Assessment of health literacy in the adult population registered to family medicine physicians in the Republic of Srpska, Bosnia and Herzegovina

Abstract

Background: Health literacy is an important determinant of health. This concept is under-researched in the Republic of Srpska, Bosnia and Herzegovina. Objectives: To assess health literacy and its association with sociodemographic variables, self-perception of health and the presence of chronic conditions in primary healthcare setting. Methods: In May 2016, a cross-sectional study was executed in two primary healthcare centres. Out of approximately 1500 patients who visited both health centres during four consecutive days, about 800 were eligible. Of these, 110 patients agreed to complete the translated Short Test of Functional Health Literacy in Adults (S-TOFHLA). The influence of demographic, social, economic, and health characteristics (independent variables) on the S-TOFHLA score (dependent variable) was assessed by multiple logistic regression analysis. Results: One questionnaire was incomplete and therefore 109 questionnaires were analysed. Inadequate, marginal, and adequate health literacy were present in 19 (17.4%), 16 (14.7%) and 74 (67.9%) respondents. Adequate health literacy was found predominantly among respondents younger than 55 years and those with a high level of education. Regression analyses showed that low level of education (OR: 5.3), age 55 years and over (OR: 3.9), living in a rural area (OR: 3.7) and having three or more chronic diseases (OR: 2) were independently associated with inadequate or marginal health literacy. Conclusion: In this study performed in two primary healthcare centres in the Republic of Srpska, Bosnia and Herzegovina, low health literacy was associated with low level of education, older age, living in a rural area, and having more chronic diseases.

Exploring Health Literacy in Patients with Chronic Diseases in Chongqing, China in 2018: A Cross-Sectional Study

“…The relationship between age and health literacy level was also observed in this study, that is, low health literacy is associated with the elderly. A previous study on the assessment of health literacy among patients in the primary healthcare centers has also found this relationship [25]. Poor educational conditions and situation in the past possibly explain the elderly's low level of health education, which was also mentioned in a related study [21].…”

Health Literacy: Current Status and Challenges in the Work of Family Doctors in Bosnia and Herzegovina

“…The representative sample of the population in the Republic of Srpska was determined by the sample size calculation. With a population size of 934,725 inhabitants older than 18 years of age in the Republic of Srpska, the proportion of inadequate health literacy of 32% (determined in a previous pilot study) [13], an error margin of 5%, a 95% Confidence Interval (CI) and an expected attrition rate of least 10%, the minimum required number of respondents was found to be 844. Every Wednesday, in the study period, investigators consecutively selected a sample of eight patients visiting their family physicians for any reason, until the desired sample size was achieved.…”

“…We used the short version of the TOFHLA questionnaire (Short Test of Functional Health Literacy in Adults, S-TOFHLA) [10] and a sociodemographic questionnaire [13]. Translation from the English language and validation of the STOFHLA questionnaire in the Serbian language was conducted previously in the same geographic regions and published elsewhere.…”

“…Translation from the English language and validation of the STOFHLA questionnaire in the Serbian language was conducted previously in the same geographic regions and published elsewhere. It was shown that S-TOFHLA had good internal consistency, reliability, and construct validity compared with the long version—the TOFHLA [12,13].…”

“…There are many tests to evaluate functional health literacy [10] in a health care system, through evaluation of word recognition, reading tests, and reading comprehension [11]. One of the most common tests and one which is valid in the local language is the Test of Functional Health Literacy in Adults (S-TOFHLA) [9,10,12,13]. Our goal was to use S-TOFHLA to evaluate health literacy of primary healthcare users in the Republic of Srpska (RS), Bosnia and Herzegovina (B&H) and to identify and analyze socioeconomic and health factors linked to the level of health literacy.…”