Infectious disease-specific health literacy in Tibet, China

Abstract

Summary This study was aimed to develop an instrument to assess infectious disease-specific health literacy (IDSHL) in the general population of Tibet, China and identify the association between IDSHL and reported infectious disease-related symptoms. A survey using a standardized questionnaire, which included 25 questions on knowledge, behaviors and skills regarding infectious diseases, was conducted in the general population of Tibet, China between September 2011 and November 2011. The 25 questions formed the index system of the instrument assessing IDSHL (total scores: 25 scores). Factors associated with index scores of IDSHL were identified by general linear model. The association between the index score of IDSHL and the occurrence of the five selected infectious disease symptoms (fever, diarrhea, rash, jaundice or conjunctivitis) were investigated using multivariate unconditional logistic regression. Among 5717 eligible participants in the survey, 4631 participants completed all of the 25 questions in the instrument. The instrument was reliable and valid as measured by the Cronbach’s alpha coefficient and split-half coefficient, and the confirmatory factor analysis. Only 1.0% (48/4631) answered ≥80% of the 25 questions correctly (score ≥20). Significant factors associated with lower health literacy score included female gender, older age, Tibetan group, lower education level, underlying diseases and more undeveloped area. For each increasing score of IDSHL, reports of fever, diarrhea or jaundice in the prior year were significantly decreased by 3% (p = 0.015), 4% (p = 0.004) and 16% (p < 0.001), respectively. Accurately measuring IDSHL could help identify those individuals with poor IDSHL, who could be targeted with specific interventions to improve health.

Do Health Information Sources Influence Health Literacy among Older Adults: A Cross-Sectional Study in the Urban Areas of Western China

“…This might be because the minority group were particularly vulnerable to literacy decline among the elderly [ 72 ]. Similar views were identified in prior research from Tibet [ 139 ] and Jilin province [ 140 ] of China. Due to socio-economic status challenges, especially the lower educational attainment, ethnic minority elderly were at risk for poor health literacy [ 141 , 142 ].…”

“…The present study also confirmed the negative association between the financial strain status of “perceived very difficult” and health literacy. This might be because poor financial status would mean disadvantaged access to financial resources [ 2 ], which adversely affect the establishment and the improvement of health literacy [ 139 ]. Moreover, individuals’ good educational and financial status are the social context factors that could help to develop health-related knowledge and capability among older adults.…”

Socio-demographic heterogeneities as determinants of water and food-borne disease burden in Ahmedabad City, India

“…There is empirical evidence of diarrhea disease being closely associated with childhood due to higher exposure and transmission of pathogens [37][38][39] . Other studies have shown that illiteracy, socio-economic status, and sanitation signi cantly impact the distribution of under-ve diarrhea across India 15,40 . One study from Ahmednagar district in western Maharashtra, India, showed that low socio-economic status and poor sanitary conditions are responsible for recurrent diarrhea among children 41 .…”

“…In a theoretical sense, an urbanized environment ought to reduce infectious disease burden by rendering better civic amenities; however, empirical evidence has depicted an elevated risk of infectious diseases in cities, possibly due to consequences stemming from poor sanitation and overcrowding 5,9 . In fact, prior studies have shown that infectious disease burdens in urban settings are in uenced by a myriad of risk factors, including social/economic 10 , sanitation 11 , population demography 12 , nutritional status 13 , lack of awareness 14 , and education 14,15 .…”

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“…119 High HL was associated with higher education levels, young people, and urban residents. 119,120 In Japan, dementia literacy was higher in young people than older adults, in higher educational levels, living with family, accessing more dementia-related information and resources, and higher frequencies of chatting and reading. 121 Meanwhile, in China, low dementia literacy was associated with males, labor work before retirement, low education, susceptible cognitive impairment, and lower income.…”