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Background: Mental health problems represent a growing global concern. This has intensified since the coronavirus pandemic and is also partly due to greater awareness of the extent of mental health problems and the lack of attention they have received over time. In many high-income countries, increases in service provision have been accompanied by efforts to increase the mental health literacy of the general population. One example of this in Australia, is the mental health first aid training program which is informed by the mental health first aid guidelines created to promote mental health literacy among the general population, reduce stigma, and enable lay people to provide timely support, and facilitate access to health services for a person developing a mental health problem or in a mental health crisis. Methods: Between March 2020 and May 2023, a consortium of researchers from Australia, Argentina and Chile carried out the cultural adaptation of five guidelines (drinking problems, depression, suicide risk, trauma, and psychosis) using the Delphi consensus methodology. Health professionals with expertise in each of the topics and people with lived experience (their own or as informal caregivers) from Argentina and Chile were grouped into separate panels. Over two survey rounds, they evaluated the items from the Australian guidelines and gave their opinion on the importance of their inclusion in the local guidelines. Additionally, they suggested items not included in the Australian guidelines. Results: This report presents the details of the methodology used and the most significant results of each of the five adapted guidelines, particularly, those of relevance to the Argentinian and Chilean context. The general acceptance of the role of the first aider stands out as an important outcome. However, in comparison to Australia, the first aider's role was reduced and the health professional role was expanded. Self-help recommendations were typically not endorsed by local experts, suggesting skepticism toward these strategies. Other specific recommendations for each of the guidelines are described and analyzed in this report. Conclusions: A study of the implementation of training courses based on these guidelines is required to make the necessary adaptations and determine their local usefulness.

Introducción: Los problemas de salud mental en la comunidad representan una preocupación global creciente, intensificada desde la pandemia por coronavirus y gracias a una mayor conciencia respecto de su extensión y del bajo nivel de atención que recibieron a lo largo del tiempo. En Australia se crearon las primeras guías de primeros auxilios en salud mental para promover un mayor conocimiento de temas de salud mental en la población general, brindar apoyo oportuno, facilitar el acceso a los servicios de salud por esta problemática, y disminuir el estigma asociado al padecimiento mental. Método: Un consorcio de investigadores de Australia, Argentina y Chile, entre marzo de 2020 y mayo de 2023, realizó la adaptación cultural de cinco guías (consumo problemático de alcohol, depresión, riesgo de suicidio, trauma, y psicosis) siguiendo la metodología de consenso Delphi. Profesionales expertos en cada uno de los temas y personas con experiencia vivida  (propia o como cuidadores informales) conformaron sendos paneles con miembros de Argentina y de Chile. En dos rondas de consulta evaluaron los ítems provenientes de las guías de Australia y opinaron sobre su pertinencia para formar parte de las guías locales. Adicionalmente, sugirieron ítems que no estaban contemplados en las guías australianas. Resultados: El presente reporte presenta el detalle de la metodología empleada y los resultados más significativos de cada una de las cinco guías adaptadas y, particularmente, su aplicabilidad para Argentina y Chile. Sobresale la aceptación general del rol del asistente de primeros auxilios en salud mental, aunque también con limitaciones en el rol y funciones en favor del privilegio de profesionales de la salud. Las recomendaciones de auto-ayuda fueron mayoritariamente no aceptadas por los expertos locales, sugiriendo desconfianza respecto de estas estrategias. Otras recomendaciones específicas para cada una de las guías se describen y analizan en este reporte. Conclusiones: Se requiere un estudio de la implementación de la capacitación en base a estas guías para realizar ulteriores adaptaciones y determinar su utilidad local.

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OBJECTIVE: This study was conducted to examine the relationship between the pre-operative anxiety levels of patients scheduled for thoracic surgery and their e-health literacy levels pertaining to skills such as finding and evaluating electronic health information about health problems. METHODS: This study was a descriptive and correlational study. One hundred and two patients scheduled for thoracic surgery were interviewed in Izmir. The Amsterdam pre-operative anxiety and information scale (APAIS), the Visual Analog Scale for anxiety (VAS-A), the eHealth literacy scale (eHEALS), and a patient information form were used to collect data. RESULTS: The mean VAS-A score of the patients was 6.02 ± 2.51, their mean APAIS score was 18.73 ± 5.85, and their mean eHEALS score was 24.84 ± 9.21. There was no significant relationship between the anxiety and e-health literacy levels of the patients. Significant differences were found in the e-health literacy levels of the patients according to their ages and reasons for surgery. CONCLUSION: Patients scheduled for thoracic surgery were determined to experience moderate anxiety and need moderate levels of information. The patients were also found to have moderate e-health literacy levels. There was no significant relationship between the anxiety and e-health literacy levels of the patients.

