Health literacy among university students in Greece: determinants and association with self-perceived health, health behaviours and health risks

Archives of Public Health

Athanassios Vozikis¹  Kyriakos Drivas¹  Kostantinos Milioris¹ 

[1] Economics Department, University of Piraeus, 80, Karaoli & Dimitriou str, 18534 Piraeus, Greece

关键词: University student;    Greece;    Health risks;    Health behaviour;    Health literacy;   

Others  :  790463
DOI  :  10.1186/2049-3258-72-15

 received in 2013-10-10, accepted in 2014-02-21,  发布年份 2014

【 摘 要 】

Background

Health literacy is widely considered as a key determinant of health and a priority in the public health policy agenda. Low health literacy has been associated with poorer health states, broader inequalities and higher health systems’ costs. In the present study we bring into focus the functional health literacy among university students in Greece, researching and assessing mainly their ability to apply basic knowledge in a health context.

Methods

The study was carried out during the period 15–30 April 2013, among a random sample of 1,526 students of 14 Higher Tertiary Public universities and Technological Educational Institutes in Greece. The objective of the study was to assess the functional health literacy among university students in Greece, adopting the short four-item comprehension test of Bostock and Steptoe. Summary statistics, correlations and regressions were used to assess the determinants of health literacy and the association with self-perceived health, health behaviours and health risks.

Results

Economic factors, such as family income, demographic factors, such as gender, and health behaviours and risks, namely consumption of alcohol, smoking and physical workout are associated with the level of health literacy and health status of the participant. While the results of the study are consistent with previous work in this area, several findings worth further research.

Conclusions

Though, health promotion interventions in Greece include health literacy as one of the basic pillars of the public health policy agenda, it is clear, that health literacy needs to become a key policy issue in Greece, mainly focusing in young ages, where healthy (or unhealthy) behaviours are established affecting the health through the life span.

