Abstract
Aim: This study analyzes factors associated with dimensions of health literacy (HL) functional, communicative and critical among public health service users with chronic non-communicable diseases. Methods: A cross-sectional analytical research was carried out in Piracicaba, São Paulo, Brazil, with adults and older adults attending Family Health Units (FHU). Data were collected by oral exam (CPOD and CPI) and a questionnaire on systemic conditions, sociodemographic factors, health behaviors and HLS (HLS-14). The outcomes consisted of functional, communicative, and critical HL dimensions dichotomized by median (high and low), which were analyzed by chi-square test (p<0.05) to find associations with the variables studied. Results: The study sample comprised 238 FHU users with 62.7 (± 10.55) mean age, of which 47.5% (n=113) showed high functional HL, 50.0% (n=119) high communicative HL, and 46.2% (n=110) high critical HL. High functional HL was associated with men (p<0.05). Functional and communicative HL were associated with having higher education (p<0.001 and p=0.018, respectively). High communicative and critical HL were associated with regular use of dental and medical services (p<0.05). Individuals with low functional HL were more likely to present poor tooth brushing (p=0.020). High HL (in all three dimensions) was associated with regular flossing and having more teeth (p<0.05). Conclusion: Functional, communicative and critical HL were associated with health behaviors and clinical outcomes, whereas the functional dimension was also associated with sociodemographic factors. HL dimensions allowed to differentiate health-related factors.
References
Hazra NC, Gulliford M. Evolution of the "fourth stage" of epidemiologic transition in people aged 80 years and over: population-based cohort study using electronic health records. Popul Health Metr. 2017 May;15(1):18. doi: 10.1186/s12963-017-0136-2.
WHO. Health literacy: the solid facts. Geneva: World Health Organization; 2013.
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 Sep;15(3):259-67. doi: 10.1093/heapro/15.3.259.
Kickbusch, I. Improving Health Literacy in the European Union: towards a Europe of informed and active health citizens. In: European Health Forum Gastein. 2004 Oct 8 [cited 2022 Jan 5]. Available from: https://www.infosihat.gov.my/images/Bahan_Rujukan/He_Ict/Improving_Health_literacy.pdf.
Antunes ML, Lopes C. [Contributions of health literacy to the promotion and rationalization of health costs]. In: Lopes C, Almeida CV, editors. [Health literacy: models, strategies and intervention]. Lisboa: Edições ISPA; 2018. p.43-63. Portuguese.
Lopes C, Almeida CV. [Introduction]. In: Lopes C, Almeida CV, editors. [Health literacy in practice]. Lisboa; 2019. p.17-23. Portuguese.
Lima LCM, Neves ÉTB, Dutra LDC, Firmino RT, Araújo LJS, Paiva SM, et al. Psychometric properties of BREALD-30 for assessing adolescents' oral health literacy. Rev Saude Publica. 2019 Aug;53:53. doi: 10.11606/S1518-8787.2019053000999.
Sousa AAD, Quintão ALA, Brito AMG, Ferreira RC, Barros AME, Martins L. Development of a health literacy instrument related to diabetic foot. Esc Anna Nery. 2019;23(3):e20180332. doi: 10.1590/2177-9465-ean-2018-0332.
Al Sayah F, Williams B, Johnson JA. Measuring health literacy in peoples with diabetes: a systematic review and evaluation of available measures. Health Educ Behav. 2013 Feb;40(1):42-55. doi: 10.1177/1090198111436341.
Suka M, Odajima T, Kasai M, Igarashi A, Ishikawa H, Kusama M, et al. The 14-item health literacy scale for Japanese adults (HLS-14). Environ Health Prev Med. 2013 Sep;18(5):407-15. doi: 10.1007/s12199-013-0340-z.
Pavão ALB, Werneck GL. [Health literacy in low- and middle-income countries: a systematic review]. Cien Saude Colet. 2021 Sep;26(9):4101-14. Portuguese. doi: 10.1590/1413-81232021269.05782020.
Ishikawa H, Takeuchi T, Yano E. Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care. 2008 May;31(5):874-9. doi: 10.2337/dc07-1932.
Firmino RT, Martins CC, Faria LDS, Martins Paiva S, Granville-Garcia AF, Fraiz FC, et al. Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta-analysis. J Public Health Dent. 2018 Jun;78(3):231-45. doi: 10.1111/jphd.12266.
Batista MJ, Marques ACP, Silva Junior MF, Alencar GP, Sousa MLR. Translation, cross-cultural adaptation and psychometric evaluation of Brazilian Portuguese version of the 14-item Health Literacy Scale. Cien Saude Colet. 2020 Jul;25(7):2847-57. doi: 10.1590/1413-81232020257.22282018.
Malta M, Cardoso LO, Bastos FI, Magnanini MMF, Silva CMFP. STROBE initiative: guidelines on reporting observational studies. Rev Saude Publica. 2010; 44(3): 559-65. doi: 10.1590/S0034-89102010000300021.
IBGE. Brazilian Institute of Geography and Statistics Foundation. [Panorama]. Rio de Janeiro: IBGE; 2010 [cited 2022 Jan 4]. Available from: https://cidades.ibge.gov.br/brasil/sp/piracicaba/panorama. Portuguese.
Puello SCP. [Evaluation of health literacy] [dissertation]. Piracicaba: School of Dentistry of Piracicaba, University of Campinas; 2018. Portuguese.
Morgan BS. [Evaluation of telephone monitoring in the promotion of diabetes self-care in primary health care] [dissertation]. Belo Horizonte: School of Nursing, Federal University of Minas Gerais; 2013. Portuguese.
