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Our objective was to assess the level and sociodemographic correlates of health literacy (HL) among university students of health sciences in Kosovo. A cross-sectional study was conducted in Kosovo during February-April 2024, including 470 students of health sciences from the universities of Prishtina and Gjakova (≈86% females; mean age: 20.7±2.7 years; response rate: 70%). The internationally standardised European Health Literacy Survey Questionnaire (HLS-EU-Q) was self-administered, along with information on sociodemographic factors. Binary logistic regression was used to assess the independent sociodemographic correlates of HL. Only 7% of the students exhibited \"inadequate and/or problematic\" HL, whereas about 93% of participants displayed \"sufficient and/or excellent\" HL. In multivariable-adjusted binary logistic regression models, \"inadequate and/or problematic\" HL was strongly and positively associated with the male gender only (OR=3.6, 95%CI=1.5-8.9). We evidenced a relatively high general HL level among university students of health sciences in Kosovo, especially among females. Enhancing HL among future health professionals could guide policies that prioritise embedding health education and resources into higher education institutions, potentially improving students' health behaviours and health outcomes, as a major prerequisite for their future work with patients and communities.

Health literacy entails the knowledge, motivation, and competencies to access, understand, appraise, and apply health information in order to make judgments and decisions in everyday life concerning health care, disease prevention, and health promotion to maintain or improve quality of life throughout the life course. It has become an essential concept in public health. It is considered a modifiable determinant of health decisions, health behaviors, health, and healthcare outcomes. Prior studies suggest highly variable levels of health literacy across European countries. Assessing and monitoring health literacy is critical to support interventions and policies to improve health literacy. This study aimed to describe the process of adaptation to Portugal of the short-form version of the Health Literacy Survey (HLS19-Q12) from the Health Literacy Population Survey Project 2019–2021, also establishing the health literacy levels in the Portuguese population. The sample comprised 1247 valid cases. The survey consisted of a brief questionnaire on the determinants of health literacy, plus the HLS19-Q12 questionnaire and the specific health literacies packages on digital health literacy, navigational health literacy, and vaccination health literacy. The results suggest that 7 out of 10 people in Portugal (mainland) have high health literacy levels and support the results of other studies concerning the main socioeconomic determinants of general health literacy. Furthermore, the results suggest that “navigation in the health system” tasks are the most challenging tasks regarding specific health literacies. The overall data suggest the HLS19-Q12 as a feasible measure to assess health literacy in the Portuguese population. Thus, it can be used in Portugal to assess the population’s needs and monitor and evaluate policies and initiatives to promote health literacy by addressing its societal, environmental, personal, and situational modifiable determinant factors.

As our societies transform into knowledge societies, skills are playing an ever-increasing role in life. Despite recent efforts to consistently measure adult skills across countries, a challenge remains to understand how skills evolve over time and what the main drivers behind these changes are. By applying demographic methods to estimate the development of skills over the life course, this paper presents the reconstruction of empirical adult literacy test results along cohort lines by age, sex, and educational attainment for 44 countries for the period 1970-2015. Results suggest significant heterogeneity in the pattern of changes in literacy skills with age, reflecting the differential exposure to cognitive stimulation over the life course and suggesting that the development of skills in a country is also the consequence of a changing composition of its population. Gender, however, was found to have hardly any effect on how literacy skills evolve between the ages of 15 and 65. On the aggregate level, findings reveal considerable differences between countries - regarding both the level of skills and their development over time. Overall, it was found that massive educational expansions happening globally in the recent past only partly resulted in a corresponding rise in skills.

Using Item Response Theory to analyse survey data from a representative sample of 551 Swedish citizens, a new 16-question measure of fact-based financial literacy is developed and validated. Uni-dimensionality of the measure is verified, and expected correlations are observed with an existing measure of fact-based financial literacy, a measure of subjective financial literacy or confidence, and age, gender, and income. A significant impact of fact-based and subjective financial literacy are found on three time-ordered stages of individuals’ retirement behaviour: planning, saving, and investment management. It is concluded that policies increasing final literacy are important in different phases of the life cycle.