OBJETIVO: Examinar la relación entre los niveles de ansiedad pre-operatoria de los pacientes que se someterán a una cirugía torácica y la alfabetización en salud electrónica, como encontrar y evaluar información de salud electrónica sobre problemas de salud. MÉTODOS: Estudio descriptivo y relacional. Para recopilar datos se utilizaron la Escala de Ansiedad e Información Pre-operatoria de Amsterdam (APAIS), la Escala de Ansiedad Analógica Visual (EVA-A) y la Escala de Alfabetización en E-salud, y un formulario de información descriptiva del paciente. RESULTADOS: Según la EVA-A, los niveles de ansiedad de los pacientes fueron de 6.02 ± 2.51. La puntuación APAIS fue de 18.73 ± 5.85. La puntuación de la escala de alfabetización en salud electrónica de los pacientes fue de 24.84 ± 9.21. No hubo una relación significativa entre los niveles de ansiedad de los pacientes y su alfabetización en salud electrónica. Se encontró una diferencia significativa entre los niveles de alfabetización en salud electrónica de los pacientes según su edad y el motive de la cirugía. CONCLUSIONES: Los pacientes que serán sometidos a cirugía torácica experimentan ansiedad moderada y se determinó que necesitan información moderada. También se descubrió que los pacientes tenían niveles moderados de conocimientos sobre cibersalud. No hubo una relación significativa entre la ansiedad y los niveles de alfabetización en salud electrónica de los pacientes.

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BACKGROUND: The frequency of health-related information seeking on the internet and social media platforms has increased remarkably. Thus, the ability to understand and select accurate health-related information online, known as EHealth literacy, is crucial for the population. Therefore, this study aimed to evaluate how eHealth literacy influences the critical analysis of oral health-related information obtained from the Internet and its influence on oral health-related behaviors.  METHODS: A cross-sectional online study was conducted with 418 Brazilian adults who responded to the eHEALS questionnaire, with questions regarding the influence of online information on oral health decisions. Socioeconomic and demographic characteristics were also collected. RESULTS: The mean eHEALS score was 27.85 (± 8.13), with a range spanning from 8 to 40 points. Participants with higher eHEALS scores reported using social media platforms to seek for dentists and to acque information about symptoms, diagnoses, and treatments. Furthermore, this group tended not to disregard professional health recommendations based on Internet information and abstained from utilizing products promoted by digital influencers. In multivariate models, increased eHEALS scores were associated with reduced consumption of products endorsed by digital influencers. CONCLUSIONS: The findings from this study suggest that individuals with higher scores on the eHealth literacy questionnaire often conduct research on their health status and seek for health care providers on the Internet. Moreover, these individuals were less likely to be influenced by digital influencers.

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Introduction: The drinking habit is an important factor of metabolic imbalance among people with diabetes. However, individuals with higher levels of health literacy can perform behaviors that create barriers to the emergence of complications of this disease. Checking the health reading related to the drinking habit can be useful to reduce the consequences of diabetes. Objective: To identify the factors associated with health literacy related to the addiction among people with diabetes assisted by primary health care. Methods: Cross-sectional study conducted in health units in the city of Montes Claros, MG, Brazil. Demographic and economic conditions were analyzed, in addition to the levels of health literacy assessed from the instrument Alcohol Health Literacy. Results: The study included 215 people with diabetes with a mean age of 60.73 years, mostly women (63.7%; n=137). Lower levels of alcohol health literacy were present in 31.2% (n=67) of the participants. The following variables were associated with lower levels of health literacy: sex (men, OR 0.46; 95%CI 0.23-0.94; p=0.032), low schooling (early childhood education, OR 7.00; 95%CI 2.55-19.20; p<0.001; illiterate, OR 28.06; 95%CI 4.40-178.83); and spending on diabetes-related drugs (OR 2.27; 95%CI 1.14-4.50; p=0.019). Conclusion: There were better levels of health literacy related to the habit of alcohol use among men, with higher education and who did not have spending on diabetes-related drugs.

