Cross-sectional study using the Health Literacy Questionnaire in Cantabria. Preliminary Results

Background

The Health Literacy Questionnaire (HLQ) is a multidimensional measurement tool. We aimed to describe health literacy (HL) among adults living in urban, semi-urban, and rural areas of Cantabria (Northern Spain).

Methods

This study was conducted within the framework of Work Package 6 of the European Joint Action on Cardiovascular Diseases and Diabetes (JACARDI). To reflect real-life conditions, a total of 670 face-to-face interviews were conducted during full mornings in primary care health centers over several consecutive days. The geographic distribution of the sample was: rural areas (n = 135; 20.1%), semi-urban areas (n = 147; 21.9%), and urban areas (n = 388; 57.9%). HLQ measures nine conceptually distinct domains: (1) healthcare provider support, (2) having sufficient information to manage health, (3) actively managing health, (4) social support for health, (5) critical appraisal, (6) active engagement with healthcare providers, (7) navigating the healthcare system, (8) ability to find good health information, and (9) reading and understanding health information.

Results

The mean age of respondents was 55.4 years (range: 18–91). Women represented 66.6% of the sample, and 33.6% had not completed secondary education. Diabetes was reported by 9.9% of participants and arterial hypertension by 19.1%. Mean scores (± SD) for the HLQ scales were 3.1±0.6, 3.0±0.6, 2.9±0.5, 3.1±0.6, 2.8±0.7, 3.9±0.8, 3.8±0.8, 3.7±0.8, and 4.0±0.7, respectively. Lower scores were observed in rural areas for the Actively managing health domain (p = 0.024). In contrast, participants from rural settings showed higher scores in Healthcare provider support (p < 0.001), Having sufficient information (p = 0.011), Social support (p = 0.017), and Active engagement (p = 0.003).

Conclusions

This study provide valuable insights into the relationship between geographical context and HL and can inform the development of more equitable and context-sensitive health interventions.

Key messages

• Our study reveals health literacy differences across nine domains of health literacy in adults using health services as a function or their geographical area of living.

• These findings provide insights into the relationship between health literacy and potential vulnerable groups and provide guidance for the development of equitable interventions.