Do I know that I do not know? Results of a survey on health literacy in a cohort of 414 elderly people in Italy (Preprint)

Abstract

BACKGROUND Health literacy is widely recognised as an important social determinant of health, although it is difficult to measure it at national, regional and local level. OBJECTIVE This study aims to measure the level of health information literacy in a sample of elderly people living in the city of Pescara (Central Italy). Besides, the level of health information literacy, as an integral part of health literacy, was checked among the people surveyed. METHODS The study was conducted through a questionnaire during an eye screening in a cohort of elderly people in 2017. The targeted audience included 595 individuals (60 and over years of age); 414 questionnaires were eligible for examination. The questionnaire was organised into two sections, the first one was set up by the authors of this paper, whilst the second one was based on the European Health Literacy Survey (HLS-EU). RESULTS Data collected refer to the number of respondents per question, as a matter of fact not all surveyed people (414) answered to each question. Most respondents (283 out of 411) were women (69 %). The sample revealed low education level: only 9% had a degree and/or post-doc; 25% had a high school diploma, 39% attended only primary school and 27% junior high school. The family doctor was the preferred source to get information from, Internet was the less used source (22%, 91 out of 414). Most participants sought information in Italian. As regards the subject of information retrieved, the answers collected (90) highlighted that the majority of respondents looked for information on diseases in general (94%), on therapies (77%), on nutrition issues (74%), and on diagnosis (69%). A good percentage looks for information on drugs (50%) and on health facilities (44%). Most of them also declared that they easily understand what their practitioner says. Besides, they claimed they did not find any difficulty in understanding medicines’ labels and drug prescriptions, or to cope with other health conditions. CONCLUSIONS This survey addressed a homogeneous group of elderly people living in a small area of Central Italy. Most respondents declared to address family and/or specialist doctors for health information, and just a minor percentage (22%) also declared they surf the Internet, mainly through search engines, claiming to be rather satisfied with results without questioning their reliability. Most respondents declared to have an easy access and understanding of health information. Yet the study results showed that respondents were not aware of that information overload requires critical skills in order to select trusted and updated medical information. Health information literacy is difficult to measure; this survey shows the need of further investigation and the use of standardised measuring tools. It is also fundamental to promote corrective strategies, like prescription of information (Information RX) or creation of quality health portals in native languages (e.g. ISSalute) and to offer professional support (patient’s libraries or information points) for improving health literacy levels.