The number of cancer survivors in Switzerland is increasing. Many individuals face challenges in dealing with health-related information and navigating the health care system. Digitalization offers new care and support opportunities, but its effective use requires digital and navigational health literacy (HL) and self-management skills. This study aimed to assess the competencies of cancer survivors in Switzerland, compare them with those of the general population, and identify vulnerable subgroups. A cross-sectional online survey was conducted using validated scales from the Health Literacy Survey 2019-2021 (HLS19), measuring digital HL, interaction with digital devices, frequency of use of digital resources, and navigational HL. Self-management skills were assessed with the Health Education Impact Questionnaire (heiQ). HLS19 scores were compared to data from the general Swiss population and a subpopulation with chronic diseases provided by the Federal Office of Public Health, using Mann-Whitney U tests, chi-square tests, and independent t tests. Regression analyses identified associations of sociodemographic and clinical factors with digital and navigational HL and self-management skills. A total of 131 cancer survivors (74.8% female, 41% with breast cancer) completed the survey. Only 30% reported high digital HL, while self-management skills were generally high, particularly in \"health service navigation\" (median 3.6, IQR 0.8 on a 4-point Likert scale) and \"constructive attitudes\" (median 3.6, IQR 1). Compared to the general population, cancer survivors had significantly higher scores in digital interaction and digital resource use (P≤.002), while no differences were observed in digital or navigational HL. Digital and navigational HL, as well as self-management, were consistently associated with education level, social support, and financial deprivation. Cancer survivors in Switzerland report low digital and navigational HL, comparable to the general population, while self-management skills were strong overall. Support strategies should simultaneously target individual and systemic factors to improve cancer survivors' ability to access and use digital health resources. Future research should include a more representative sample to validate these findings.

Health literacy entails the knowledge, motivation, and competencies to access, understand, appraise, and apply health information in order to make judgments and decisions in everyday life concerning health care, disease prevention, and health promotion to maintain or improve quality of life throughout the life course. It has become an essential concept in public health. It is considered a modifiable determinant of health decisions, health behaviors, health, and healthcare outcomes. Prior studies suggest highly variable levels of health literacy across European countries. Assessing and monitoring health literacy is critical to support interventions and policies to improve health literacy. This study aimed to describe the process of adaptation to Portugal of the short-form version of the Health Literacy Survey (HLS19-Q12) from the Health Literacy Population Survey Project 2019-2021, also establishing the health literacy levels in the Portuguese population. The sample comprised 1247 valid cases. The survey consisted of a brief questionnaire on the determinants of health literacy, plus the HLS19-Q12 questionnaire and the specific health literacies packages on digital health literacy, navigational health literacy, and vaccination health literacy. The results suggest that 7 out of 10 people in Portugal (mainland) have high health literacy levels and support the results of other studies concerning the main socioeconomic determinants of general health literacy. Furthermore, the results suggest that \"navigation in the health system\" tasks are the most challenging tasks regarding specific health literacies. The overall data suggest the HLS19-Q12 as a feasible measure to assess health literacy in the Portuguese population. Thus, it can be used in Portugal to assess the population's needs and monitor and evaluate policies and initiatives to promote health literacy by addressing its societal, environmental, personal, and situational modifiable determinant factors.

Health literacy is important for effective disease prevention and health promotion. People with disabilities may require especially strong health literacy because they have higher unmet healthcare needs and more chronic disease. Although some studies suggest lower health literacy among people with disabilities, evidence from nationally representative data is limited. Using the 2021 Korea Health Panel Survey, we assessed health literacy among adults aged 19+ ( N  = 11,057) and compared those with and without disabilities defined by the National Disability Registration System. Sensitivity analyses used an alternative definition of disability derived from self-reported difficulties in daily activities. Linear regressions adjusted for gender, age, education, income, and chronic conditions. Adults with disabilities scored 0.94 points lower on the 16-point European Health Literacy Survey Questionnaire scale than those without ( p  < 0.001). Under the alternative definition, the gap was larger at 1.49 points ( p  < 0.001). Differences varied by disability type: cognitive limitations were associated with the largest deficit (− 3.93, p  < 0.001), followed by hearing limitations (− 2.01, p  < 0.001); physical disabilities did not differ significantly. These findings indicate clear disparities in health literacy by disability status and heterogeneity across disability types in Korea. Programs and policies to improve health literacy among people with disabilities should be tailored to disability type.

