker RM, Editors. NLM Pub. No. CBM 2000-1. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services. Available from: URL: http://www.nlm.nih.gov/archive//20061214/pubs/cbm/hliteracy.html.Joint
Sihota S, Lennard L. Health literacy: being able to make the most of health. London: National Consumer Council; 2004: 11 Available from:http://www.ncc.org.uk/nccpdf/poldocs/NCC064_health_literacy.pdf
Joint Committee on National Health Education Standards. National Health Education Standards: Achieving Health Literacy. Atlanta, GA: American Cancer Society; 1995.
Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of Limited health literacy. J Gen Intern Med 2005; 20(2):175–84.
Williams MV, Parker RM, Baker DW, Parikh NS, Pitkin K, Coates WC, Nurss JR. Inadequate functional health literacy among patients at two public hospitals. JAMA 1995; 274(21):1677–82.
von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. JECH 2007; 61(12):1086-90.
Parker R. Health literacy: a challenge for American patients and their health care providers. Health promotion International 2000; 15(4): 277-83.
National Work Group on Literacy and Health. Communicating with patients who have limited literacy skills. Report of the National Work Group on Literacy and Health. J of Fam Pract 1998, 46(2): 168-76.
Rosenthal MS, Werner MJ, Dubin NH. The effect of a literacy training program on family medicine residents. Fam Med 2004; 36(8):582-7.