Frias AC, Antunes JLF, Narvai PC. ]Reliability and validity of oral health surveys: dental caries in the city of Sao Paulo, 2002]. Rev Bras Epidemiol. 2004;7(2):144-54. Portuguese. doi: 10.1590/S1415-790X2004000200004.
Ministry of Health of Brazil. [SB Brazil 2010: national oral health survey: main results]. Brasília: Ministry of Health; 2011 [cited 2019 Apr 29]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/pesquisa_nacional_saude_bucal.pdf. Portuguese.
WHO. World Health Organization. Oral health surveys: basic. 5th ed. Genebra: WHO; 2017 [acesso 2019 jan 07]. Available from: https://www.who.int/publications/i/item/9789241548649.
Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975 Dec;25(4):229-35.
Silva Junior MF, de Sousa MdR, Batista MJ. Prospective cohort of adult oral health in Piracicaba, SP, Brazil. BMC Res Notes. 2019 Apr;12(1):221. doi: 10.1186/s13104-019-4243-y.
Armellini D, von Fraunhofer JA. The shortened dental arch: a review of the literature. J Prosthet Dent. 2004 Dec;92(6):531-5. doi: 10.1016/j.prosdent.2004.08.013.
Ministry of Health of Brazil. [Strategies for the care of the person with chronic disease: systemic arterial hypertension Brasília]: Ministry of Health; 2013 [cited 2021 Dec 12]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/estrategias_cuidado_pessoa_doenca_cronica.pdf. Portuguese.
Queres JFM, Lima BA, Camara MPM, Santos MCC, Taboada GF. [Evaluation of knowledge and attitudes and their relation to diabetes mellitus control parameters]. J Health Connect. 2018;2(1):21-9. Portuguese.
Taoufik K, Divaris K, Kavvadia K, Koletsi-Kounari H, Polychronopoulou A. Development of a Greek Oral health literacy measurement instrument: GROHL. BMC Oral Health. 2020 Jan;20(1):14. doi: 10.1186/s12903-020-1000-5.
Ghaffari M, Rakhshanderou S, Ramezankhani A, Mehrabi Y, Safari-Moradabadi A. Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties. BMC Oral Health. 2020 Jul;20(1):186. doi: 10.1186/s12903-020-01170-y.
Dennis S, Williams A, Taggart J, Newall A, Denney-Wilson E, Zwar N, Shortus T, et al. Which providers can bridge the health literacy gap in lifestyle risk factor modification education: a systematic review and narrative synthesis. BMC Fam Pract. 2012 May;13:44. doi: 10.1186/1471-2296-13-44.
Borges FM, Silva ARVD, Lima LHO, Almeida PC, Vieira NFC, Machado ALG. Health literacy of adults with and without arterial hypertension. Rev Bras Enferm. 2019 Jun;72(3):646-53. doi: 10.1590/0034-7167-2018-0366.
Chin J, Madison A, Gao X, Graumlich JF, Conner-Garcia T, Murray MD, et al. Cognition and Health Literacy in Older Adults' Recall of Self-Care Information. Gerontologist. 2017 Apr;57(2):261-8. doi: 10.1093/geront/gnv091.
Argimon Irani I. de Lima, Lopes Regina Maria Fernandes, Terroso Lauren Bulcão, Farina Marianne, Wendt Guilherme, Esteves Cristiane Silva. [Gender and education: a study through the mini-mental state examination (MMSE) in elderly]. Aletheia. 2012 Dec;38-39:153-61. Potuguese.
Mesa MS. Health Care Disparities Between Men and Women With Type 2 Diabetes. Prev Chronic Dis. 2018;15:E46. doi: 10.5888/pcd15.170120.
Matsuyama RK, Wilson-Genderson M, Kuhn L, Moghanaki D, Vachhani H, Paasche-Orlow M. Education level, not health literacy, associated with information needs for patients with cancer. Patient Educ Couns. 2011 Dec;85(3):e229-36. doi: 10.1016/j.pec.2011.03.022.
Marmot M, Atkinson T, Bell J, Black C, Broadfoot P, Cumberlege J, et al. Fair society, healthy lives: the Marmot Review. Strategic review of health inequalities in England. The Marmot Review; 2010 Feb [cited 2020 Oct 11]. Available from: https://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review/fair-society-healthy-lives-full-report-pdf.pdf.
Friis K, Lasgaard M, Rowlands G, Osborne RH, Maindal HT. Health Literacy Mediates the Relationship Between Educational Attainment and Health Behavior: A Danish Population-Based Study. J Health Commun. 2016;21(sup2):54-60. doi: 10.1080/10810730.2016.1201175.
Batista MJ, Lawrence HP, Sousa MDLR. Oral health literacy and oral health outcomes in an adult population in Brazil. BMC Public Health. 2017 Jul;18(1):60. doi: 10.1186/s12889-017-4443-0.
Timková S, Klamárová T, Kovaľová E, Novák B, Kolarčik P, Madarasová Gecková A. Health literacy associations with periodontal disease among slovak adults. Int J Environ Res Public Health. 2020 Mar;17(6):2152. doi: 10.3390/ijerph17062152.
Tenani CF, De Checchi MHR, Bado FMR, Ju X, Jamieson L, Mialhe FL. Influence of oral health literacy on dissatisfaction with oral health among older people. Gerodontology. 2020 Mar;37(1):46-52. doi: 10.1111/ger.12443.
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Roundtable on Health Literacy. Integrating Oral and General Health Through Health Literacy Practices: Proceedings of a Workshop. Wojtowicz A, Olson S, editors. Washington (DC): National Academies Press (US); 2019 Jul 31.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Carla Fabiana Tenani, Manoelito Ferreira Silva Junior, Maria da Luz Rosário de Sousa, Marília Jesus Batista