Health literacy has been increasingly recognized as one of the most important social determinants for health. However, an appropriate and comprehensive assessment tool is not available in many Asian countries. This study validates a comprehensive health literacy survey tool European health literacy questionnaire (HLS-EU-Q47) for the general public in several Asian countries. A cross-sectional survey based on multistage random sampling in the target countries. A total of 10,024 participants aged ≥15 years were recruited during 2013–2014 in Indonesia, Kazakhstan, Malaysia, Myanmar, Taiwan, and Vietnam. The questionnaire was translated into local languages to measure general health literacy and its three domains. To evaluate the validity of the tool in these countries, data were analyzed by confirmatory factor analysis, internal consistency analysis, and regression analysis. The questionnaire was shown to have good construct validity, satisfactory goodness-of-fit of the data to the hypothetical model in three health literacy domains, high internal consistency (Cronbach's alpha >0.90), satisfactory item-scale convergent validity (item-scale correlation ≥0.40), and no floor/ceiling effects in these countries. General health literacy index score was significantly associated with level of education (P from <0.001 to 0.011) and perceived social status (P from <0.001 to 0.016), with evidence of known-group validity. The HLS-EU-Q47 was a satisfactory and comprehensive health literacy survey tool for use in Asia. •A comprehensive health literacy survey tool was validated in several countries.•Health literacy was significantly associated with education and social status.•The tool was shown to be reliable for public health survey in Asia.

Background To examine the psychometrics properties of the French version of two scales measuring general (HLS 19 -Q12) and navigational (HLS 19 -NAV) health literacy (HL) using validation methods based on modern psychometric test theories: a Rasch model analysis. Methods The data on representative samples of the French adult population came from the Health Literacy Survey ( N  = 2 003), conducted in France in two waves (2020 and 2021), and from the third wave of SLAVACO study ( N  = 2 022), conducted in December 2021. A Rasch analysis was performed using a partial credit model with marginal maximum likelihood estimation adapted to polytomous data. Category probability curves were used to examine whether participants found it consistently difficult to distinguish between response options. Differential item functioning (DIF) was also examined for each item in the two scales as a function of age, gender, and economic status. A Person Separation Index (PSI) of 0.7 has conventionally been considered to be the minimum acceptable PSI level. Chi-square fit statistics, expressed as infit and outfit mean square statistics, were calculated for each item in the two scales. An acceptable fit corresponded to average values between 0.7 and 1.3. The dimensionality of the scales was assessed using Principal Components Analysis (PCA) on the residual correlation matrix to identify whether items are locally independent. Additionally, Smith’s method was employed to detect potential multidimensionality. Results The PSI values for both scales were greater than 0.90. No disordered categories were observed. No evidence of significant DIF was found when associated with gender and economic status. However, two items for both scales had a DIF which was dependent on age but did not have a significant impact on scale scores between younger and older people. Minor local dependence was noted on the HLS 19 -NAV scale. However, a PCA and Smith’s method demonstrated the unidimensionality of the French version of the scales measuring general and navigational HL. Conclusions Our results, based on a rigorous statistical analysis, verified the psychometric parameters of the French version of the HLS 19 -Q12 and HLS 19 -NAV scales. Despite strong correlation between both scales, each measured a different latent trait. Moreover, despite the fact that presence of DIF was weak, attention must nonetheless be paid when comparing scale response scores between young and older respondents.

Background Poor health literacy was found to be one of the key barriers in older adults’ disease prevention practice. However, it has still been unclear how different processes in health literacy play a role in older adult’s vaccination-related competencies. By adopting the European Health Literacy Survey (HLS-EU), the current study aimed to examine older adults’ competences in accessing, understanding, evaluating and applying health information, as well as how they are related to perceived difficulties in vaccination-related practices. . Methods With a cross-sectional design, a quantitative exploratory study was conducted using structured questionnaires. Four-hundred and 86 community-dwelling older adults aged 65 and above were recruited from non-government organizations in Hong Kong. Health literacy was measured by the Chinese version of 47-item HLS-EU (HLS-Asia-Q), which assesses the competences in accessing, understanding, evaluating and applying health information across the domains of health care, disease prevention, and health promotion. Linear regression was performed to test the association between different aspects of health literacy and vaccination-related information processing. Results The findings showed that the health literacy of Hong Kong older adults has been limited, particularly in information appraisal. Poorer competences in accessing and appraising health information were associated with greater difficulties in making vaccination decision. Conclusions By identifying the health literacy processes associated with vaccination, our findings suggested that health-promotion programs strengthening the appraisal and comparison of vaccination information should be provided for the general public. Meanwhile, health professionals and mass media should reduce the complexity when delivering the health messages, and make it easier for older adults to access and comprehend, thus increasing the inclination to take vaccine and preventing the spread of communicable diseases.