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BACKGROUND: Low medication literacy is prevalent among older adults and is associated with adverse drug events. The Medication Literacy Test for Older Adults (TELUMI) was developed and content validated in a previously published study. AIM: To evaluate the psychometric properties and provide norms for TELUMI scores. METHOD: This was a cross-sectional methodological study with older adults selected from the community and from two outpatient services. Descriptive item-analysis, exploratory factor analysis (EFA), item response theory (IRT), reliability, and validity analysis with schooling and health literacy were performed to test the psychometric properties of the TELUMI. The classification of the TELUMI scores was performed using percentile norms. RESULTS: A total of 344 participants, with a mean age of 68.7 years (standard deviation = 6.7), were included; most were female (66.6%), black/brown (61.8%), had low schooling level (60.2%) and low income (55.2%). The EFA pointed to the one-dimensional structure of TELUMI. A three-parameter logistic model was adopted for IRT. All items had an adequate difficulty index. One item had discrimination < 0.65, and three items had an unacceptable guessing index (< 0.35) and were excluded. The 29-item version of TELUMI had excellent internal consistency (KR20 = 0.89). There was a positive and strong association between TELUMI scores and health literacy and education level. The scores were classified as inadequate medication literacy (≤ 10.0 points), medium medication literacy (11-20 points), and adequate medication literacy (≥ 21 points). CONCLUSION: The results suggest that the 29-item version of TELUMI is psychometrically adequate for measuring medication literacy in older adults.

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BACKGROUND: Health literacy (HL) impacts people's health and well-being. In Latin America and the Caribbean (LAC), there are no general estimates of the prevalence of low HL. This study aimed to estimate the prevalence of low HL among citizens of LAC and identify the tools used to measure it. METHODS: We included observational studies quantifying the prevalence of low HL in people living in LAC. We searched PubMed, CINAHL, EMBASE, ERIC, LILACS, PsycINFO, Redalyc, SciELO, Web of Science, PQDT, and the reference lists of the included studies in June 2023. Two reviewers independently conducted the selection, extraction, and risk of bias assessment using the JBI Critical Appraisal Tools. Meta-analysis of proportions using random effects models was used to summarize the prevalence of low HL estimated. This prevalence was measured in each study using different classification methods: word recognition items, reading and numeracy comprehension items, and self-reported comprehension items. RESULTS: Eighty four studies involving 23,914 participants from 15 countries were included. We identified 23 tools to assess HL, and most of the studies were carried out in health services. The pooled prevalence of low HL were 44.02% (95%CI: 36.12-52.24) for reading and numeracy comprehension items, 50.62% (95%CI: 41.82-59.39) for word recognition items, and 41.73% (95%CI: 31.76-52.43) for self-reported comprehension items. CONCLUSION: Despite the variability in the prevalence of low HL and a diversity of tools, the average of low HL is of concern. Almost half of the participants in the included studies have low HL. Most of the studies targeted users of healthcare services. Further research investigating the prevalence of low HL in the general population and actions focused on health education, communication, and information are necessary. TRIAL REGISTRATION: PROSPERO (CRD42021250286).

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BACKGROUND: Health literacy (HL) is a key component of health promotion and sustainability and contributes to well-being. Despite its global relevance, HL is an under-researched topic in South America but is now debuting its exploration in Brazil. To leverage its benefits for South America, the mere translation of validated tools into Portuguese is insufficient. Rather, it is necessary to examine their validity. This study aims to assess the psychometric properties of the European Health Literacy Questionnaire (HLS-EU-BR47) using the Item Response Theory (IRT) in a population-based sample of adults in Brazil. METHODS: A cross-sectional online study was conducted across Brazil and included 1028 participants aged 18 years and above (80% women). Cronbach's alpha, McDonald's omega, factor analysis, graded responses model, Item Characteristic Curve, HL levels based on this, HL standard calculation, IRT, and regular score correlation were computed. RESULTS: The instrument exhibit high reliability (Cronbach's alpha 0.95). Factor analysis yielded one factor. IRT was appropriate for data analysis because it allowed quality evaluation of items and constructed a scale to quantify HL. The 47 items and latent features of respondents in the same unit of measurement are positioned in the construction of the HLS-EU-BR47 instrument. The percentages of individuals at each HL level, calculated using IRT, were found to be comparable to those obtained through the standard computation, e.g., 3.2% of people reported very low HL versus 10.8% inadequate HL, 56.2% reported low HL versus 39.5% problematic HL, 31.1% had moderate HL versus 30.1% sufficient HL, and 9.5% had high HL versus 19.7% with excellent HL. The mean HL scores were comparable between women and men (33.9 vs. 33.7, P = 0.36). CONCLUSION: This study provides new evidence of the validity of a widely used HL instrument for the population of South America (in this case, Brazil). This tool can be utilized by citizens, health professionals, and regional/national policymakers to inform the development of initiatives to assess and improve the HL of individuals, groups, and communities. Further studies are needed to confirm and extend the findings and to explore the influence of local cultures and practices in the vast Brazilian territory on HL.

