BACKGROUND: Prostate cancer is the tumor with the highest incidence in Spanish men. The implementation of health literacy and therapeutic education programs adapted to the needs of the population could be a resource to minimize the sequelae derived from the treatments used to combat this pathology. To this end, it would be necessary to know the level of health literacy about prostate cancer.
OBJECTIVE: To determine the level of health literacy in prostate cancer in the Spanish male population using the validated version of the PCKQ-12 for the Spanish population.
METHODS: Cross-sectional, population-based, descriptive study. Spanish-speaking men of legal age were included. To carry out the study, an ad hoc questionnaire was designed on the Google Forms platform, which was distributed via WhatsApp. Previously, it was necessary to validate the PCKQ-12 to the Spanish population in two phases, a first phase for translation and cross-cultural adaptation and a second phase to test the measurement properties.
RESULTS: The Spanish version of the PCKQ-12 showed good language, conceptual, semantic and content equivalence and could be used to assess health literacy in prostate cancer. Three hundred and seventy Spanish men with a mean age of 43.87 (SD 13.65) years responded to the questionnaire. The level of prostate cancer health literacy found was low (6.72 points), being 2 points higher in health men.
CONCLUSIONS: Health literacy about prostate cancer in the Spanish male population is low.

In the last years, the digital transformation, has become a reality influencing organizational processes and advancing services for users. This transformation must align with WHO guidelines, addressing the needs of individuals globally and acknowledging Social Determinants of Health and emerging Digital Determinants of Health and the digital divide thas has been created. To accomplish this, the appropriate legislation and infrastructures are required. Correspondingly technology enables enhanced self-care and increased participation in decision-making across various levels, consequently, addressing the digital divide must not be an exception, and needs to include citizens, communities, entities, and professionals to work on how to diminish it and solve it. As a result of this national and supranational campaigns should formulate unified plans and strategies, that include training requirements and establishing programs for both professionals and users, highlighting the significance of incorporating digital knowledge on both groups.

BACKGROUND: Health literacy integrates skills around health care. The measurement of health literacy is relevant for proposing improvement interventions. The European HLS-EU-Q16 scale allows to comprehensively evaluate health literacy, but its psychometric properties have not been assessed in Mexico.
OBJECTIVE: To validate the HLS-EU-Q16 scale in patients with hypertension in Mexico.
METHODS: A validation study of a measuring instrument was carried out. The construct was evaluated by means of factor analysis; internal consistency, using Cronbach\'s alpha; and test-retest reliability, using intraclass correlation coefficient (ICC). The information was collected by interviewing 349 patients with hypertension in a family medicine unit of the Mexican Institute of Social Security, from April to June 2022.
RESULTS: In 23.8% of the patients, health literacy was inadequate; in 44.4%, problematic; and in 31.8%, sufficient. The scale was found to retain 12 items and two factors (HLS-EU-Q12M). Cronbach\'s alpha was 0.83, and ICC was 0.94.
CONCLUSIONS: The HLS-EU-Q12M scale in Mexican Spanish is a valid instrument for assessing health literacy in adults with hypertension.
BACKGROUND: La alfabetización en salud integra las habilidades en torno al cuidado de la salud. La medición de la alfabetización en salud es relevante para proponer intervenciones de mejora. La escala europea HLS-EU-Q16 permite evaluar la alfabetización en salud de forma integral, pero sus propiedades psicométricas no se han evaluado en México.
OBJECTIVE: Validar la escala HLS-EU-Q16 en pacientes con hipertensión en México.
UNASSIGNED: Se realizó estudio de validación de un instrumento de medición. El constructo se evaluó mediante análisis factorial, la consistencia interna mediante alfa de Cronbach y la confiabilidad prueba-reprueba mediante coeficiente de correlación intraclase (CCI). La información fue recolectada mediante entrevistas a 349 pacientes con hipertensión en una unidad de medicina familiar del Instituto Mexicano del Seguro Social, de abril a junio de 2022.
RESULTS: El 23.8 % de los pacientes tuvo una alfabetización en salud inadecuada; 44.4 %, problemática; y 31.8 %, suficiente. Se encontró que la escala está conformada por 12 reactivos y dos factores (HLS-EU-Q12M). El alfa de Cronbach fue de 0.83 y el CCI, de 0.94.
UNASSIGNED: La escala HLS-EU-Q12M es un instrumento válido en español de México para evaluar la alfabetización en salud en adultos con hipertensión arterial.

