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  • 1
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    Online Resource
    Adapting the European Health Literacy Survey for Fourth-Grade Students in Germany: Questionnaire Development and Qualitative Pretest
    SLACK, Inc. ; 2020
    In:  HLRP: Health Literacy Research and Practice Vol. 4, No. 2 ( 2020-04-09)
    Details
    In: HLRP: Health Literacy Research and Practice, SLACK, Inc., Vol. 4, No. 2 ( 2020-04-09)
    Abstract: Promoting health literacy in early life is regarded as an important means of sustaining health literacy and health over the life course. However, little evidence is available on children's health literacy, partly due to a scarcity of suitable measurement tools. Although there are 18 tools to measure specific items of health literacy for people younger than age 13 years, there is a lack of comparable, valid, and age-appropriate measures of generic health literacy. Objective: This study aimed to develop and qualitatively test an age-adapted version of the European Health Literacy Survey Questionnaire (HLS-EU-Q) for German-speaking children age 9 and 10 years. Although validated for adults and adolescents, the HLS-EU-Q has never been age-adapted or used with children. Methods: The content and language of HLS-EU-Q items were adapted for this age range. The literature was consulted to inform this process, and adaptations were developed and selected based on consensus among authors. From an item pool of 102 adapted items, 37 were given to 30 fourth-grade students in a cognitive pretest, which is a standard procedure in questionnaire development aiming to explore how items are interpreted. Participants (18 girls, 12 boys) were mostly age 9 or 10 years (range, 9–11 years). Key Results: Problems with misinterpretation were identified for some items and participants (e.g., items designed to assess participants' perceived difficulty in accessing and appraising health information were partly answered on the basis of knowledge and experience). A final selection of 26 well-performing items corresponded to the underlying HLS-EU-Q framework. Conclusions: This is the first age-adapted version of the HLS-EU-Q. A preliminary 26-item questionnaire was successfully developed that performed well in a cognitive pretest. However, further research needs to verify its validity and reliability. The present findings help to advance the measurement of generic self-reported health literacy in children and highlight the need for cognitive pretesting as an essential part of questionnaire development . [ HLRP: Health Literacy Research and Practice . 2020;4(2):e119–e128.] Plain Language Summary: The European Health Literacy Survey Questionnaire is used for testing adults' health literacy. It was adapted for German-speaking children age 9 and 10 years. Based on a review of the original items and the literature, 26 questionnaire items were developed and tested in interviews with 30 children. Although problems with understanding could be identified, the questionnaire was mostly well understood.
    Type of Medium: Online Resource
    ISSN: 2474-8307 , 2474-8307
    URL: Article
    DOI: 10.3928/24748307-20200326-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 3009838-5
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  • 2
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    Adapting the European Health Literacy Survey Questionnaire for Fourth-Grade Students in Germany: Validation and Psychometric Analysis
    SLACK, Inc. ; 2020
    In:  HLRP: Health Literacy Research and Practice Vol. 4, No. 3 ( 2020-07-14)
    Details
    In: HLRP: Health Literacy Research and Practice, SLACK, Inc., Vol. 4, No. 3 ( 2020-07-14)
    Abstract: Until now, children younger than age 13 years have received little attention in research on health literacy. Although some tools assess children's health literacy, no validated tool is available that assesses self-reported health literacy in a systematic and comparable way. The European Health Literacy Survey Questionnaire (HLS-EU-Q) is a valid and reliable measure of adults' self-reported health literacy. It has also been used among adolescents, but it has never been adapted for use with children. We believe it would be worth adapting for younger age groups so that self-reported health literacy could be assessed continuously. Objective: This study aimed to quantitatively test an adapted scale based on the HLS-EU-Q developed for German-speaking children age 9 and 10 years. Methods: An adapted 26-item HLS-EU-Q scale was given in a paper-and-pencil survey to 907 fourth-grade students in North Rhine-Westphalia, Germany. The psychometric properties of the scale were investigated with item analysis and factor analyses, and both convergent and discriminant validity were assessed. Key Results: Of the 26 tested items, 9 were discarded due to poor performance in terms of missing values, item difficulty, and factor structure. This left a 15-item scale with a high internal consistency (α = .791) that takes only a short time to administer. The scale, called the HLS-Child-Q15, had a low correlation with functional health literacy ( r = .107, p 〈 .001), and a moderate correlation with indicators of self-efficacy (ρ = .280 to .306, p 〈 .001). The latter indicates adequate discriminant validity, whereas the former points to a need to further investigate convergent validity. Conclusions: This is the first study to apply an age-adapted version of the HLS-EU-Q to children. Statistical analyses indicated the successful development of a promising instrument, but further research is needed on its factor structure and validity. This study contributes significantly to the comparative assessment of health literacy across the life course by providing a measurement tool for children age 9 and 10 years. [ HLRP: Health Literacy Research and Practice . 2020;4(3):e144–e159.] Plain Language Summary: The European Health Literacy Survey Questionnaire was adapted for German-speaking 9- and 10-year-old children, and 26 adapted items were tested in a written survey of 907 children. Item analysis resulted in a 15-item scale with satisfactory psychometric properties. This scale, the HLS-Child-Q15, shows high internal consistency and can be used to assess self-reported health literacy in German-speaking 9- and 10-year-old children. Nonetheless, further studies are needed to validate these results.
