HEALTH LITERACY ASSESSMENT OF GOVERNMENT SCHOOL TEACHERS OF DISTRICT ATTOCK A CROSS SECTIONAL STUDY

PRESENTED BY: DR MOAZZAM ALI KHAN

SUPERVISOR: DR SHAHZAD ALI KHAN

CONTENTS INTRODUCTION RATIONALE AIM & OBJECTIVES METHODOLOGY RESULTS RECOMMENDATIONS/ ENABLING

FACTORS

INTRODUCTION1. LITERACY IS ABALITY TO Read Write Use numbers Handle information Express ideas and opinions Make decisions Solve problems

HEALTH LITERACY Health literacy defined as ” Health

literacy is the ability to obtain, read, understand and use healthcare information to make appropriate health decisions and follow instructions for treatment”

A person has advanced literacy skills their ability to obtain, understand and apply health information in a specific health context may be poor

TYPES General health literacy

Conceptual health literacy

Functional health literacy

WHY HEALTH LITERACYIn the public health perspective the Health literacy is very

important to combat the upcoming challenges in health care

system

Access to health care services, use of services Self care of chronic conditions Active role in health care Decision and management Maintenance of health and wellness

HEALTH LITERACY AND SCHOOL SETTINGS

Schools are essential in achieving health literacy The school is a fundamental institution in building the

wealth and health of countries, Schools throughout the world contribute to the

achievement of public health goals

TEACHERS HEALTH LITERACY IN SCHOOL SETTINGS

Teacher’s abilities and knowledge regarding health. Understand the severity of health issues. Teacher’s behavior regarding its own health. Use of knowledge of health and transform to students Resources regarding health information drives. socioeconomic and demographic awareness of students of

school Equal attention should be given to teachers own health

literacy.

RATIONALE Health literacy of teachers is an important aspect in school sittings.

Equal attention should be given to teacher health literacy. The capacity

of teachers to obtain, interpret, and understand basic health

information and services, more it would be beneficial for students.

Survey will enable us to understand the level of health literacy in

teachers and helps in designing of further interventions to increase the

literacy level

AIM & OBJECTIVES AimTo improve the health literacy of teachers to promote health education

Objectives1- To assess the current health literacy level in school teachers of district Attock. 2- To explore the factors (demographic, functional, social and economic and personal health information) related to health literacy of teachers of District, Attock.

METHODOLOGY Study Design: a cross sectional study

Study Area: Attock ,Punjab

Study Population: Government school teachers

Duration of Study: Two (02) months

Sampling technique: simple random sampling

Sample Size: sample size 295 + 10%=325 questionnaire were prepared to

for data collection but only 290 return filled

Data Collection: Quantitative

Data collection tool: health literacy survey Asia tools of assessment a project Taipei medical

university, Taiwan

Data Analysis tool Microsoft excel .SPSS 20

Data analysis method descriptive analysis of variables Health literacy indices health literacy indices is based on the European

health literacy survey (HLS-EU) indices Formula for indices is Index = (mean - 1) * (50/3) Scale is between 1-50 for convenient calculations of literacy level Correlations analysis. Spearman’s rho Correlation is used for analysis of

association of several economic factors. Relation between health literacy, and gender the Chi square test is applied 95% confidence interval with a significance level of p-value <0.05 is used

for all analyses.

INCLUSION CRITERIA. Male and female Government school teachers of district

Attock whether they are permanent employ or temporary. Those who will accept the inform consent and have a will for contribution