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Objetivo: identificar o Letramento em Saúde (LS), relacionados ao HIV/aids, à Tuberculose, às Hepatites Virais e às Infecções Sexualmente Transmissíveis (IST), na área de conhecimento da Enfermagem. Métodos: Pesquisa exploratória, descritiva, com base em materiais documentais, acerca do HIV/aids, tuberculose, hepatites virais e IST, no campo da Enfermagem, considerando as produções de dissertações e teses, até o ano de 2023. Resultados: Elencou-se 62 produções abordando o LS na área de conhecimento em Enfermagem, sendo a primeira em 2012. Após análise, identificou-se nove estudos: três teses (33,3%) e seis dissertações (66,7%), sendo, cinco (55,6%) de HIV/ Aids, um (11,1%) de tuberculose, um (11,1%) de hepatite C e dois (22,2%) de IST. Conclusão: As produções incipientes sobre LS no contexto do HIV/aids, tuberculose, hepatites virais e IST, bem como, na área de Enfermagem, requer o desenvolvimento de novas investigações, visto a proposta de eliminar essas doenças/ infecções como problema de saúde pública até 2030. Faz-se necessário compreender o LS dos indivíduos nessas áreas, como ferramenta para potencializar a atenção prestada, principalmente, no contexto da APS, considerando a atuação da enfermagem como estratégica para o planejamento e a oferta do cuidado e para a promoção do autocuidado. (AU)

Objective: to identify Health Literacy (HL), related to HIV/AIDS, Tuberculosis, Viral Hepatitis and Sexually Transmitted Infections (STIs), around nursing knowledge. Methods: This is an exploratory, descriptive research, based on documentary materials, about HIV/AIDS, tuberculosis, viral hepatitis and STIs, in the field of nursing, considering the production of dissertations and theses, until the year 2023. Results: 62 productions were listed addressing LS around knowledge in Nursing, the first being in 2012. After analysis, nine studies were identified: three theses (33.3%) and six dissertations (66.7%), five (55.6%) of HIV/AIDS, one (11.1%) of tuberculosis, one (11.1%) of hepatitis C and two (22.2%) of STIs. Conclusion: The incipient productions on LS in the context of HIV/AIDS, tuberculosis, viral hepatitis and STIs, as well as, around nursing, requires the development of new investigations, given the proposal to eliminate these diseases/infections as a public health problem by 2030. if necessary, understand the HL of individuals in these areas, as a tool to enhance the care provided, mainly in the context of PHC, considering nursing actions as strategic for planning and offering care and promoting self-care. (AU)

Objetivo: identificar la Alfabetización en Salud (AS), relacionada con VIH/SIDA, Tuberculosis, Hepatitis Virales e Infecciones de Transmisión Sexual (ITS), en el área de conocimiento de enfermería. Métodos: Se trata de una investigación exploratoria, descriptiva, basada en material documental, sobre VIH/SIDA, tuberculosis, hepatitis virales e ITS, en el campo de la enfermería, considerando la producción de disertaciones y tesis, hasta el año 2023. Resultados: 62 producciones. fueron listados abordando LS en el área de conocimiento en Enfermería, siendo el primero en 2012. Luego del análisis, se identificaron nueve estudios: tres tesis (33,3%) y seis disertaciones (66,7%), cinco (55,6%) sobre VIH/ SIDA, uno (11,1%) de tuberculosis, uno (11,1%) de hepatitis C y dos (22,2%) de ITS. Conclusión: Las incipientes producciones sobre LS en el contexto de VIH/SIDA, tuberculosis, hepatitis virales e ITS, así como así como, en el área de enfermería, requiere el desarrollo de nuevas investigaciones, ante la propuesta de eliminar estas enfermedades/infecciones como un problema de salud pública para el año 2030. De ser necesario, entender la AS de los individuos en estas áreas, como una herramienta. potenciar los cuidados prestados, principalmente en el contexto de la APS, considerando las acciones de enfermería como estratégicas para planificar y ofrecer cuidados y promover el autocuidado. (AU)

