Measuring general health literacy using the HLS-Q12 in specialty consultations in Spain.

Background: General health literacy (general HL) affects both individual and population health on numerous levels, with low general HL leading to increased morbidity, poor health service utilization, and increased healthcare spending. This study calculated health literacy scores of a population attending specialty consultations in the community of Aragon, Spain. It further produced a sociodemographic profile and examined the relationships between patients' scores and sociodemographic variables.

Methods: A sample of 150 patients from specialty consultations completed the internationally- validated HLS-Q12 to measure adult general HL. A 4-point-Likert scale gathered information regarding 12 items of health literacy. Final scores were divided into four categorical levels: excellent, sufficient, problematic, or inadequate. Independent sample t-test, one-way ANOVA, and a generalized linear model (GLM) analysis were performed to examine key relationships with respect to sociodemographic variables and health literacy scores.

Results: The survey was completed by 150 subjects aged 18 and over in specialty clinics in Aragon, Spain. 59% of respondents had inadequate or problematic general HL, while 41% had sufficient or excellent general HL. Income level had a significant effect on health literacy scores, F = 2.129, (p < 0.05), as did different work situations, F = 3.762, (p < 0.001). Patients who self-reported as having diabetes had a significantly higher health literacy score, t = 2.356 (p < 0.05) than those reporting other health conditions. According to GLM analysis, education, health status, income, and the number of appointments were the strongest predictors of the heath literacy score.

Conclusions: General HL in this patient population was limited, and lower than in some comparable studies. The sociodemographic profile constructed, and associations with health literacy established, provide policy makers, healthcare administrators, and clinicians with information to consider new policies, processes and strategies to improve general HL in this specific population.