Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Distribution of health literacy strengths and weaknesses across socio-demographic groups: a cross-sectional survey using the Health Literacy Questionnaire (HLQ)

Authors: Alison Beauchamp, Rachelle Buchbinder, Sarity Dodson, Roy W. Batterham, Gerald R. Elsworth, Crystal McPhee, Louise Sparkes, Melanie Hawkins, Richard H. Osborne

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

Recent advances in the measurement of health literacy allow description of a broad range of personal and social dimensions of the concept. Identifying differences in patterns of health literacy between population sub-groups will increase understanding of how health literacy contributes to health inequities and inform intervention development. The aim of this study was to use a multi-dimensional measurement tool to describe the health literacy of adults in urban and rural Victoria, Australia.

Methods

Data were collected from clients (n = 813) of 8 health and community care organisations, using the Health Literacy Questionnaire (HLQ). Demographic and health service data were also collected. Data were analysed using descriptive statistics. Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between demographic sub-groups.

Results

Mean age of respondents was 72.1 (range 19–99) years. Females comprised 63 % of the sample, 48 % had not completed secondary education, and 96 % reported at least one existing health condition. Small to large ES were seen for mean differences in HLQ scales between most demographic groups. Compared with participants who spoke English at home, those not speaking English at home had much lower scores for most HLQ scales including the scales ‘Understanding health information well enough to know what to do’ (ES −1.09 [95 % confidence interval (CI) -1.33 to −0.84]), ‘Ability to actively engage with healthcare providers’ (ES −1.00 [95 % CI −1.24, −0.75]), and ‘Navigating the healthcare system’ (ES −0.72 [95 % CI −0.97, −0.48]). Similar patterns and ES were seen for participants born overseas compared with those born in Australia. Smaller ES were seen for sex, age group, private health insurance status, number of chronic conditions, and living alone.

Conclusions

This study has revealed some large health literacy differences across nine domains of health literacy in adults using health services in Victoria. These findings provide insights into the relationship between health literacy and socioeconomic position in vulnerable groups and, given the focus of the HLQ, provide guidance for the development of equitable interventions.
Literature
1.
go back to reference Helitzer D, Hollis C, Sanders M, Roybal S. Addressing the “Other” Health Literacy Competencies—Knowledge, Dispositions, and Oral/Aural Communication: Development of TALKDOC, an Intervention Assessment Tool. J Health Commun. 2012;17(sup3):160–75.CrossRefPubMedPubMedCentral Helitzer D, Hollis C, Sanders M, Roybal S. Addressing the “Other” Health Literacy Competencies—Knowledge, Dispositions, and Oral/Aural Communication: Development of TALKDOC, an Intervention Assessment Tool. J Health Commun. 2012;17(sup3):160–75.CrossRefPubMedPubMedCentral
2.
go back to reference Naik AD, Street RL, Castillo D, NS A. Health literacy and decision making styles for complex antithrombotic therapy among older multimorbid adults. Patient Educ Couns. 2011;85(3):499–504.CrossRefPubMedPubMedCentral Naik AD, Street RL, Castillo D, NS A. Health literacy and decision making styles for complex antithrombotic therapy among older multimorbid adults. Patient Educ Couns. 2011;85(3):499–504.CrossRefPubMedPubMedCentral
3.
go back to reference Dodson S, Beauchamp A, Batterham RW, Osborne RH: Information sheet 1: What is health literacy. In Ophelia Toolkit: A step-by-step guide for identifying and responding to health literacy needs within local communities. Part A: Introduction to health literacy. 2014. Available from www.ophelia.net.au. In. Dodson S, Beauchamp A, Batterham RW, Osborne RH: Information sheet 1: What is health literacy. In Ophelia Toolkit: A step-by-step guide for identifying and responding to health literacy needs within local communities. Part A: Introduction to health literacy. 2014. Available from www.​ophelia.​net.​au. In.
4.
go back to reference DeWalt DA, Callahan LF, Hawk VH, Broucksou KA, Hink A: Health Literacy Universal Precautions Toolkit. (Prepared by North Carolina Network Consortium, The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, under Contract No. HHSA290200710014.) AHRQ Publication No. 10-0046-EF). Rockville, MD, Agency for Healthcare Research and Quality. 2010. DeWalt DA, Callahan LF, Hawk VH, Broucksou KA, Hink A: Health Literacy Universal Precautions Toolkit. (Prepared by North Carolina Network Consortium, The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, under Contract No. HHSA290200710014.) AHRQ Publication No. 10-0046-EF). Rockville, MD, Agency for Healthcare Research and Quality. 2010.
