Health literacy in Israel – from measurement to intervention: Two case studies

This report focuses on opportunities, challenges and outcomes of health literacy related interventions in Israel, based on health literacy measurement. The importance of a system’s and community approaches are discussed, as is cultural appropriateness. Two case studies are highlighted - the first on childhood immunization and the second on self-management of chronic health situations. In the second example, a combination of community, media, digital, and face-to-face interventions comprise a broad approach to intervention. The impact and some findings are presented, including conclusions derived from each initiative.

Generic Health Literacy Measurements for Adults: A Scoping Review

Background: Generic health literacy measurement (GHLM) is an important tool to identify individuals with limited health literacy and can assist the design of tailored interventions for improving public health literacy. However, there is no consensus on measuring generic health literacy. The present study aims to review current GHLM used for adults in the literature. Methods: A scoping review was undertaken to map the available measurements designed to assess generic health literacy. Results: The review identified 19 GHLM for adults. Most of them applied a multidimensional definition of health literacy with a focus on individuals’ abilities to access, appraise, understand, and apply health information and services. Nutbeam’s conceptual model and Sørensen’s integrated model were widely used among the identified measures as the theoretical foundation. While the social determinants of health (SDH) were acknowledged in the two models, it remains unmentioned in many of the identified measures based on the Nutbeam’s model and needs further development in the measure based on the Sørensen’s model. A total of 39 different domains were assessed in the 19 measurements: prose was identified in 8 measurements and was the most prominent domain; followed by numeracy (n = 7) and interactive (n = 7). SDH related domains such as social support (n = 3), social capital (n = 1) were seldom included in the identified measurements. Conclusions: Although current GHLM adopted a multidimensional construct, they mainly focused on individuals’ abilities and SDH has not been well-developed in the assessment. Further research is required to advance the measuring of the interaction between SDH and health literacy.

Evolution of Health literacy measurement tools

Introduction This study aimed to provide a review of the tool characteristics and dimensions of health literacy measurement tools. Indeed, it is crucial to establish a clear correlation between what the tools detect and the definition of health literacy. The research question is therefore to what extent health literacy measurement tools are able to detect the ability and levels to make judgment and take decisions in everyday life concerning health. Methods A systematic review was conducted. PubMed, EMBASE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials were searched using MeSH, EMTREE terms, keywords, and keyword phrases on Health literacy tools and instruments from 1990 through 2020. An environmental scan was conducted to identify other health literacy measurement tools. For each tool, researchers evaluated validation, items and conceptual dimensions, and psychometric properties. Results 198 tools were identified, 96 measured general health literacy, 38 measuring comprehension, the others were aimed to assess health literacy for specific diseases or populations. Most tools are performance-based, require in-person administration, and are exclusively available in a pencil and paper testing mode. Reported administration times vary, from less than 1 to 30 minutes. Validation procedures for most of the tools are limited by inadequate power to ensure reliability across subgroups. Conclusions The health literacy measurement tools currently available represent a narrow set of conceptual dimensions with limited modes of administration. Most of the tools are lacking key psychometric properties. Significant work is needed to establish important aspects of the construct, convergent, and predictive validity for many tools. Furthermore, from a more practical point of view doubts emerged about the actual suitability of these tools in the day to day health care/promotion settings. Work is needed to develop more rapid and straightforward tools for practice. Key messages Measure health literacy save lives. Health literacy is a vital sign.