The European Health Literacy Survey - Iuhpe ...
The European Health Literacy Survey - Iuhpe ...
The European Health Literacy Survey - Iuhpe ...
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<strong>The</strong> <strong>European</strong> <strong>Health</strong> <strong>Literacy</strong> <strong>Survey</strong> –<br />
from measurement to policy<br />
Kristine Sorensen; Stephan van den Broucke; Jürgen Pelikan<br />
on behalf of the HLS-EU consortium
Rationale for the HLS-EU project<br />
• <strong>The</strong> increasing recognition of health literacy as a<br />
public health goal.<br />
• <strong>The</strong> need of re-orientating health systems to be<br />
more health literacy friendly.<br />
• <strong>The</strong> need to expand the "traditional", medical<br />
oriented conceptualization of health literacy towards<br />
a broader, health promotion oriented concept.<br />
• <strong>The</strong> lack of appropriate measurement tools to<br />
capture this broader conceptualization.<br />
• Low literacy contributes to inequalities and health<br />
literacy to health inequalities<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
Aim and objectives of the HLS-EU Project<br />
• To contribute to further developing the<br />
concept of health literacy<br />
• To measure health literacy in Europe<br />
• To discuss social and political significances of<br />
health literacy<br />
• To influence policies on health literacy issues<br />
through national advisory bodies<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
<strong>The</strong> HLS-EU consortium<br />
Austria<br />
Bulgaria<br />
Germany<br />
Greece<br />
Ireland<br />
Netherlands<br />
Poland<br />
Spain<br />
HLS●EU<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
Milestones in the HLS-EU survey<br />
• Literature review<br />
• Conceptual model<br />
• Questionnaire development (HLS-EU-Q)<br />
• Pilot<br />
– Focus groups (Ireland, Greece and the Netherlands)<br />
– Face to face interviews (Ireland and the Netherlands in<br />
progress)<br />
• <strong>Survey</strong> in eight countries (September 2010)<br />
• Results and report (Primo 2011)<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
Faculty of <strong>Health</strong>, Medicine and Life Sciences
<strong>The</strong> HLS-EU ‘all inclusive’ working definition<br />
<strong>Health</strong> literacy entails people’s<br />
capacities, skills, knowledge,<br />
motivation and confidence to access,<br />
understand, appraise and apply health<br />
information to form judgments and<br />
take decisions in everyday life in terms<br />
of healthcare, disease prevention and<br />
health promotion to improve quality of<br />
life during the life course.<br />
Sørensen et al. 2010<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
HLS-EU Conceptual model<br />
Life course<br />
Psycosocial, physical and material factors<br />
Resources,<br />
opportunities<br />
& structures<br />
Literacies<br />
Access<br />
<strong>Health</strong><br />
information<br />
Knowledge<br />
, skills,<br />
motivation<br />
&<br />
confidence<br />
Apply<br />
Understand<br />
Appraise<br />
Cure and<br />
care<br />
Disease<br />
prevention<br />
<strong>Health</strong><br />
promotion<br />
<strong>Health</strong><br />
service<br />
use<br />
<strong>Health</strong><br />
behavior<br />
Participa<br />
-tion<br />
Equity<br />
<strong>Health</strong><br />
costs<br />
<strong>Health</strong><br />
outcome<br />
s<br />
Empowe<br />
rment<br />
Sustainability<br />
Individual level<br />
Population level<br />
Sorensen et al. 2010 – submitted to BMC Public <strong>Health</strong><br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
<strong>Health</strong><br />
literacy<br />
matrix<br />
Access/<br />
obtain<br />
Understand Appraise Apply<br />
Cure &<br />
Care<br />
How easily do you<br />
find information<br />
on the following<br />
medical issues?...<br />
Cancers, resp.<br />
diseases etc.<br />
How easily do you<br />
understand the<br />
content of the<br />
leaflets that come<br />
with medications?<br />
Do you consider<br />
advantages and<br />
disadvantages of<br />
treatment options?<br />
How often do you<br />
follow your<br />
doctor's advice?<br />
Disease<br />
prevention<br />
How easily do<br />
you find<br />
information on<br />
the following risk<br />
factors?… tobacco,<br />
alcohol etc.<br />
<strong>Health</strong><br />
promotion<br />
How easily do you<br />
find information<br />
on the following<br />
health enhancing<br />
factors?... Nutrition<br />
and diet, exercise<br />
etc.<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
Questionnaire development with a concept<br />
validating approach<br />
• Matrix with health literacy dimensions<br />
• Delphi rounds among consortium<br />
members for item selection<br />
• Focus groups<br />
• Expert views<br />
• Pilot interviews<br />
• Pilot data analysis<br />
• Final selection of items<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
Pilot Questionnaire<br />
85 items (to be reduced through item<br />
analysis)<br />
– Perceived health literacy (Likert scales)<br />
– Skills (Test)<br />
Chapters<br />
• <strong>Health</strong> literacy<br />
• <strong>Literacy</strong><br />
• <strong>Health</strong> outcomes (health status, service use, life<br />
style, empowerment)<br />
• Personal information<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
HLS-EU: From evidence to policy<br />
• National levels<br />
– National surveys<br />
– <strong>Health</strong> literacy advisory bodies<br />
Ireland established<br />
Others will follow<br />
• <strong>European</strong> level<br />
– <strong>European</strong> Parliament session: June 2010<br />
– <strong>European</strong> <strong>Health</strong> Forum Gastein: October 2010<br />
– <strong>European</strong> <strong>Health</strong> <strong>Literacy</strong> Network:Launch autumn<br />
2010<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
<strong>Health</strong> literacy – closing the gap of inequality<br />
• Recognize health literacy as an asset<br />
• Put health literacy on the policy agenda<br />
• Fund necessary research, activities and<br />
evaluations<br />
• Advocate for system change, when needed<br />
• Enhance communication skills<br />
• Use new approaches and technologies<br />
• Pay attention to different needs under<br />
different circumstances<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
Thank you for your attention<br />
HLS●EU<br />
K.Sorensen@inthealth.unimaas.nl<br />
Faculty of <strong>Health</strong>, Medicine and Life Sciences
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