EXCLUSION CRITERIA. Those who will absent at that day in school

Questionnaire health literacy survey Asia tools of assessment a project

Taipei medical university, Taiwan

Part 1 – Demographics

Part 2 – Health Literacy

Part 3 – Personal Health

Information

Part 4 – Social and Economic Information

ATTOCK FATEH JANG HASSAN ABDAL HAZRO JUND PINDI GHEB

13.3

22.8

9 11.8

24.1

19

18.117.03

1014.2

21.4

16.714 17.25

13.78

10.35

27.58

17.25

QUESTIONNAIR DISTRIBUTION ACCORDING TO AREA, TEACHERS AND INSTITUTIONS

INSTITUTIONS TEACHERS sample

Health LiteracyAcess,obtain Information Relevant To Health

Understand Information Relevant To Health

Process,appraise Information Relevant To Health  

Apply, use Information Relevant To Health

HEALTH CARE

ABALITY TO ACESS HEALTH INFORMATION

ABALITY TO UNDERSTAND HEALTH INFORMATION

ABALITY TO INTERPRATE HEALTH INFORMATION

ABALITY TO APPLY HEALTH INFORMATION  

 DISEASE PREVENTION  

RISK FACTORS RISK FACTORS RISK FACTORS RISK FACTORS

HEALTH PROMOTION UP DATE ONSELF ON

HEALTH ISSUES HEALTH ISSUES

HEALTH ISSUES

APPLY PROMOTIONAL ACTIVITIES

RESULTS

RELABILITY ANALYSIS OF DATA. For internal consistency estimate of data and reliability of

score the Cronbach's alpha test is applied on health literacy segment of data

Reliability statistics

Cronbach’s Alpha Cronbach’s AlphaOn standardized items

.945 .946

variables Number of participant  Percentage

Gender    

Female 165 56.89%Male 125 43.10%

Marital status    Not married/ Separated/Divorced/

Widowed91 32.4%

Married 199 68.8 %

Education    matric 2 7%

University/College and above 63 21%Master’s degree 225 77%

Data analysis demographic part

Ability to pay for medication    

Very difficult  18 6%

Fairly difficult  63 21%

Fairly easy  102 34%

Very easy  52 20%

Self-perceived health status    

Very Bad    

Bad 3 1.0%

Fair 94 32.4 %

Good 140 48.3 %

Very good 53 18.3 %

Long-term illness   

Yes more than one 14 4.8%

Yes one 45 15.7 %

No 299 79.0 %

Limitation related to health problems

No 98 33.8%

Yes 171 59%

Times to visit DOCTOR over past 12 months    

No 108  36.6 %

1-2 times  120 42.1 %

3-5 times  24 8.6 %

6 times and more  12 4.5 %

Times to visit DENTIST over past 12 months    

No 210  71.2 %

1-2 times  30 10.7 %

3-5 times  27 9 %

6 times or more  6 1.7 %

Smoking status    

Never 30  90%

At present time  3 3 %

0 1-2 TIMES 3-5 TIMES 6 TIMES D,NT KNOW /REFUSE

A Had to contact the emergency service in the last 2 years

80.3% 5.9% 2.4% 11.4% 2%

B Been to the DOCTOR in the last 12 months 36.6% 42.1% 8.6% 4.5% 8.3%

C Been to the DENTIST in the last 12 months 72.4% 10.7% 9 % 1.7% 6.2%

D Been to the HAKEEM in the last 12 months 76.6% 13.8% 2.1% 3.1% 4.5%

E Used a hospital service in the last 12 months? 64.5% 21.7% 2.4% 7.2% 4.1%

F Used service from other health professionals, in the last 12 months

  53.1% 37.2% 9.7%  

G Raised a question during your doctor appointment? 44.1% 26.9% 12.4% 7.9% 8.6%

Diabete

s

Hypert

ensio

n

Hepati

tis

Heart d

isease

Cancer

Pneu

monia

Cerebro

vascu

lar Dis..

.

Respira

tory D

isease

Kidne

y Dise

ase

Mental

disor

der

Arthri

tis

Eye D

isease

Ear D

isease Othe

r Non

e0%

10%20%30%40%50%60%70%80%90%

100% PARENTS AND GRANDPARENTS DISEASE

Series 1

TREND OF REFRESHERS COURSES

Often Some time Rarely Never0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

education courceshealth cources

MEDICAL RELATED TV PROGRAMS

OFTEN14%

SOMETIMES42%RARELY

19%

NEVER 25%

Often 13.8% Sometimes 41.7% Rarely 19.3% Never 25.2%

INFORMATION THROUGH INTERNET

OFTEN 13%

SOME TIME 30%

RARELY 23%

NEVER 34%

Often 13.1% Sometime 30.3% Rarely 22.%8 Never 33.8%

COMPARING YOURSELF TO OTHER PEOPLE IN YOUR AGE AND GENDER

no answer17%

Worse than the major-ity5%

Average33%

Better than a few other people23%

Better than the majority22%

SPOUSE AND OWN INCOME GRAPH.

less then 35000 pkr above then 35000 pkr no answer0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

own incom

spouse incom

MEDICAL BILLS AND DOCTOR VISIT.

  Very easy Fairly easy Fairly difficult Very difficult

Pay for

medication if

needed to manage

your own health?

 

20 % 34 % 21 % 06 %

Are you able to

afford to see the

doctor in regard

to time,

16 % 24 % 29 % 10 %

0.00%

10.00%

20.00%

30.00%

BALANCE BETWEEN HEALTH AND WORK

Series 1

HEALTH LITERACY INDICES To standardize the health literacy survey results construct a health literacy indice.health literacy indices is

based on the European health literacy survey (HLS-EU) indices .linkert scale is used for answering the health literacy questions the higher value of answer very easy is 4

Scale is between 1-50 for convenient calculations of literacy level. Formula for indices is   Index = (mean - 1) * (50/3)   Index = specific calculation Mean = mean of each individual each item 1 = minimum possible value of mean

3 = range of mean 50 = maximum value of scale

Health Literacy47 Questions

Acess,obtain Information Relevant To Health (13)

Understand Information Relevant To Health (11)

Process, appraise Information Relevant To Health (12)  

Apply, use Information Relevant To Health (11)

HEALTH CARE16 QUESTIONS

ABALITY TO ACESS HEALTH INFORMATION (4)

ABALITY TO UNDERSTAND HEALTH INFORMATION (4)

ABALITY TO INTERPRATE HEALTH INFORMATION (4)

ABALITY TO APPLY HEALTH INFORMATION (4) 

 DISEASE PREVENTION15 QUESTIONS  

RISK FACTORS (4) RISK FACTORS (3) RISK FACTORS (5) RISK FACTORS (3)

HEALTH PROMOTION16 QUESTIONS

UP DATE ONSELF ON HEALTH ISSUES(5)

HEALTH ISSUES (4)

HEALTH ISSUES (3)

APPLY PROMOTIONAL ACTIVITIES (4)

Health Care

Disease Prevention

Health Promotion

Health literacy general

0 5 10 15 20 25 30 35 40 45 50

DISTRIBUTION OF HEALTH LITERACY ON HEALTH LITERACY INDICES

RELATIONSHIP BETWEEN GENDER AND HEALTH LITERACY.

From the top row of the table of Chi-square test, Pearson Chi-Square statistic, the probability of the chi-square test statistic (chi-square=167.618) was p=0.000, less than or equal to the alpha level of significance of 0.05.Therefore, the null hypothesis(Ho=female gender is not associated with health literacy) is rejected. That means alternative hypothesis (Ha= female gender is associated with health literacy) is accepted and supported by this analysis.

 Variables Value df Asymp. Sig. (2-sided)

Pearson Chi-Square 167.618a 52 0.000

Likelihood Ratio 223.675 52 0.000

N of Valid Cases 290           

CORRELATIONS ANALYSIS Spearman’s rhoCorrelation is used for analysis of association of several economic

factors is done Spearman’s rho Pay for

medication

Affordability to

doctor

Payment of

utility bills

income

Pay for

medication

1 .820** .462** _0.25

Affordability to

doctor

  1 -4.52 -0.42

Payment of

utility bills

    1 0.79

Income       1

Correlation is significant at the 0.01 level (2-tailed).*

RECOMMENDATIONS/ ENABLING FACTORS

Monitoring an evaluation of teachers health literacy Health and education courses should be mandatory for teachers

during their carrier Public health campaign or at least one week in a year should be

introduced in school by the coordination of health and education ministries.

Social media can play far better role in this field

THANK YOU