5.
go back to reference Baker D, Gazmararian J, Williams M, Scott T, Parker RM, Green D, et al. Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. Am J Public Health. 2002;92(8):1278–83.CrossRefPubMedPubMedCentral Baker D, Gazmararian J, Williams M, Scott T, Parker RM, Green D, et al. Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. Am J Public Health. 2002;92(8):1278–83.CrossRefPubMedPubMedCentral
6.
go back to reference Riegel B, Moser D, Anker S, Appel LJ, Dunbar SB, Grady KL, et al. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009;120(12):1141–63.CrossRefPubMed Riegel B, Moser D, Anker S, Appel LJ, Dunbar SB, Grady KL, et al. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009;120(12):1141–63.CrossRefPubMed
7.
go back to reference von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J Epidemiology & Community Health. 2007;61(12):1086–90.CrossRef von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J Epidemiology & Community Health. 2007;61(12):1086–90.CrossRef
8.
go back to reference Peterson PN, Shetterly SM, Clarke CL, Bekelman DB, Chan PS, Allen LA, et al. Health literacy and outcomes among patients with heart failure. JAMA. 2011;305(16):1695–701.CrossRefPubMedPubMedCentral Peterson PN, Shetterly SM, Clarke CL, Bekelman DB, Chan PS, Allen LA, et al. Health literacy and outcomes among patients with heart failure. JAMA. 2011;305(16):1695–701.CrossRefPubMedPubMedCentral
9.
go back to reference Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, et al. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006;21(8):806–12.CrossRefPubMedPubMedCentral Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, et al. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006;21(8):806–12.CrossRefPubMedPubMedCentral
10.
go back to reference Australian Bureau of Statistics: 4102.0 - Australian Social Trends. June 2009. Australian Bureau of Statistics: 4102.0 - Australian Social Trends. June 2009.
11.
go back to reference Barber MN, Staples M, Osborne RH, Clerehan R, Elder C, Buchbinder R. Up to a quarter of the Australian population may have suboptimal health literacy depending upon the measurement tool: results from a population-based survey. Health Promot Int. 2009;24(3):252–61.CrossRefPubMed Barber MN, Staples M, Osborne RH, Clerehan R, Elder C, Buchbinder R. Up to a quarter of the Australian population may have suboptimal health literacy depending upon the measurement tool: results from a population-based survey. Health Promot Int. 2009;24(3):252–61.CrossRefPubMed
15.
go back to reference Berkman N, Sheridan S, Donahue K, Halpern D, Viera A, Crotty K, et al. Health literacy interventions and outcomes: an updated systematic review. Evid Rep Technol Assess. 2011;199:1–941. Berkman N, Sheridan S, Donahue K, Halpern D, Viera A, Crotty K, et al. Health literacy interventions and outcomes: an updated systematic review. Evid Rep Technol Assess. 2011;199:1–941.
16.
go back to reference Dewalt D, Berkman D, Sheridan S, Lohr K, M P. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med. 2004;19(12):1228–39.CrossRefPubMedPubMedCentral Dewalt D, Berkman D, Sheridan S, Lohr K, M P. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med. 2004;19(12):1228–39.CrossRefPubMedPubMedCentral
17.
go back to reference Bostock S, Steptoe A. Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ. 2012;344:e106.CrossRef Bostock S, Steptoe A. Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ. 2012;344:e106.CrossRef
18.
go back to reference Australian Institute of Health and Welfare. Australia's health 2006. In: Australia's health no 10 Cat no AUS 73. Canberra: AIHW; 2006. Australian Institute of Health and Welfare. Australia's health 2006. In: Australia's health no 10 Cat no AUS 73. Canberra: AIHW; 2006.
19.
go back to reference Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez A. The burden of disease and injury in Australia 2003. In: Australian Institute of Health and Welfare, editor. AIHW Cat no PHE 82. Canberra: AIHW; 2007. Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez A. The burden of disease and injury in Australia 2003. In: Australian Institute of Health and Welfare, editor. AIHW Cat no PHE 82. Canberra: AIHW; 2007.
20.
go back to reference Australian Institute of Health and Welfare. Mortality inequalities in Australia 2009–2011. In: Bulletin no 124 Cat no AUS 184. Canberra: AIHW; 2014. Australian Institute of Health and Welfare. Mortality inequalities in Australia 2009–2011. In: Bulletin no 124 Cat no AUS 184. Canberra: AIHW; 2014.