    Type of Medium: Online Resource
    ISSN: 2474-8307 , 2474-8307
    URL: Article
    DOI: 10.3928/24748307-20200428-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 3009838-5
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  • 3
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    Physical activity promotion in daycare centres in Germany: study protocol for a cross-sectional survey within the BeweKi study
    BMJ ; 2023
    In:  BMJ Open Vol. 13, No. 6 ( 2023-06), p. e070726-
    Details
    In: BMJ Open, BMJ, Vol. 13, No. 6 ( 2023-06), p. e070726-
    Abstract: In Germany, a total of 92.2% of children between the age of 3 and school entry age attend daycare centres. Therefore, daycare centres are a suitable setting to promote physical activity among children. Yet, there is a lack of knowledge on the promotion of physical activity in daycare centres with regards to different structures and concepts, culture/policies/practices and the characteristics of directors and pedagogical staff of daycare centres in Germany. The aim of this study is to investigate (a) the status quo, as well as (b) the fostering and hindering conditions (barriers and facilitators) of physical activity promotion in daycare centres in Germany. Methods and analysis The cross-sectional study will collect data from November 2022 to February 2023. For the sample, about 5500 daycare centres will be drawn from an address database available through the German Youth Institute (DJI) and invited to the survey. From each daycare centre a director and a pedagogical staff member will be asked to fill in a standardised self-administered questionnaire. The survey explores characteristics of the daycare centre and the implementation of physical activity promotion, for example, the extent and form of physical activity promotion, the use and size of indoor and outdoor area, structural conditions such as personal and financial resources, personal attitudes towards physical activity promotion, demographic characteristics of pedagogical staff, structural daycare centre’s characteristics such as proportion of children from socioeconomic disadvantaged groups. In addition, micro-geographical data on socioeconomic and infrastructural environment of the daycare centres will be included in the data set. Ethics and dissemination The study has been received and approved by the Commissioner for Data Protection of the Robert Koch Institute and by the Ethics Committee of Alice Salomon Hochschule Berlin, University of Applied Sciences. Results will be disseminated through publications and presentations to scientific community and stakeholders.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-070726
    DOI: 10.1136/bmjopen-2022-070726.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 4
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    Motivational readiness for physical activity and health literacy: results of a cross-sectional survey of the adult population in Germany
    Springer Science and Business Media LLC ; 2023
    In:  BMC Public Health Vol. 23, No. 1 ( 2023-02-14)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-02-14)
    Abstract: Health literacy, defined as the knowledge, motivation, and competences to use health information to improve health and well-being, is associated with regular physical activity. However, there is limited evidence on whether health literacy is also related to the motivational readiness for physical activity in a general population. The aim of this study was to investigate whether motivational readiness for leisure-time physical activity is associated with health literacy. Methods Analyses were based on data of 21,895 adults from the cross-sectional German Health Update and European Health Interview Survey 2014/2015 (GEDA 2014/2015-EHIS). Motivational readiness for leisure-time physical activity was assessed with stages of change for physical activity with a set of validated items. It was then classified, according to an established algorithm, into five stages: precontemplation, contemplation, preparation, action, and maintenance. Health literacy was measured with the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and categorised as low, medium, and high. For bivariate and multinomial logistic regression analyses, the stages were categorised in three phases as: (1) no intention (precontemplation), (2) planning (contemplation or preparation), and (3) in activity (action or maintenance). The models were adjusted for sex, age, education, health consciousness, self-efficacy, and self-perceived general health status. Results High compared to low health literacy was associated with a 1.65-times (95% CI = 1.39–1.96) greater probability of being in activity than planning . High compared to low health literacy was associated with a reduced risk of having no intention to change physical activity behaviour (relative risk ratio, RRR = 0.84, 95% CI = 0.75–0.95). The associations persisted after adjusting for covariates. Conclusion High health literacy was positively associated with more advanced phases of motivational readiness for leisure-time physical activity. Therefore, taking health literacy into account in interventions to promote motivational readiness for leisure-time physical activity could be a useful approach.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-023-15219-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041338-5
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  • 5
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    Online Resource