UNASSIGNED: analizar las publicaciones de Alfabetización Sanitaria (AS) en relación con la pandemia de la COVID-19 en países de ingreso bajo, medio y medio-alto.
UNASSIGNED: se realizó una revisión sistemática de literatura publicada en las bases de datos de PubMed, Scopus, Portal BVS y Europe PMC, entre el 2019 y el 2021, siguiendo las guías de Cochrane y PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses), y se escribió de acuerdo con los elementos de informe preferidos para revisiones sistemáticas. La calidad metodológica se comprobó utilizando Mixed Methods Appraisal Tool (MMAT), para evaluar críticamente la calidad de los estudios incluidos.
UNASSIGNED: se revisaron 1397 artículos y tras la aplicación de criterios de elegibilidad se seleccionaron 92 estudios para el análisis. Se identificaron tres temas principales: dificultades y obstáculos, experiencias efectuadas sobre AS durante la pandemia y desafíos. Los determinantes sociales de la salud como educación, género, territorio y nivel socioeconómico obstaculizan la AS, además, otra de las dificultades es la ausencia en diversos países de planes, programas y guías de comunicación en salud. La infodemia fue una dificultad y un desafío en esta pandemia. Uno de los desafíos para la AS es la inequidad y pobreza. De las experiencias se encontraron mediciones de la AS en la población en general, en estudiantes y profesionales de la salud, además acciones de comunicación en salud y difusión de información para la prevención de la diseminación de la COVID-19 y para contrarrestar la infodemia. Conclusiones: las condiciones de vida de la población, así como el contexto sociocultural, económico y político de los países incluidos en esta revisión sistemática, influyen de manera decisiva en la AS de las personas.

BACKGROUND: Colombia passed Law 100 in 1993 with the goal of providing universal health care coverage, and by 2013, over 96% of the Colombian population had health insurance coverage. However, little is known about how health-related quality of life (HRQoL) and health literacy are related among those with the two most common types of health insurance coverage: subsidized (those with lower incomes) and contributory (those with higher incomes) coverage.
OBJECTIVE: In the current exploratory investigation, data from adults visiting six primary care clinics in Colombia were analysed to examine the relationship between HRQoL (assessed as problems with mobility, self-care, completing usual activities, pain/discomfort, and anxiety/depression), demographics, the two health insurance types, and health literacy. Analyses also assessed whether, within insurance types, health literacy was related to HRQoL.
RESULTS: Results showed that those with contributory health insurance coverage had greater health literacy than those with subsidized coverage, and this was accounted for by differences in education and socioeconomic status. HRQoL did not differ by insurance type. Although lower health literacy was related to worse HRQoL in the overall sample, in subgroup analyses lower health literacy significantly related to worse HRQoL only among those with subsidized health insurance coverage.
CONCLUSIONS: Targeting skills which contribute to health literacy, such as interpreting medical information or filling out forms, may improve HRQoL, particularly in those with subsidized insurance coverage.

OBJECTIVE: Doctors provide patients the information in written form by informed consents (IC), being the readability essential in the quality of care. The primary endpoint was to analyze the readability of IC published by the Chapter of Endovascular Surgery (CCEV) of the Spanish Society of Angiology and Vascular Surgery (SEACV) in 2019, and its evolution to those published by the SEACV in 2007.
METHODS: The ICs were organized by sectors and we obtained the following parameters: syllables, words, phrases, average words/phrases and syllables/words, Flesch, Flesch-Szigriszt, Fernández-Huerta and Gunning-Fog indexes, as well as the grade on the Inflesz scale.
RESULTS: The Flesch index classified the CCEV consents as very difficult, and the Gunning-Fog index reflected a readability equivalent to university texts. The Flesch-Szigriszt, Fernández-Huerta indexes and Inflesz scale classified them as normal. The ICs with less readability were those referring to supra-aortic trunks (SAT) and miscellaneous in the Fernández-Huerta (P<.020 and P<.05, respectively) and Flesch-Szigriszt (P<.05) indexes. However, ICs regarding venous pathology showed a better readability in this indexes (P<.006). CCEV consents were significantly longer than SEACV consents (P=.021). In addition, there was a decrease over time in the mean value of the Fernandez-Huerta and Flesch-Szigriszt indexes (P=.002).
CONCLUSIONS: Although CCEV consents had a normal readability, it has been observed a decrease in the readability indexes compared to those published in 2007 by the SEACV. In addition the length and content of the ICs should be reviewed, especially those relating to SAT and miscellaneous.