21.
go back to reference Evangelista LS, Rasmusson K, Laramee A, Barr J, Ammon SE, Dunbar S, et al. Health literacy and the patient with heart failure--implications for patient care and research: a consensus statement of the Heart Failure Society of America. J Card Fail. 2010;16(1):9–16.CrossRefPubMed Evangelista LS, Rasmusson K, Laramee A, Barr J, Ammon SE, Dunbar S, et al. Health literacy and the patient with heart failure--implications for patient care and research: a consensus statement of the Heart Failure Society of America. J Card Fail. 2010;16(1):9–16.CrossRefPubMed
22.
go back to reference Bohanny W, Wu S-FV, Liu C-Y, Yeh S-H, Tsay S-L, Wang T-J. Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. J American Association of Nurse Practitioners. 2013;25(9):495–502.CrossRef Bohanny W, Wu S-FV, Liu C-Y, Yeh S-H, Tsay S-L, Wang T-J. Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. J American Association of Nurse Practitioners. 2013;25(9):495–502.CrossRef
23.
go back to reference Chen AMH, Yehle KS, Plake KS, Murawski MM, Mason HL. Health Literacy and Self-Care of Patients with Heart Failure. J Cardiovasc Nurs. 2011;26(6):446–51.CrossRefPubMedPubMedCentral Chen AMH, Yehle KS, Plake KS, Murawski MM, Mason HL. Health Literacy and Self-Care of Patients with Heart Failure. J Cardiovasc Nurs. 2011;26(6):446–51.CrossRefPubMedPubMedCentral
24.
25.
go back to reference Omachi TA, Sarkar U, Yelin EH, Blanc PD, Katz PP. Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. J Gen Intern Med. 2013;28(1):74–81.CrossRefPubMed Omachi TA, Sarkar U, Yelin EH, Blanc PD, Katz PP. Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. J Gen Intern Med. 2013;28(1):74–81.CrossRefPubMed
26.
go back to reference Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25(6):391–5.PubMed Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25(6):391–5.PubMed
27.
go back to reference Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills. J Gen Intern Med. 1995;10(10):537–41.CrossRefPubMed Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills. J Gen Intern Med. 1995;10(10):537–41.CrossRefPubMed
28.
go back to reference Weiss J, Licht C, Johnson N. Assessment of psychosocial readiness for HCV treatment. J Int Assoc Physicians AIDS Care. 2011;10(3):200–1. Weiss J, Licht C, Johnson N. Assessment of psychosocial readiness for HCV treatment. J Int Assoc Physicians AIDS Care. 2011;10(3):200–1.
29.
go back to reference Jordan JE, Osborne RH, Buchbinder R. Critical appraisal of health literacy indices revealed variable underlying constructs, narrow content and psychometric weaknesses. J Clin Epidemiol. 2011;64(4):366–79.CrossRefPubMed Jordan JE, Osborne RH, Buchbinder R. Critical appraisal of health literacy indices revealed variable underlying constructs, narrow content and psychometric weaknesses. J Clin Epidemiol. 2011;64(4):366–79.CrossRefPubMed
30.
go back to reference Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R. The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ). BMC Public Health. 2013;13:658.CrossRefPubMedPubMedCentral Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R. The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ). BMC Public Health. 2013;13:658.CrossRefPubMedPubMedCentral
31.
go back to reference Buchbinder R, Batterham R, Elsworth G, Dionne C, Irvin E, Osborne R. A validity-driven approach to the understanding of the personal and societal burden of low back pain: development of a conceptual and measurement model. Arthritis Res Ther. 2011;13(5):R152.CrossRefPubMedPubMedCentral Buchbinder R, Batterham R, Elsworth G, Dionne C, Irvin E, Osborne R. A validity-driven approach to the understanding of the personal and societal burden of low back pain: development of a conceptual and measurement model. Arthritis Res Ther. 2011;13(5):R152.CrossRefPubMedPubMedCentral
32.
go back to reference Batterham R, Buchbinder R, Beauchamp A, Dodson S, Elsworth G, Osborne R. The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform. BMC Public Health. 2014;14:694.CrossRefPubMedPubMedCentral Batterham R, Buchbinder R, Beauchamp A, Dodson S, Elsworth G, Osborne R. The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform. BMC Public Health. 2014;14:694.CrossRefPubMedPubMedCentral
35.
go back to reference Muthén B, Asparouhov T. Bayesian structural equation modeling: A more flexible representation of substantive theory. Psychol Methods. 2012;17(3):313–35.CrossRefPubMed Muthén B, Asparouhov T. Bayesian structural equation modeling: A more flexible representation of substantive theory. Psychol Methods. 2012;17(3):313–35.CrossRefPubMed
36.
go back to reference Elsworth GE, Batterham R, Dodson S, Beauchamp A, Osborne R: Measurement invariance of the Health Literacy Questionnaire: A Bayesian Structural Equation Modelling approach. Forthcoming. Elsworth GE, Batterham R, Dodson S, Beauchamp A, Osborne R: Measurement invariance of the Health Literacy Questionnaire: A Bayesian Structural Equation Modelling approach. Forthcoming.