    Health literacy and health behavior in adolescence: results of a nationwide online survey among adolescents
    Springer Science and Business Media LLC ; 2022
    In:  Prävention und Gesundheitsförderung Vol. 17, No. 4 ( 2022-11), p. 479-487
    Details
    In: Prävention und Gesundheitsförderung, Springer Science and Business Media LLC, Vol. 17, No. 4 ( 2022-11), p. 479-487
    Abstract: There is lack of information about the association between health literacy and health behavior in Germany, although strengthening health literacy is regarded as a promising approach to promote health behavior, especially for young people in adolescence. Objective This study examined the extent to which different dimensions of generic health literacy are associated with health behavior among adolescents, considering also sociodemographic factors and self-efficacy. Material and methods Data are based on a nationwide online survey on “Health literacy among adolescents” (GeKoJu) with 1235 adolescents aged between 14 and 17 years in Germany. Data of four dimensions of generic health literacy were collected with the self-report measurement tool “Measurement of Health Literacy Among Adolescents Questionnaire” (MOHLAA-Q). Health behavior was examined with questions on sports, diet, alcohol consumption and smoking. Univariate and bivariate analyses as well as multiple regression analyses were conducted. Results Adolescents with low levels in all examined health literacy dimensions had increased odds of not consuming fruit and vegetables daily. The odds of smoking or not exercising were also higher among those with lower communication and interaction skills and passive attitudes toward health and health information. Risky alcohol consumption was not associated with health literacy. Conclusion The findings suggest the strengthening of active attitudes toward health and health information and communication and interaction skills regarding health-related topics for promoting health behavior among adolescents.
    Type of Medium: Online Resource
    ISSN: 1861-6755 , 1861-6763
    URL: Article
    DOI: 10.1007/s11553-021-00913-1
    RVK:
    XF 1500
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2211781-7
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  • 6
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    Online Resource
    Entwicklung des Fragebogens zum Sicherheitsklima in Hausarztpraxen (FraSiK): Transkulturelle Adaptation – ein Methodenbericht
    Elsevier BV ; 2009
    In:  Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen Vol. 103, No. 8 ( 2009-1), p. 521-529
    Details
    In: Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, Elsevier BV, Vol. 103, No. 8 ( 2009-1), p. 521-529
    Type of Medium: Online Resource
    ISSN: 1865-9217
    URL: Article
    DOI: 10.1016/j.zefq.2009.08.005
    RVK:
    XC 1600
    Language: German
    Publisher: Elsevier BV
    Publication Date: 2009
    detail.hit.zdb_id: 2413601-3
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  • 7
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    Differences in risk perception, knowledge and protective behaviour regarding COVID-19 by education level among women and men in Germany. Results from the COVID-19 Snapshot Monitoring (COSMO) study
    Public Library of Science (PLoS) ; 2021
    In:  PLOS ONE Vol. 16, No. 5 ( 2021-5-12), p. e0251694-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 5 ( 2021-5-12), p. e0251694-
    Abstract: The main strategy for combatting SARS-CoV-2 infections in 2020 consisted of behavioural regulations including contact reduction, maintaining distance, hand hygiene, and mask wearing. COVID-19-related risk perception and knowledge may influence protective behaviour, and education could be an important determinant. The current study investigated differences by education level in risk perception, knowledge and protective behaviour regarding COVID-19 in Germany, exploring the development of the pandemic over time. The COVID-19 Snapshot Monitoring study is a repeated cross-sectional online survey conducted during the pandemic in Germany from 3 March 2020 (waves 1–28: 27,957 participants aged 18–74). Differences in risk perception, knowledge and protective behaviour according to education level (high versus low) were analysed using linear and logistic regression. Time trends were accounted for by interaction terms for education level and calendar week. Regarding protective behaviour, interaction terms were tested for all risk perception and knowledge variables with education level. The strongest associations with education level were evident for perceived and factual knowledge regarding COVID-19. Moreover, associations were found between low education level and higher perceived severity, and between low education level and lower perceived probability. Highly educated men were more worried about COVID-19 than those with low levels of education. No educational differences were observed for perceived susceptibility or fear. Higher compliance with hand washing was found in highly educated women, and higher compliance with maintaining distance was found in highly educated men. Regarding maintaining distance, the impact of perceived severity differed between education groups. In men, significant moderation effects of education level on the association between factual knowledge and all three protective behaviours were found. During the pandemic, risk perception and protective behaviour varied greatly over time. Overall, differences by education level were relatively small. For risk communication, reaching all population groups irrespective of education level is critical.
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
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    DOI: 10.1371/journal.pone.0251694
    DOI: 10.1371/journal.pone.0251694.g001
    DOI: 10.1371/journal.pone.0251694.g002
    DOI: 10.1371/journal.pone.0251694.g003
    DOI: 10.1371/journal.pone.0251694.g004
    DOI: 10.1371/journal.pone.0251694.g005
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    DOI: 10.1371/journal.pone.0251694.g007
    DOI: 10.1371/journal.pone.0251694.g008
    DOI: 10.1371/journal.pone.0251694.t001
    DOI: 10.1371/journal.pone.0251694.t002
    DOI: 10.1371/journal.pone.0251694.t003
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2021
    detail.hit.zdb_id: 2267670-3
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  • 8
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    Online Resource
    Die Gesundheitskompetenz von Jugendlichen mit dem MOHLAA-Q messen
    Walter de Gruyter GmbH ; 2022
    In:  Public Health Forum Vol. 30, No. 2 ( 2022-06-27), p. 116-120
    Details
    In: Public Health Forum, Walter de Gruyter GmbH, Vol. 30, No. 2 ( 2022-06-27), p. 116-120
    Abstract: Im Projekt „Measurement of Health Literacy Among Adolescents“ (MOHLAA) wurde der Fragebogen MOHLAA-Q für 14- bis 17-Jährige in einem mehrstufigen Prozess entwickelt und validiert. Der MOHLAA-Q umfasst 29 Items und 4 Skalen, erfasst verschiedene Dimensionen von Gesundheitskompetenz und wurde in einer bundesweiten Online-Befragung bei 1.235 Jugendlichen erfolgreich eingesetzt. Mit dem MOHLAA-Q lassen sich differenziert Bedarfe zur Förderung der Gesundheitskompetenz bei Jugendlichen identifizieren.
    Type of Medium: Online Resource
    ISSN: 1876-4851 , 0944-5587
    URL: Article
    DOI: 10.1515/pubhef-2022-0003
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2022
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  • 9
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    Exploring pandemic-related health literacy among adolescents in Germany: a focus group study
    Springer Science and Business Media LLC ; 2022
    In:  Archives of Public Health Vol. 80, No. 1 ( 2022-08-05)
    Details
    In: Archives of Public Health, Springer Science and Business Media LLC, Vol. 80, No. 1 ( 2022-08-05)
    Abstract: Health literacy enables people to cope efficiently with health threats, such as the COVID-19 pandemic. However, little is known about health literacy among adolescents in general and especially in the context of pandemics. This study aimed to explore pandemic-related health literacy among adolescents by addressing cognitive, behavioral, conative, and affective components of the multidimensional health literacy construct. Methods Four online focus groups with 24 adolescents aged 13-17 years from four German federal states were conducted during the COVID-19 pandemic in May and June 2021. Data were analyzed using qualitative content analysis. Results Regarding the cognitive and behavioral components of pandemic-related health literacy, adolescents reported to use a broad range of traditional and digital media and personal information sources. The adolescents considered pandemic-related information to be good and easy to understand, when the information is presented in a concise and structured manner. The participants stated difficulties in finding, understanding, and evaluating pandemic-related information regarding particular protective measures. The adolescents described themselves to be critical when evaluating pandemic-related information and reported a high level of adherence to protective measures. Regarding the conative and affective components of health literacy, the adolescents explained that their wish to protect their loved ones from getting infected was the predominant motive for adherence to protective measures. They were convinced that people of their age play a role in pandemic containment. The adolescents reported sometimes making exceptions from adhering to protective measures to cope with negative feelings they experienced during the pandemic. Conclusions This study provides insights on how measures to improve pandemic-related health literacy among adolescents may be tailored to their needs. Prompt, concise, structured, and comprehensible preparation and communication of pandemic-related information in addition to educational efforts to strengthen health-related cognitive skills and critical health literacy may be supportive to reduce barriers in finding, understanding, and evaluating pandemic-related content.
    Type of Medium: Online Resource
    ISSN: 2049-3258
    URL: Article
    DOI: 10.1186/s13690-022-00937-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2133388-9
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  • 10
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    Online Resource
    Do adolescents understand the items of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) – German version? Findings from cognitive interviews of the project “Measurement of Health Literacy Among Adolescents” (MOHLAA) in Germany
    Springer Science and Business Media LLC ; 2018
    In:  Archives of Public Health Vol. 76, No. 1 ( 2018-12)
    Details
    In: Archives of Public Health, Springer Science and Business Media LLC, Vol. 76, No. 1 ( 2018-12)
    Type of Medium: Online Resource
    ISSN: 2049-3258
    URL: Article
    DOI: 10.1186/s13690-018-0276-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2133388-9
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