Health literacy : what is it and why is it important to measure?

This report summarizes the proceedings of the first Outcome Measures in Rheumatology Clinical Trials (OMERACT) Health Literacy Special Interest Group workshop at the OMERACT 10 conference. Health literacy refers to an individual’s capacity to seek, understand, and use health information. Discussion centered on the relevance of health literacy to the rheumatology field; whether measures of health literacy were important in the context of clinical trials and routine care; and, if so, whether disease-specific measures were required. A nominal group process involving 27 workshop participants, comprising a patient group (n = 12) and a healthcare professional and researcher group (n = 15), confirmed that health literacy encompasses a broad range of concepts and skills that existing scales do not measure. It identified the importance and relevance of patient abilities and characteristics, but also health professional factors and broader contextual factors. Sixteen themes were identified: access to information; cognitive capacity; disease; expression/communication; finances; health professionals; health system; information; literacy/numeracy; management skills; medication; patient approach; dealing with problems; psychological characteristics; social supports; and time. Each of these was divided further into subthemes of one or more of the following: knowledge, attitude, attribute, relationship, skill, action, or context. There were virtually no musculoskeletal-specific statements, suggesting that a generic health literacy tool in rheumatology is justified. The detailed concepts across themes provided new and systematic insight into what needs to be done to improve health literacy and consequently reduce health inequalities. These data will be used to derive a more comprehensive measure of health literacy.

Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain : an assessment of health literacy

Background: Despite the large volume of research dedicated to understanding chronic low back pain (CLBP), patient outcomes remain modest while healthcare costs continue to rise, creating a major public health burden. Health literacy - the ability to seek, understand and utilise health information - has been identified as an important factor in the course of other chronic conditions and may be important in the aetiology of CLBP. Many of the currently available health literacy measurement tools are limited since they measure narrow aspects of health literacy. The Health Literacy Measurement Scale (HeLMS) was developed recently to measure broader elements of health literacy. The aim of this study was to measure broad elements of health literacy among individuals with CLBP and without LBP using the HeLMS.
Methods: Thirty-six community-dwelling adults with CLBP and 44 with no history of LBP responded to the HeLMS. Individuals were recruited as part of a larger community-based spinal health study in Western Australia. Scores for the eight domains of the HeLMS as well as individual item responses were compared between the groups.
Results: HeLMS scores were similar between individuals with and without CLBP for seven of the eight health literacy domains (p > 0.05). However, compared to individuals with no history of LBP, those with CLBP had a significantly lower score in the domain ‘Patient attitudes towards their health’ (mean difference [95% CI]: 0.46 [0.11- 0.82]) and significantly lower scores for each of the individual items within this domain (p < 0.05). Moderate effect sizes ranged from d = 0.47-0.65.
Conclusions: Although no differences were identified in HeLMS scores between the groups for seven of the health literacy domains, adults with CLBP reported greater difficulty in engaging in general positive health behaviours. This aspect of health literacy suggests that self-management support initiatives may benefit individuals with CLBP.

Tertiary literacy on the cusp

This paper outlines some of the recent concerns regarding a perceived decline in literacy standards in Australia, with reference to changing literacy abilities and standards in tertiary education. It presents a summary and critique of the current discussions on changes in literacy expectations and contemporary notions of literacy. It concludes with a summary of three important 'agents of change': economic rationalism, multiculturalism and computerisation.

Mobile texts and migrant audiences : rethinking literacy and assessment in a new media age

This article highlights the importance of rethinking literacy assessment in a digital and global world. Although pressures currently abound to narrow conceptions and practices of literacy, especially in an era of high stakes testing, digital multimodality and connectivity offer the potential for new ways of thinking, representing, and communicating, as well as new avenues for participating in relationships across social, geographic, and cultural difference. We explore the challenges of redesigning assessments so that they better take into account children's multiliterate capabilities. In so doing, we offer examples from our work in afterschool contexts that demonstrate how we have grappled with the complexities of assessment in new times.

Researching kids and computer games : games, game play and literacy in the twenty first century

Videogames, and young people's engagement with them, are of growing interest to education. This paper reports on initial find ings from the study: Literacy in the Digital World of the Twenty First Century: Leaming from computer games, focussing on the opportunities offered by studying young people's immersion in game play for understanding more about contemporary forms of  engagement and textuality, new forms of literacy,community and identity multimodality, and the implications of such forms and changes for contemporary literacy and English education. Taking videogames as examples of global, ICT-based popular culture, where meaning is built from muhimodal elements, and where young players have to he actively teaming and involved in order to play, the project asks how English and literacy education might benefit from examining videogames, as rich exemplars of contemporary digital culture, and the ways in which young people make use of them, to improve the teaching of print and multi modal forms of literacy.