37.
go back to reference IBM Corp. IBM SPSS Statistics for Windows VA. NY: IBM Corp; 2012. IBM Corp. IBM SPSS Statistics for Windows VA. NY: IBM Corp; 2012.
38.
go back to reference Welch BL. On the comparison of several mean values: An alternative approach. Biometrika. 1951;38:330–6.CrossRef Welch BL. On the comparison of several mean values: An alternative approach. Biometrika. 1951;38:330–6.CrossRef
39.
go back to reference StataCorp. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP; 2013. StataCorp. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP; 2013.
40.
go back to reference Cohen J. Statistical power analysis for behavioral sciences (revised ed.). New York: Academic; 1977. Cohen J. Statistical power analysis for behavioral sciences (revised ed.). New York: Academic; 1977.
41.
go back to reference Krieger N, Kosheleva A, Waterman PD, Chen JT, Beckfield J, Kiang MV. 50-year trends in US socioeconomic inequalities in health: US-born Black and White Americans, 1959–2008. Int J Epidemiol. 2014;43(4):1294–313.CrossRefPubMedPubMedCentral Krieger N, Kosheleva A, Waterman PD, Chen JT, Beckfield J, Kiang MV. 50-year trends in US socioeconomic inequalities in health: US-born Black and White Americans, 1959–2008. Int J Epidemiol. 2014;43(4):1294–313.CrossRefPubMedPubMedCentral
42.
go back to reference Luckett T, Goldstein D, Butow PN, Gebski V, Aldridge LJ, McGrane J, et al. Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncology. 2011;12(13):1240–8.CrossRefPubMed Luckett T, Goldstein D, Butow PN, Gebski V, Aldridge LJ, McGrane J, et al. Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncology. 2011;12(13):1240–8.CrossRefPubMed
43.
go back to reference The World Bank. World Development Report 2012: Gender Equality and Development (Report). Washington, DC: The World Bank; 2012. The World Bank. World Development Report 2012: Gender Equality and Development (Report). Washington, DC: The World Bank; 2012.
44.
go back to reference van der Heide I, Wang J, Droomers M, Spreeuwenberg P, Rademakers J, Uiters E. The Relationship Between Health, Education, and Health Literacy: Results From the Dutch Adult Literacy and Life Skills Survey. J Health Commun. 2013;18(sup1):172–84.CrossRefPubMedPubMedCentral van der Heide I, Wang J, Droomers M, Spreeuwenberg P, Rademakers J, Uiters E. The Relationship Between Health, Education, and Health Literacy: Results From the Dutch Adult Literacy and Life Skills Survey. J Health Commun. 2013;18(sup1):172–84.CrossRefPubMedPubMedCentral
46.
go back to reference Nolte S, Osborne R. A systematic review of outcomes of chronic disease self-management interventions. Qual Life Res. 2013;22(7):1805–16.CrossRefPubMed Nolte S, Osborne R. A systematic review of outcomes of chronic disease self-management interventions. Qual Life Res. 2013;22(7):1805–16.CrossRefPubMed
47.
go back to reference Clark DO, Frankel RM, Morgan DL, Ricketts G, Bair MJ, Nyland KA, et al. The meaning and significance of self-management among socioeconomically vulnerable older adults. J Gerontol B Psychol Sci Soc Sci. 2008;63B(5):S312–319.CrossRef Clark DO, Frankel RM, Morgan DL, Ricketts G, Bair MJ, Nyland KA, et al. The meaning and significance of self-management among socioeconomically vulnerable older adults. J Gerontol B Psychol Sci Soc Sci. 2008;63B(5):S312–319.CrossRef
48.
go back to reference Ethnic Communities' Council of Victoria. An investment not an expense: Enhancing health literacy in culturally and linguistically diverse communities. Policy paper. 2012 Ethnic Communities' Council of Victoria. An investment not an expense: Enhancing health literacy in culturally and linguistically diverse communities. Policy paper. 2012
49.
