Large diversity in Danish health literacy profiles: perspectives for care of long-term illness and multimorbidity

Abstract

Background Health literacy is an important, modifiable, social determinant of health. This study aims to explore health literacy challenges of people with long-term illness or multimorbidity and provide detailed profiles revealing health literacy strengths and weaknesses within a Danish population. Methods In this cross-sectional study among Danish individuals (n = 490), health literacy was assessed using the nine-scale Health Literacy Questionnaire (HLQ). Using multiple logistic regression and hierarchical cluster analysis, we estimated the association between HLQ scale scores and the likelihood of long-term illness and multimorbidity, and identified socio-demographic and health characteristics related to profiles of health literacy strengths and weaknesses. Results An increase in ‘actively managing my health’ and ‘social support for health’ decreased the odds of having a long-term illness [odds ratio, OR 0.53 (0.31–0.9); OR 0.43 (0.24–0.74)] and multimorbidity [OR 0.51 (0.26–0.98); OR 0.33 (0.17–0.62)], respectively. Conversely, an increase in ‘healthcare provider support’ increased the odds of having long-term illness [OR 2.97 (1.78–5.08)] and multimorbidity [OR 2.94 (1.53–5.87)], respectively. Five profiles were identified based on the cluster analysis. Each cluster was characterized by specific health characteristics, e.g. Cluster A by better health status (χ2 = 39.976 (4), P < 0.001) and well-being (χ2 = 28.832 (4), P < 0.001) and Cluster D by poor health status (χ2 = 39.976 (4), P < 0.001) and increased likelihood of long-term illness (χ2 = 18.641 (4), P < 0.001). Conclusions The association of health literacy with long-term illness and multimorbidity in combination with the health literacy profiling based on cluster analysis provides a comprehensive needs assessment and a promising starting point for the development of health literacy responsive interventions.

Health Literacy among People in Cardiac Rehabilitation: Associations with Participation and Health-Related Quality of Life in the Heart Skills Study in Denmark

“…To a large extent, our population resembles other populations in cardiac rehabilitation, with a large proportion of men and a relatively high mean age [1]. Compared with a similar study in a general Danish population [41], the HLQ scores of our population are low for scales 5 through 9, while the mean score for scale 3 (actively managing my health) was somewhat high in comparison. In summary, the population generally has low "cognitive capacities", while the level of "executive capacities" is more mixed (cf.…”

“…However, in our study, this association did not reach statistical significance. Thus, even though most cardiac rehabilitation programs focus on educating patients about disease and risk, the learning needs that people with low PCS present with may also be associated with their ability to act upon this knowledge and use the health system in an appropriate way [36,41].…”

Identifying Core Variables Associated With Health Literacy in Kidney Transplant Recipients

“…The association between poor health and low HL has been found in several studies (71,72,81,(171)(172)(173). In the context of kidney transplant recipients, studies have focused on objective measures of health and found lower HL-scores to be associated with higher blood pressure (122), higher creatinine (18,22) and lower eGFR (22).…”

Using the Health Literacy Questionnaire (HLQ) with Providers in the Early Intervention Setting: A Qualitative Validity Testing Study

“…Evidence for the consequences of testing is a long-term effort requiring pre-post data. This is an ongoing process through the use of the HLQ in the Optimising Health Literacy and Access (Ophelia) process [51][52][53][54], which is now being widely implemented through independent projects and the WHO National Health Literacy Demonstration Projects (NHLDPs) [55]. This study with EI providers contributes evidence based on response processes for the interpretation of HLQ data from healthcare providers.…”