【 授权许可】

   
2014 Vozikis et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Coulter A, Parsons S, Askham J: Where are the patients in decision-making about their own care? Policy Paper. Copenhagen: World Health Organization, on behalf of the European Observatory on Health Systems and Policies 2008; 2008.
• [2]Ratzan SC, Parker R: National Library of Medicine current bibliographies in medicine: health literacy (introduction). Maryland, US: National Institutes of Health; 2000.
• [3]Nielsen-Bohlman L, Panzer AM, Kindig DA (Eds): Health literacy: a prescription to end confusion. Washington, DC: National Academies Press; 2004.
• [4]HLS-EU Consortium: Comparative report on health literacy in eight EU member states. The European Health Literacy Project 2009–2012. Maastricht; 2012. http://www.health-literacy.eu webcite, accessed 1 September 2013
• [5]World Health Organization: Health literacy and health behaviour. 2011. http://www.who.int/healthpromotion/conferences/7gchp/track2/en/ webcite, accessed 2 February 2013
• [6]World Health Organization Regional Office for Europe: Health literacy: The solid facts. Edited by Ilona K, Pelikan JM, Franklin A, Tsouros AD. Copenhagen: WHO Regional Office for Europe; 2013.
• [7]Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H: Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 2012, 12:80. BioMed Central Full Text
• [8]Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G: Priority actions for the non-communicable disease crisis. Lancet 2011, 377(9775):1438-1447.
• [9]Department of Health: Healthy lives, healthy people: our strategy for public health in England. London: DoH; 2010.
• [10]Eichler K, Wieser S, Brugger U: The costs of limited health literacy: a systematic review. Int J Public Health 2009, 54:313-324.
• [11]Weiss BD: Health literacy and patient safety: help patients understand. Manual for clinicians. 2nd edition. Chicago: American Medical Association Foundation and American Medical Association; 2007. http://www.ama-assn.org/ama1/pub/upload/mm/367/healthlitclinicians.pdf webcite, accessed 1 September 2013
• [12]Berkman ND: Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 2011, 155:97-107.
• [13]Marmot M, Allen J, Goldblatt P, Boyce T, McNeish D, Grady M, Geddes I: Fair society, healthy lives. London: Marmot Review; 2008. http://www.hospitaldr.co.uk/features/marmot-review-reducing-health-inequalities-in-england webcite, accessed 1 September 2013
• [14]Levin-Zamir D, Wills J: Health literacy, culture and community. In Health literacy in context: international perspectives. Edited by Begoray D, Gillis DE, Rowlands G. Hauppauge: NY, Nova Science Publishers; 2012:99-123.
• [15]Nutbeam D: The evolving concept of health literacy. Soc Sci Med 2008, 67:2072-2078.
• [16]Nutbeam D: Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st Century. Health Promot Int 2000, 15(3):9-17.
• [17]Zaza S, Briss P, Harris K: The Guide to Community Preventive Services: What Works to Promote Health?. New York: Oxford University Press; 2005.
• [18]Feinstein L: Inequality in the early cognitive development of British children in the 1970 cohort. Economica 2003, 70:73-97.
• [19]Leger St L: Schools, health literacy and public health: possibilities and challenges. Health Promot Int 2000, 15(4):46-54.
• [20]Robert SA, Booske BC, Rigby E, Rohan AM: Public views on determinants of health, interventions to improve health, and priorities for government. Wis Med J 2008, 107(3):124-130.
• [21]Kickbusch I: Health literacy: Skilling students for better health. In Children, Youth and Women’s Health Service, Volume 41. Government of South Australia: Virtually Health newsletter; 2006:2-3.
• [22]Hernandez L: Measures of Health Literacy: Workshop Summary Roundtable on Health Literacy. Institute of Medicine; 2009. http://www.nap.edu/catalog/12690.html webcite, accessed 1 September 2013)
• [23]Baker DW: The meaning and the measure of health literacy. J Gen Intern Med 2006, 21:878-883.
• [24]Jordan J, Osborne R, Buchbinder R: A critical appraisal of the content and psychometric properties of 19 health literacy indices. J Clin Epidemiol 2011, 64(4):366-379.
• [25]Bostock S, Steptoe A: Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ 2012, 344:e1602.
• [26]Organisation for Economic Cooperation and Development and Statistics Canada: Literacy in the information age: final report of the International Adult Literacy Survey. Canada: OECD and Statistics; 2000.
• [27]Statistics Canada and Organisation for Economic Cooperation and Development: Learning a living: first results of the adult literacy and life skills survey. Canada: Statistics Canada and Organisation for Economic Cooperation and Development; 2005.
• [28]Kirsch I: The International Adult Literacy Survey: understanding what was measured. Princeton: Educational Testing Service; 2001.
• [29]HLS-EU Consortium: The European Health Literacy Project 2009–2012. Maastricht: The European Health Literacy Survey–Greece; 2012. http://www.health-literacy.eu webcite, accessed 1 September 2013
• [30]Harper R: Comprehensive health literacy assessment for college students. Colorado State University: Ph.D. Dissertation Thesis, Department of Journalism and Technical Communication; 2013.
• [31]Ross PT, Lukela MP, Agbakwuru U, Lypson ML: Medical students’ recognition of health literacy in a single embedded curricular activity. Int J Med Educ 2013, 4:115-119.
• [32]Martin TL, Ruder T, Escarce JJ, Ghosh-Dastidar B, Sherman D, Elliott M, Bird CE, Fremont A, Gasper C, Culbert A, Lurie N: Developing Predictive Models of Health Literacy. J Gen Intern Med 2009, 24(11):1211-1216.
• [33]Berkman N, Sheridan S, Donahue K, Halpern D, Viera A, Crotty K, Holland A, Brasure M, Lohr K, Harden E, Tant E, Wallace I, Viswanathan M: Health Literacy Interventions and Outcomes: An Updated Systematic Review. Rockville, MD: Agency for Healthcare Research and Quality. Evidence Report/Technology Assesment No. 199. (Prepared by RTI International–University of North Carolina Evidence-based Practice Center under contract No. 290-2007-10056-I. AHRQ Publication Number 11-E006); 2011.
• [34]Vardavas C, Kondilis B, Patelarou E, Akrivos P, Falagas M: Health Literacy and sources of health education among adolescents in Greece. Int J Adolesc Med Health 2009, 21(2):179-186.
• [35]John RB, Ronald MR: Adolescent mental health literacy: young people’s knowledge of depression and help seeking. J Adolesc 2006, 29:225-239.
• [36]Marks R: Health Literacy and School-based Education. Bingley, UK: Emerald Books; 2012.
• [37]Potter L, Martin C: Health Literacy Fact Sheets. Hamilton, NJ: Center for Health Care Strategies; 2005.
• [38]Chan K, Prendergast G, Gronhoj A, Bech-Larsen T: Adolescents’ perceptions of healthy eating and communication about healthy eating. Health Educ 2009, 109(6):474-490.
• [39]Leger St L: Schools, health literacy and public health: possibilities and challenges. Health Promot Int 2001, 16(2):197-205.
• [40]Davis TC, Wolf MS, Bass PF, Middlebrooks M, Kennen E, Baker DW, Bennett CL, Durazo-Arvizu R, Bocchini A, Savory S, Parker RM: Low Literacy Impairs Comprehension of Prescription Drug Warning Labels. J Gen Intern Med 2006, 21(8):847-851.
• [41]Wolf MS, Davis TC, Shrank W, Rapp DN, Bass PF, Connor UM, Clayman M, Parker RM: To err is human: Patient misinterpretations of prescription drug label instructions. Patient Educ Couns 2007, 67:293-300.
• [42]Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J: Development of a brief test to measure functional health literacy. Patient Educ Couns 1999, 38(1):33-42.
• [43]Ratzan SC: Health literacy: Communication for the public good. Health Promot Int 2001, 16(2):207-214.
• [44]Parker RM, Ratzan SC, Lurie N: Health literacy: A policy challenge for advancing high-quality health care. Health Aff 2003, 22(4):147-153.
• [45]Al Sayah F, Williams B, Johnson JA: Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures. Health Educ Behav 2013, 40(1):42-55.
• [46]MoE&RA: National Action Plan for Health Education Programs. Athens: Ministry of Education and Religious Affairs; 2008.
• [47]MoH: National Action Plan for Public Health 2008–2012. Athens: Ministry of Health; 2008.