go back to reference Jatrana S, Pasupuleti SSR, Richardson K. Nativity, duration of residence and chronic health conditions in Australia: Do trends converge towards the native-born population? Soc Sci Med. 2014;119:53–63.CrossRefPubMed Jatrana S, Pasupuleti SSR, Richardson K. Nativity, duration of residence and chronic health conditions in Australia: Do trends converge towards the native-born population? Soc Sci Med. 2014;119:53–63.CrossRefPubMed
53.
go back to reference Marcin J, Schembri M, He J, P R. A Population-based analysis of socioeconomic status and insurance status and their relationship with pediatric trauma hospitalization and mortality rates. Am J Public Health. 2003;93:461–6.CrossRefPubMedPubMedCentral Marcin J, Schembri M, He J, P R. A Population-based analysis of socioeconomic status and insurance status and their relationship with pediatric trauma hospitalization and mortality rates. Am J Public Health. 2003;93:461–6.CrossRefPubMedPubMedCentral
54.
go back to reference Sentell T. Survey of California adults suggests low health literacy predicts likelihood of being uninsured. Health Aff. 2012;31(5):1039–48.CrossRef Sentell T. Survey of California adults suggests low health literacy predicts likelihood of being uninsured. Health Aff. 2012;31(5):1039–48.CrossRef
55.
go back to reference Gilbert AL, Caughey GE, Vitry AI, Clark A, Ryan P, McDermott RA, et al. Ageing well: Improving the management of patients with multiple chronic health problems. Australas J Ageing. 2011;30:32–7.CrossRefPubMed Gilbert AL, Caughey GE, Vitry AI, Clark A, Ryan P, McDermott RA, et al. Ageing well: Improving the management of patients with multiple chronic health problems. Australas J Ageing. 2011;30:32–7.CrossRefPubMed
56.
go back to reference Rosland A-M, Heisler M, Piette J. The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review. J Behav Med. 2012;35(2):221–39.CrossRefPubMed Rosland A-M, Heisler M, Piette J. The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review. J Behav Med. 2012;35(2):221–39.CrossRefPubMed
57.
go back to reference Gallagher R, Luttik M-L, Jaarsma T. Social Support and Self-care in Heart Failure. J Cardiovascular Nursing. 2011;26(6):439–45.CrossRef Gallagher R, Luttik M-L, Jaarsma T. Social Support and Self-care in Heart Failure. J Cardiovascular Nursing. 2011;26(6):439–45.CrossRef
59.
go back to reference Caress A-L, Luker KA, Chalmers KI, Salmon MP. A review of the information and support needs of family carers of patients with chronic obstructive pulmonary disease. J Clin Nurs. 2009;18(4):479–91.CrossRefPubMed Caress A-L, Luker KA, Chalmers KI, Salmon MP. A review of the information and support needs of family carers of patients with chronic obstructive pulmonary disease. J Clin Nurs. 2009;18(4):479–91.CrossRefPubMed
60.
go back to reference Washington KT, Meadows SE, Elliott SG, Koopman RJ: Information needs of informal caregivers of older adults with chronic health conditions. Patient Education and Counseling, 83(1):37–44. Washington KT, Meadows SE, Elliott SG, Koopman RJ: Information needs of informal caregivers of older adults with chronic health conditions. Patient Education and Counseling, 83(1):37–44.
61.
go back to reference Manderson B, McMurray J, Piraino E, Stolee P. Navigation roles support chronically ill older adults through healthcare transitions: a systematic review of the literature. Health Soc Care Community. 2012;20(2):113–27.CrossRefPubMed Manderson B, McMurray J, Piraino E, Stolee P. Navigation roles support chronically ill older adults through healthcare transitions: a systematic review of the literature. Health Soc Care Community. 2012;20(2):113–27.CrossRefPubMed
62.
go back to reference Kim K, Lustria M, Burke D: Predictors of cancer information overload: findings from a national survey. Information Research 2007, 12(4). Kim K, Lustria M, Burke D: Predictors of cancer information overload: findings from a national survey. Information Research 2007, 12(4).
