Health Literacy Beyond the Individual: A Meta-Narrative Review

Pitt, Ruth; Davis, Terry C.; Manganello, Jennifer A.; Massey, Philip M.; McFarlane, Lu-Anne; Buchthal, V; Davis, Jordan; Arnold, Connie L.; Sentell, Tetine

doi:10.1093/eurpub/ckx187.232

Cited by 6 publications

(9 citation statements)

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“…Interestingly, the emotional experience of carers was similar to that of patients. This finding appears to be novel in the context of dietetic advice, but is similar to previous work by others investigating psychological adaptation to self-management in CKD or other chronic illness contexts (Sidell 1997;Telford et al 2006;Boer et al 2014;Swallow et al 2014;Marlow et al 2016;Pitt et al 2017). However, participants in this study also described moving on from feeling overwhelmed and frustrated, to accepting that the diet was important to maintain their health and developed strategies enabling them to apply the renal diet to their everyday lives.…”

Section: Discussionsupporting

confidence: 86%

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How do patients and carers make sense of renal dietary advice? A qualitative exploration

Lambert

Mansfield

Mullan

2018

Journal of Renal Care

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SUMMARY Background Dietary modification is an integral part of chronic kidney disease (CKD) management. However, adherence to the renal diet is often suboptimal. Methods The aims of this study were to (i) describe the experiences of patients with CKD and their carers in their process of interpreting and implementing renal dietary advice; (ii) to explore strategies they used to make sense of and apply renal diet information and (iii) to develop recommendations for improved clinical practice. To achieve these aims, individual semi‐structured interviews with 26 patients and 10 carers were conducted, using interview questions guided by Sensemaking theory. Findings Six themes emerged from the data which did not differ according to CKD stage, geographic location or renal replacement therapy (RRT) type. The renal diet was perceived by patients and carers to be overwhelming, frustrating and emotionally demanding; as well as being complex and challenging. To help make sense of and apply renal dietary advice, participants highly valued the input of the dietitian; and patients believed that their carer support was important. Individual problem‐solving strategies were developed by participants to help them make sense of the renal diet, and many of them expressed a desire for additional resources and/or support. Conclusions This study highlights that learning to make sense of renal diet information is an emotionally challenging journey for patients and carers. In addition to utilising the expertise of dietitians, carer support was perceived to be integral to learning and using renal dietary advice. The study describes a number of important problem‐solving strategies utilised by patients and carers, as well as recommendations to help improve sensemaking and adherence to the renal diet.

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Section: Discussionsupporting

confidence: 86%

“…; Pitt et al . ). However, participants in this study also described moving on from feeling overwhelmed and frustrated, to accepting that the diet was important to maintain their health and developed strategies enabling them to apply the renal diet to their everyday lives.…”

Section: Discussionmentioning

confidence: 97%

How do patients and carers make sense of renal dietary advice? A qualitative exploration

Lambert

Mansfield

Mullan

2018

Journal of Renal Care

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“…WHO [ 3 ] has emphasized the critical importance of the interface between organisations, the setting, and the individual for health literacy competences. Reviews on the link between health literacy and social context also highlights the different conceptual understanding and empirical operationalization of health literacy as a concept between disciplines, methods and research communities [ 10 , 11 ]. Concepts such as social networks, social support, social ties, social inclusion and social practice are strongly represented in the theoretical literature but are used very loosely and widely in empirical research on health literacy [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Employment Status and Health Literacy in Denmark: A Population-Based Study

Svendsen¹,

Damgaard²,

Bak³

et al. 2021

Int J Public Health

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Objectives: Examining whether specific population groups who are not working and those who have an employment have the same health literacy level.Methods: Data were retrieved from a nationally representative cross-sectional study of the Danish population conducted with the health literacy questionnaire (HLS-EU-Q16) in 2016 and 2017. Socio-demographic characteristics were drawn from national registers. Odds ratio for the association between employment status and health literacy was estimated from logistic regression models, adjusted for socio-demographic characteristics. Probability weights were used to adjust for differences in responses.Results: Logistic regression analyses showed that receiving unemployment benefits, social assistance, employment and support allowance, retirement pension and sickness benefit were significantly associated with having inadequate health literacy compared to being employed in any industry. The highest odds ratio for inadequate health literacy was present for receiving unemployment benefit OR = 1.78 (95% CI: 1.23–2.56).Conclusion: Population groups not working and receiving economic public support have higher odds of inadequate health literacy competencies compared to those active in the labor force, considering age and socioeconomic factors. The result contributes to understanding health disparities in connection to occupational situation.

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“…While health literacy is often defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions," [1] few individuals experience chronic illness, confront health crises, and/or make health decisions entirely alone [2][3][4][5][6][7][8]. For this reason, scholars have called for more empirical research on socioecological influences in health literacy [2,3,6,7,[9][10][11][12]. Conceptualizing health literacy within social networks can capture how skills and knowledge are leveraged for health-related decisions and actions, and how they can be utilized to strengthen health interventions [13].…”

Section: Introductionmentioning

confidence: 99%

Considering Health Literacy, Health Decision Making, and Health Communication in the Social Networks of Vulnerable New Mothers in Hawai‘i: A Pilot Feasibility Study

Sentell

Agner

Pitt

et al. 2020

IJERPH

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Health literacy is understudied in the context of social networks. Our pilot study goal was to consider this research gap among vulnerable, low-income mothers of minority ethnic background in the state of Hawai‘i, USA. Recruitment followed a modified snowball sampling approach. First, we identified and interviewed seven mothers (“egos”) in a state-sponsored home visiting program. We then sought to interview individuals whom each mother said was part of her health decision-making network (“first-level alters”) and all individuals whom the first-level alters said were part of their health decision-making networks (“second-level alters”). Health literacy was self-reported using a validated item. A total of 18 people were interviewed, including all mothers (n = 7), 35% of the first-level alters (n = 7/20), and 36% of the second-level alters (n = 4/11). On average, the mothers made health decisions with 2.9 people (range: 1-6); partners/spouses and mothers/mothers-in-law were most common. One mother had low health literacy; her two first-level alters also had low health literacy. Across the full sample, the average number of people in individuals’ health decision networks was 2.5 (range: 0–7); 39% of those interviewed had low health literacy. This can inform the design of future studies and successful interventions to improve health literacy.

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Health Literacy Beyond the Individual: A Meta-Narrative Review

Cited by 6 publications

References 0 publications

How do patients and carers make sense of renal dietary advice? A qualitative exploration

How do patients and carers make sense of renal dietary advice? A qualitative exploration

Employment Status and Health Literacy in Denmark: A Population-Based Study

Considering Health Literacy, Health Decision Making, and Health Communication in the Social Networks of Vulnerable New Mothers in Hawai‘i: A Pilot Feasibility Study

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