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Objective: Health literacy is associated with many patient outcomes. This study sought to determine the association between a person's level of health literacy and their knowledge about Chagas disease. Methods: A cross-sectional survey was conducted with people living in two counties in rural Loja Province, Ecuador who attended a mobile health clinic. The communities in which the study was conducted are at high risk of Chagas disease and have limited access to both health care and educational resources. The Spanish version of Short Assessment for Health Literacy measured health literacy. The Chagas Disease Knowledge questionnaire measured knowledge of Chagas disease. T-tests and correlational analysis were used to assess associations. Results: Overall 85 people participated in this study. A majority of the respondents were female (64.1%), and a plurality were married (40.7%) and had education less than secondary (40.7%). The average age of the sample was 44.31 ± 18.85. Health literacy levels and Chagas disease knowledge in the communities were low. About half of people had inadequate health literacy. No association between health literacy and Chagas knowledge was found. Conclusion: Health literacy levels and Chagas disease knowledge were not found to be correlated. Explanations for the lack of association may include common causes of inadequate investment in Chagas disease education as well as neglect of health systems in rural Ecuador. Efforts to improve both health literacy and Chagas disease knowledge in poorer, rural areas of Ecuador are needed. Innovation: This is the first study to assess relationships between health literacy and knowledge of Chagas disease in an uninfected population. For novel conditions, relationships between health literacy and disease knowledge should be investigated before communication campaigns are adapted.

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PURPOSE: This study aims to conduct a thorough analysis of the concept of insufficient health literacy (IHL) in older adults and to refine a nursing diagnosis proposal while considering the specific characteristics of this demographic. METHODS: A comprehensive concept analysis was undertaken using Walker & Avant's method as a framework. FINDINGS: A systematic search across seventeen databases yielded 29 relevant studies for inclusion. Through analysis, we identified 15 antecedents, 3 attributes, and 7 consequents associated with IHL in older adults. CONCLUSIONS: The concept analysis brought clarity to the understanding of IHL within older adults, facilitating the refinement of a diagnosis proposal. This process was instrumental in establishing a diagnostic structure that accounts for the unique needs and challenges faced by older adults. IMPLICATIONS FOR NURSING PRACTICE: The structured diagnosis derived from the concept analysis provides a solid theoretical foundation for nurses specializing in Gerontology. By tailoring care interventions to address the specific requirements of older adults, this framework enhances the quality of nursing practice and contributes to improved patient outcomes in geriatric care settings.

OBJETIVO: Este estudo tem como objetivo realizar uma análise detalhada do conceito de Letramento em saúde insuficiente na população idosa e refinar uma proposta de diagnóstico de enfermagem, levando em consideração as características específicas desse público. MÉTODOS: Foi realizada uma análise conceitual abrangente utilizando o método de Walker & Avant. RESULTADOS: Uma busca sistemática em dezessete bases de dados resultou em 29 estudos relevantes para inclusão. Através da análise, identificamos quinze antecedentes, três atributos e sete consequentes associados ao Letramento em saúde insuficiente na população idosa. CONCLUSÕES: A análise conceitual trouxe clareza à compreensão do Letramento em saúde insuficiente na população idosa, facilitando o refinamento de uma proposta de diagnóstico. Esse processo foi fundamental para estabelecer uma estrutura diagnóstica que considera as necessidades e desafios únicos enfrentados pelos idosos. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: O diagnóstico estruturado derivado da análise conceitual fornece uma base teórica sólida para enfermeiros especializados em Gerontologia. Ao adaptar intervenções de cuidados para atender aos requisitos específicos dos idosos, esse framework melhora a qualidade da prática de enfermagem e contribui para resultados de pacientes aprimorados em ambientes de cuidados geriátricos.

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OBJECTIVE: Limited Health Literacy implies an insufficient understanding of relevant health information, being associated with various variables. The objective of the study was to measure the prevalence of the level of Limited Sexual and Reproductive Health Literacy (AS-SR), its associated variables and the differences in scores between levels of AS-SR, universities and science of study in Chilean university students. METHODS: A multicenter and cross-sectional study, which applied a validated scale to measure levels of AS-SR, was carried out in a sample of 2,186 Chilean university students, categorizing it as high, medium high, medium low and low. The level of Limited AS-SR was obtained by adding the medium-low and low categories. Tests were carried out: descriptive, psychometric and reliability; association, logistic regression and differences between variables of interest. RESULTS: The prevalence of Limited AS-SR was 52.7%. The variables most associated with the level of Limited AS-SR were: low interest in information about health care (OR=2.819; 95% CI: 2.132-3.726), prevention (OR=2.564; 95% CI: 1.941-3.388), sexuality (OR=2.497; 95% CI: 1.807-3.452) and health promotion (OR=1.515; 95% CI: 1.239-1.853); certain sources of Information (OR=1.915; 95% CI:1.614-2.272); low economic income (OR=1.661; 95% CI: 1.361-2.026), among others. There were statistically significant differences in scores between categories of AS-SR levels, universities and study science. The scale had a reliability of 0.940. CONCLUSIONS: More than half of the students have Limited AS-SR, mainly associated with low interest in health information. The scale presents excellent psychometric indicators, being recommended for diagnoses of health situations.

OBJECTIVE: La Alfabetización en Salud Limitada implica una comprensión insuficiente de la información relevante en salud, asociándose con diversas variables. El objetivo del estudio fue medir la prevalencia del nivel de Alfabetización en Salud Sexual y Reproductiva (AS-SR) Limitada, sus variables asociadas y las diferencias de puntajes entre niveles de AS-SR, universidades y ciencia de estudio en universitarios chilenos. METHODS: Se realizó un estudio multicéntrico y transversal, que aplicó una escala validada para medir niveles de AS-SR, en una muestra de 2.186 estudiantes universitarios chilenos, categorizándola en alta, media-alta, media-baja y baja. El nivel de AS-SR Limitada se obtuvo mediante el sumatorio de categorías media-baja y baja. Se realizaron pruebas: descriptivas, psicométricas y fiabilidad; asociación, regresión logística y de diferencias entre variables de interés. RESULTS: La prevalencia de AS-SR Limitada fue del 52,7%. Las variables mayormente asociadas al nivel de AS-SR Limitada fueron: bajo interés en información sobre atención en salud (OR=2,819; IC 95%:2,132-3,726), prevención (OR=2,564; IC 95%: 1,941-3,388), sexualidad (OR=2,497; IC 95%: 1,807-3,452) y promoción de la salud (OR=1,515; IC 95%: 1,239-1,853); ciertas fuentes de Información (OR=1,915; IC 95%:1,614-2,272); bajo ingreso económico (OR=1,661; IC 95%: 1,361-2,026), entre otras. Existieron diferencias estadísticamente significativas de puntajes entre categorías de niveles de AS-SR, universidades y ciencia de estudio. La escala presentó fiabilidad de 0,940. CONCLUSIONS: Más de la mitad de los estudiantes poseen AS-SR Limitada, asociada principalmente al bajo interés en información en salud. La escala presenta excelentes indicadores psicométricos, siendo recomendable para diagnósticos de situación de salud.

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This study aimed to analyze the communication process of healthcare professionals for the promotion of health literacy. It is a qualitative study that utilized individual online interviews with 46 healthcare professionals working in Brazil. The thematic content analysis technique proposed by Bardin was employed, and Atlas Ti software assisted in the assessment and interpretation of the texts. Content categorization revealed 26 sub-themes, and the coding of these identified nine themes and three categories. The communication process in health literacy education was composed of a set of interdependent and interrelated variables termed emotions, professional preparedness, interprofessional collaboration, patient needs assessment, building rapport, family inclusion in the educational process, environmental aspects, strategies, and resources for teaching and learning. These data may support the analysis of health communication in healthcare services, the creation of data collection instruments, and the development of training programs to enhance skills within the context of the identified variables.

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BACKGROUND: Although comprehensive lifestyle habits are crucial for healthy aging, their adherence tends to decline as individuals grow older. Sustaining a healthy life over time poses a motivational challenge. Some digital tools, such as smartphone apps aimed at promoting healthy habits, have been used to counteract this decline. However, a more profound investigation is necessary into the diverse experiences of users, particularly when it concerns older adults or those who are unfamiliar with information and communications technologies. OBJECTIVE: We aimed to develop a mobile app focused on promoting the health of older adults based on the principles of software engineering and a user-centered design. The project respected all ethical guidelines and involved the participation of older adults at various stages of the development of the app. METHODS: This study used a mixed methods approach, combining both quantitative and qualitative methodologies for data collection. The study was conducted in Ribeirão Prêto, São Paulo, Brazil, and involved 20 older adults of both genders who were aged ≥60 years and enrolled in the Physical Education Program for the Elderly at the University of São Paulo. The research unfolded in multiple phases, encompassing the development and refinement of the app with active engagement from the participants. RESULTS: A total of 20 participants used a mobile health app with an average age of 64.8 (SD 2.7) years. Most participants had a high school education, middle-class status, and varying health literacy (mean score 73.55, SD 26.70). Overall, 90% (18/20) of the participants owned smartphones. However, 20% (4/20) of the participants faced installation challenges and 30% (6/20) struggled with web-based searches. The focus groups assessed app usability and satisfaction. Adjustments increased satisfaction scores significantly (Suitability Assessment of Materials: 34.89% to 70.65%; System Usability Scale: 71.23 to 87.14). Participant feedback emphasized font size, navigation, visual feedback, and personalization, and suggestions included health device integration, social interaction, and in-app communication support. CONCLUSIONS: This study contributes to the development of health care technologies tailored to the older adult population, considering their specific needs. It is anticipated that the resulting app will serve as a valuable tool for promoting healthy habits and enhancing the quality of life for older adults.