63.
go back to reference Bo A, Friis K, Osborne R, Maindal H. National indicators of health literacy: ability to understand health information and to engage actively with healthcare providers - a population-based survey among Danish adults. BMC Public Health. 2014;14(1):1095.CrossRefPubMedPubMedCentral Bo A, Friis K, Osborne R, Maindal H. National indicators of health literacy: ability to understand health information and to engage actively with healthcare providers - a population-based survey among Danish adults. BMC Public Health. 2014;14(1):1095.CrossRefPubMedPubMedCentral
64.
go back to reference Kutner M, Greenberg E, Paulsen C: The health literacy of America’s adults: results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). In.: U.S. Department of Education. Washington, DC: National Center for Education Statistics. Available at: http://nces.ed.gov/pubs2006/2006483.pdf; 2006. Kutner M, Greenberg E, Paulsen C: The health literacy of America’s adults: results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). In.: U.S. Department of Education. Washington, DC: National Center for Education Statistics. Available at: http://​nces.​ed.​gov/​pubs2006/​2006483.​pdf; 2006.
65.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
66.
go back to reference Guyatt GH, Osoba D, Wu AW, Wyrwich KW, Norman GR. Clinical Significance Consensus Meeting Group. Methods to explain the clinical significance of health status measures. Mayo Clin Proc. 2002;77:371–83.CrossRefPubMed Guyatt GH, Osoba D, Wu AW, Wyrwich KW, Norman GR. Clinical Significance Consensus Meeting Group. Methods to explain the clinical significance of health status measures. Mayo Clin Proc. 2002;77:371–83.CrossRefPubMed
67.
go back to reference Wyrwich KW, Norquist JM, Lenderking WR SA. Methods for interpreting change over time in patient-reported outcome measures. Qual Life Res. 2103;22:475–83.CrossRef Wyrwich KW, Norquist JM, Lenderking WR SA. Methods for interpreting change over time in patient-reported outcome measures. Qual Life Res. 2103;22:475–83.CrossRef
68.
go back to reference Revicki DA, Cella D, Hays RD, Sloan JA, Lenderking WR, Aaronson NK. Responsiveness and minimal important differences for patient reported outcomes. Health Qual Life Outcomes. 2006;4:70.CrossRefPubMedPubMedCentral Revicki DA, Cella D, Hays RD, Sloan JA, Lenderking WR, Aaronson NK. Responsiveness and minimal important differences for patient reported outcomes. Health Qual Life Outcomes. 2006;4:70.CrossRefPubMedPubMedCentral
69.
go back to reference Batterham RW, Buchbinder R, Hawkins M, Collins P, Osborne RH: Health Literacy: What is it and how can an understanding of the concept help to reduce health inequities? British Medical Journal 2014, Resubmitted. Batterham RW, Buchbinder R, Hawkins M, Collins P, Osborne RH: Health Literacy: What is it and how can an understanding of the concept help to reduce health inequities? British Medical Journal 2014, Resubmitted.
70.
go back to reference Gazmararian JA, Yang B, Elon L, Graham M, Parker R. Successful Enrollment in Text4Baby More Likely With Higher Health Literacy. J Health Commun. 2012;17(sup3):303–11.CrossRefPubMed Gazmararian JA, Yang B, Elon L, Graham M, Parker R. Successful Enrollment in Text4Baby More Likely With Higher Health Literacy. J Health Commun. 2012;17(sup3):303–11.CrossRefPubMed
71.
go back to reference Shue CK, O'Hara LLS, Marini D, McKenzie J, Schreiner M. Diabetes and Low-Health Literacy: A Preliminary Outcome Report of a Mediated Intervention to Enhance Patient-Physician Communication. Communication Education. 2010;59(3):360–73.CrossRef Shue CK, O'Hara LLS, Marini D, McKenzie J, Schreiner M. Diabetes and Low-Health Literacy: A Preliminary Outcome Report of a Mediated Intervention to Enhance Patient-Physician Communication. Communication Education. 2010;59(3):360–73.CrossRef
72.
go back to reference Allen K, Zoellner J, Motley M, P E. Understanding the internal and external validity of health literacy interventions: A systematic literature review using the RE-AIM framework. J Health Commun. 2011;16:55–72.CrossRefPubMed Allen K, Zoellner J, Motley M, P E. Understanding the internal and external validity of health literacy interventions: A systematic literature review using the RE-AIM framework. J Health Commun. 2011;16:55–72.CrossRefPubMed
Metadata
Title
Distribution of health literacy strengths and weaknesses across socio-demographic groups: a cross-sectional survey using the Health Literacy Questionnaire (HLQ)
Authors
Alison Beauchamp
Rachelle Buchbinder
Sarity Dodson
Roy W. Batterham
Gerald R. Elsworth
Crystal McPhee
Louise Sparkes
Melanie Hawkins
Richard H. Osborne
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2056-z

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue