University Center for General Medicine and Public Health (Unisanté), Department of Vulnerabilities and Social Medicine, University of Lausanne, Lausanne, Switzerland.
La Source School of Nursing, HES-SO, University of Applied Sciences and Arts, Western Switzerland, Lausanne, Switzerland.
PLoS One. 2023 Aug 9;18(8):e0288381. doi: 10.1371/journal.pone.0288381. eCollection 2023.
Health literacy, or a person's competence to access, understand, appraise and apply health information, can be considered a mediating factor between socioeconomic characteristics and health disparities. Socioeconomically disadvantaged people in particular present with less health literacy skills. To develop targeted interventions tailored to their real needs, it is important to understand how they function and what difficulties they encounter when dealing with health information. The purpose of this study was to explore their experiences when accessing, understanding, appraising, and applying health information in their everyday lives.
Semi-structured face-to-face interviews were conducted with 12 socioeconomically disadvantaged adults living in the community in Switzerland (age range: 44-60 years old).
Thematic analysis of the interviews yielded four themes, describing the health literacy processes of participants, related barriers, and compensatory strategies used: Financial insecurity triggers the need for health information; Pathway 1: Physicians as ideal (but expensive) interlocutors; Pathway 2: The internet as a suboptimal alternative; and Pathway 3: Relatives as a default resource. The progression of socioeconomically disadvantaged people in the health literacy process is like an 'obstacle course', with numerous steps taken backwards before they can develop compensatory strategies to overcome the barriers to obtaining health information.
Financial deprivation seems to be the most important factor contributing to health literacy barriers. Appraising health information is the health literacy skill with which socioeconomically disadvantaged people struggle the most. Physician-based, individual skills-based, organizational, and policy-based interventions are needed to help them overcome their health literacy challenges.
健康素养是指人们获取、理解、评估和应用健康信息的能力，可以被视为社会经济特征与健康差异之间的中介因素。社会经济地位处于劣势的人群，其健康素养技能往往更差。为了制定针对他们实际需求的有针对性的干预措施，了解他们在处理健康信息时的功能和遇到的困难非常重要。本研究旨在探讨他们在日常生活中获取、理解、评估和应用健康信息的体验。
对瑞士社区中 12 名社会经济地位处于劣势的成年人（年龄范围：44-60 岁）进行了半结构化的面对面访谈。
对访谈内容进行主题分析，得出了四个主题，描述了参与者的健康素养过程、相关障碍和使用的补偿策略：经济不安全感引发对健康信息的需求；途径 1：医生是理想的（但昂贵的）对话者；途径 2：互联网是次优的替代方案；途径 3：亲属是默认资源。社会经济地位处于劣势的人在健康素养过程中的进展就像一场“障碍赛”，在他们能够发展出克服获取健康信息障碍的补偿策略之前，他们会多次倒退。
经济贫困似乎是导致健康素养障碍的最重要因素。评估健康信息是社会经济地位处于劣势的人最难以掌握的健康素养技能。需要采取以医生为基础、以个体技能为基础、以组织和政策为基础的干预措施，帮助他们克服健康素养挑战。