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Introduction: Older people are the group with the greatest digital gap, so their digital literacy is important to improve the conditions in which they age. Methods: A study was conducted with pre- and post-evaluation of a digital literacy (DL) intervention in people aged 60 years and over. A total of 56 participants (experimental group N = 32 and control group N = 24) were recruited for convenience in community centers. The intervention was adapted to the needs of the participants, there were five face-to-face sessions and remote reinforcement for three months, carried out by trained university students for five months. Sociodemographic variables such as self-perception of socioeconomic level and education, among others, were evaluated. The impact was assessed using the digital literacy scale (MDPQ16), indicators of frequency and types of internet and mobile phone use, health literacy (SAHLSA and NSV), quality of life (SF-12), hedonic well-being (Diener's SWLS and Cummins' PWI) and perceived social support using the Zimet scale. Results: The intervention had a significant impact with an effect size of r = 0.27 on digital literacy, separate t-test comparisons revealed a markedly significant change for digital literacy in the experimental group, before and after the pre-post t-test(31) = 3.56, p = 0.001, but not in the control group, t(23) = 0.082, p = 0.93. No direct impact on health literacy, health-related quality of life, and hedonic well-being was identified. We examined the indirect impact of change in digital literacy and found that it correlated with improvements in well-being and social support, as well as quality of life. Individuals with significant changes were detected and compared with those who did not change. Discussion: Evaluation that contributes by identifying elements for improvement in future interventions and discusses the importance of culturally adapting continuing education in older people.

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Research suggests that health literacy (HL) is critical in preventing and managing health problems. However, over half of adults in Mexico report having inadequate health literacy. Research suggests the parent-child relationship can be a key predictor of developmental competencies; however, little research has examined how dyadic family interactions relate to HL. This study examined whether parent-child relationship conflict was associated with adolescent health literacy among families living in Mexico. Data from a parent-child dyads in Mexico were gathered using online surveys (N = 746, 373 parent-child dyads). Our findings suggested that child-reported family conflict-but not parent-reported family conflict - was associated with lower adolescent health literacy. Researchers and practitioners should consider how parent-child conflict may impact adolescent health outcomes, and prioritise child reports in data collection.

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BACKGROUND: Disparities in the timely diagnosis and care of cancer patients, particularly concerning geographical, racial/ethnic, and economic factors, remain a global health challenge. This study explores the multifaceted interplay between socioeconomic status, health literacy, and specific patient perceptions regarding care access and treatment options that impact cancer care in Uruguay. METHODS: Using the Cancer Health Literacy Test, Spanish Version (CHLT-30-DKspa), and a highly comprehensive questionnaire, we dissected the factors influencing the pathway to diagnosis and route of cancer care. This was done to identify delays by analyzing diverse socioeconomic and sex subgroups across multiple healthcare settings. RESULTS: Patients with lower income took longer to get an appointment after showing symptoms (p = 0.02) and longer to get a diagnosis after having an appointment (p = 0.037). Race/ethnicity also had a significant impact on the length of time from symptoms to first appointment (p =0.019), whereas employment status had a significant impact on patients being susceptible to diagnostic delays beyond the advocated 14-day window (p = 0.02). Higher educational levels were positively associated with increased cancer health literacy scores (p = 0.043), revealing the potential to mitigate delays through health literacy-boosting initiatives. Women had significantly higher self-reported symptom duration before seeking an intervention (p = 0.022). We also found many other significant factors effecting treatment delays and cancer health literacy. CONCLUSIONS: While affirming the global pertinence of socioeconomic- and literacy-focused interventions in enhancing cancer care, the findings underscore a complex, gendered, and perceptually influenced healthcare navigation journey. The results highlight the urgent necessity for strategically crafted, globally relevant interventions that transcend equitable access to integrate literacy, gender sensitivity, and patient-perception alignments in pursuit of optimized global cancer care outcomes.