OBJECTIVE: To design a questionnaire to identify patients with difficulties to obtain, understand and use health information.
METHODS: Qualitative study through semi-structured interviews and a consensus technique. A review of the literature on health literacy was carried out. Five semi-structured interviews were conducted with experts in the field. A 12-item instrument was designed. Content validity was determined using the Health Consensus technique. Participants were health professionals and patient representatives (5 semi-structured interviews and 60 Health Consensus). An instrument to measure the level of skills and literacy in patients\' health was developed. The measures were 7categories on the health competencies and literacy construct: Ability to search for information, ability to understand the information, ability to communicate with health professionals, capacity for operational understanding, competence in decision making, ability to move and navigate through the health system, and competencies in self-care.
RESULTS: A 12-item questionnaire was designed. The median scores obtained in the Health Consensus ranged between 6.08 (1.43) and 7.22 (1.52), with an agreement level of between 73.87% to 84.19%. Finally, a 5-item instrument was obtained to assess the patients\' health competencies.
CONCLUSIONS: The questionnaire is a useful tool to detect those at risk of having difficulties in obtaining, understanding and using health information. This would allow professionals to focus their attention on the type of information patients need and better adapt it to their needs.

To validate the Brazilian version of the Short Assessment of Health Literacy in Portuguese-speaking Adults (SAHLPA), a 50-item test proposed as a particularly helpful instrument to assess health literacy in people with limited skills, in the Portuguese population.
We used the standard procedure for cultural adaptation and administered the instrument to 249 participants. We examined construct validity using groups with expectedly increasing levels of health literacy (laypersons from the general population, engineering researchers, health researchers, and physicians), and through association with age and educational attainment, dichotomizing scores at the median of the layperson\'s group.
Exploratory factor analysis revealed the instrument was one-dimensional and justified reduction to 33 items. SAHLPA-33 displayed adequate reliability (Cronbach\'s α = 0.73). The frequency of limited health literacy was highest among laypersons and lowest among physicians (p <0.001; p for trend <0.001). The proportion of participants with limited health literacy decreased with increasing education attainment (age- and sex-adjusted p for trend <0.001). Limited health literacy also tended to decrease with age, although the association was non-significant (sex- and education-adjusted p for trend = 0.067).
We culturally adapted a brief and simple instrument for health literacy assessment, and showed it was valid and fairly reliable. In Portuguese low-literate adults, SAHLPA-33 fills the gap in health literacy assessment instruments, and may be used to guide communication strategies with vulnerable patients and communities.

To describe the psychometric properties and the level of understanding of the health literacy questionnaire HLS-EU-Q16 in Spanish, implemented in the Health Survey of the Valencian Region (Spain) of 2016.
Descriptive cross-sectional study to describe understanding, reliability, structure and internal consistency of the questionnaire on a sample of 5485 subjects, aged 15 or over, who participated in the survey.
The percentages of understanding without much difficulty were high. Reliability was high (intraclass correlation coefficient:.923; kappa:.814). The factorial analysis suggested a unifactorial structure (79.1% of variability explained by the common factor), with high factorial loads. The consistency was high (Cronbach\'s alpha: 0.982).
The HLS-EU-Q16 in Spanish is a short, adequate and valid instrument to measure the level of health literacy in the population.

OBJECTIVE: The aim of this study was to determine the level of health literacy of diabetic patients aged 50 to 75 years, from Ourense, Spain, as well as its relationship with the glycated haemoglobin (HbA1c) concentration and cardiovascular risk of the patient.
METHODS: Cross-sectional study using a self-completed questionnaire. From a multi-stage sampling, urban, type 2 diabetic patients were randomly included. The level of health literacy, using the HLS-EU-Q47 questionnaire, the last concentration of HbA1c, and both total and fatal cardiovascular risk at 10 year follow-up, measured using the UKPDS (U.K. Prospective Diabetes Study) algorithm, were determined. The age, gender, level of education, level of social support, social class, and comorbidities were used as covariates.
RESULTS: A total of 103 patients were analysed. Out of all the patients, 81.5% (84) had an unsuitable health literacy level (29.1% had an inadequate level and 52.4% had a problematic level). A clear association was seen between a higher level of health literacy and higher levels of education. Moreover, the level of health literacy was seen to be inversely related to the level of control of the patients\' diabetes measured on the basis of their HbA1c (P=.03) concentration. However, no such association was found with the cardiovascular risk (P=.3).
CONCLUSIONS: The results of the present study show that the level of literacy of the analysed population was insufficient, and that its improvement could result in a better outcome in the treatment of diabetic patients.