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Background and purpose: Assessment of digital health literacy should be a major concern for healthcare providers. We aimed to translate and adapt the Digital Health Literacy (DHL) Instrument into Brazilian Portuguese and examine the content validity for individuals with heart failure (HF). Methods: The instrument was translated, back translated, and evaluated by a panel of six experts regarding linguistic equivalences. An agreement analysis was performed, with values ≥80% considered acceptable. The experts then evaluated clarity, theoretical relevance, and practical pertinence. The content validity index (CVI) was calculated for each item. A CVI ≥.83 was considered acceptable. The expert's opinions were also evaluated through the modified kappa coefficient for content validity studies. Values >.74 were considered excellent. The content validity ratio (CVR) was also calculated. A critical value of CVR of 1.00 was determined. Cognitive testing (understanding the meaning of each item and their respective answers) was performed with 33 individuals with HF. Results: The adapted version obtained an agreement of ≥83.3% for each item on linguistic equivalences. Total CVI was ≥0.83, kappa values for each item were >.74, and the CVR values were 1.00 for all items. After two rounds of evaluation, all patients were able to understand the items and response scale. Conclusions: The Brazilian version has satisfactory evidence of linguistic and content validity to measure DHL in patients with HF. Additional psychometric properties will be tested in the country.

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OBJECTIVE: To assess the relationship between the self-perceived consultation time and the knowledge of the proposed treatment. METHODS: Secondary data from a 2015 national survey of health services in Peru were analyzed. The self-perceived consultation time was calculated by asking how long it took from when you entered the consultation until you departed. It was then categorized as low, medium, and high. Five self-reported questions were used to construct a knowledge of the prescribed treatment. Adjusted regression models from the Poisson family models were used to evaluate the relationship. We report adjusted prevalence ratios (aPR) with their 95% confidence intervals (95%CI). RESULTS: A total of 9939 outpatients were analyzed, with 58% women; the average age was 44 years; and 45.4% had higher education. Using low self-perceived consultation time as references, medium and high consultation times were associated with understanding the prescribed treatment (aPR=1.17; 95%CI, 1.04-1.33 and aPR=1.30; 95%CI, 1.20-1.40, respectively). CONCLUSION: Patients who reported a medium and high self-perceived consultation time better understood the prescribed treatment. IMPLICATIONS FOR PRACTICE: Healthcare professionals should strive to maximize consultation time to ensure effective communication and improve patient knowledge of treatments, improving overall patient satisfaction and health outcomes.

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Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population. In addition, personal factors (i.e., demographics) were analyzed to determine their influence on the nurse's predictions and patients' HLL. Data were collected from 84 participant patient-nurse couplets admitted to a medical-surgical unit in a rural setting located on the United States-Mexico border. In addition to demographic information collected via survey, RNs were asked to predict their patient's health literacy abilities while the Newest Vital Sign, a health literacy assessment tool, was deployed to determine the actual HLL of patients participating in the study. Data were analyzed using descriptive statistics, t-tests, and chi-square tests while a Spearman correlational model was used to examine the relationship between predicted HLL and actual HLL. Finally, a logistic regression model was used to analyze the relationship between personal factors and HL data for RNs and patients. Analysis of the data revealed that RNs consistently overestimated patients' abilities, as evidenced by the disparity between patients' actual HLL (mean 1.71) and predicted HLL (mean 4.26) by RNs, with a moderately strong positive relationship (rs = .418). Notably, higher academic preparation and years of experience did not enhance the RNs' ability to identify LHL while the highest level of education completed was the only statistically significant predictor of adequate health literacy in the patient population sampled. These findings emphasize the need to prioritize effective health literacy education in RN academic preparation and clinical practice to support the detection of LHL when a standardized health literacy assessment tool is not utilized in the clinical setting. By recognizing the presence of LHL, healthcare professionals can better support patients' needs and bridge the knowledge gap, ultimately improving patient outcomes.

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PURPOSE: This study aimed to evaluate the association of oral health literacy (OHL) and oral health-related quality of life (OHRQoL) of pregnant women. METHODS: This cross-sectional study evaluated a representative sample of pregnant women assisted in public health services in southern Brazil. Demographic, socioeconomic, psychosocial and behavioural data were collected through structured questionnaires. The Oral Health Impact Profile (OHIP-14) questionnaire was used to evaluate the OHRQoL. The Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) was used to measure OHL. Dental caries and gingival bleeding were evaluated by clinical examinations. Adjusted multilevel Poisson regression models with a hierarchical approach were used to assess the associations. The results are presented as rate ratio (RR) and 95% confidence interval (95% CI). RESULTS: A total of 520 pregnant women were evaluated. Pregnant women with lower levels of OHL presented overall OHIP-14 scores 14% higher (RR 1.14; 95% CI 1.07-1.22) than their counterparts. High household income and high education level were related to low overall OHIP-14 scores. Furthermore, less dental attendance, low social support, untreated dental caries and gingival bleeding were also associated with high overall OHIP-14 scores. CONCLUSION: Our findings reinforce that health literacy levels influence patient-reported outcomes. Pregnant women with lower OHL were more likely to present poorer OHRQoL.

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