Josefin Wångdahl

Health literacy among refugees in Sweden – a cross-sectional study

BackgroundRefugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. This study aims to determine levels of functional and comprehensive health literacy, and factors associated with inadequate health literacy, in refugees coming to Sweden.MethodA cross-sectional study was performed among 455 adult refugees speaking Arabic, Dari, Somali or English. Participants in 16 strategically selected language schools for immigrants responded to a questionnaire. Health literacy was measured using the Swedish Functional Health Literacy Scale and the HLS-EU-Q16 questionnaire. Uni- and multivariate statistical methods were used to investigate group differences.ResultsThe majority of the participating refugees had inadequate or limited functional health literacy and comprehensive health literacy. About 60% of them had inadequate functional health literacy and 27% had inadequate comprehensive health literacy. Low education and/or being born in Somalia were factors associated with an increased risk of having inadequate functional health literacy. Having inadequate functional health literacy was associated with an increased risk of having inadequate comprehensive health literacy.ConclusionsThe majority of refugees in the language schools had limited or poor health literacy. Health literacy should be taken into consideration in contexts and in activities addressing migrants. More research is needed to better understand health literacy among refugees and to develop strategies and methods to increase health literacy and make life easier for those with low health literacy.

Measuring health literacy – the Swedish Functional Health Literacy scale

BACKGROUND The benefits of health promotion efforts vary due to a complexity of reasons. One possible reason for an absence of effects is the level of functional health literacy among the individuals that participate in the interventions. Thus, valid and reliable instruments that capture these kinds of skills are needed. The aim of this study was to develop a Swedish Functional Health Literacy scale to use in health promotion and health prevention by translating the Japanese Functional Health Literacy scale into Swedish and testing some aspects of its validity and test-retest reliability. METHODS The research project comprised six phases including translation and back translation, validity tests of the two first versions of the instrument based on interviews with professionals and representatives for the target group of the instrument, and a test-retest of the first version among target groups. RESULTS The items in the first two versions were experienced as unclear, which led to improvements of the next version. The final version of the translated instrument (the Swedish Functional Literacy scale) showed evidence of content validity, and the test-retest confirmed that the instrument had stability over time with a percentage agreement for the items ranging from 63% to 92% (M = 77.2%). CONCLUSION The items in the Swedish version of the scale are equivalent to the original Japanese scale in terms of language and contents and cover the major aspects of functional health literacy as it is defined in the literature. The translated instrument shows stability over time, that is, reliability, at least for a part of the Swedish population. More validity tests of the Swedish Functional Health Literacy scale based on a broader population are needed.

The Communicative and Critical Health Literacy Scale – Swedish Version

Background: Health literacy (HL) is an important determinant for health and a valuable health indicator within public health. As such, it is a significant outcome variable of health promotion efforts. Valid and reliable instruments are needed to evaluate health promotion interventions and to assess levels of HL in a population. One of the few measurements of communicative and critical HL is the Japanese Communicative and Critical Health Literacy scale (C & C HL scale). To make it possible to use this instrument in Sweden, the C & C HL scale was translated into Swedish and different aspects of validity, including test–retest reliability, of the translated version were tested. Methods: After translation and back-translation, The Swedish C & C HL scale was tested for content validity and test–retest reliability. Data were collected from a committee consisting of public health experts and bilingual people, and from a test group of 35 persons. Results: The Swedish C & C HL scale was understandable and showed evidence of content validity. The test–retest confirmed that it was stable over time, percentage agreements for the items ranging from 66% to 89% (M = 74%). Conclusions: The Swedish C & C HL scale is equivalent to the Japanese C & C HL scale in terms of language and content. The items cover the major aspects of communicative and critical HL and are understandable and stable over time, i.e., reliable.

Poor health and refraining from seeking healthcare are associated with comprehensive health literacy among refugees: a Swedish cross-sectional study

ObjectivesThe objectives of the study were to explore the distributions of comprehensive health literacy (CHL), general health, psychological well-being, and having refrained from seeking healthcare among refugees in Sweden. Further objectives were to examine associations between CHL and the above-mentioned factors.MethodsA cross-sectional study was conducted among 513 refugees speaking Arabic, Dari, and Somali. Participants in the civic orientation course in Sweden responded to a questionnaire. CHL was measured using the HLS-EU-Q16 questionnaire. Uni- and multivariate logistic regression was used to investigate potential associations.ResultsThe majority of the respondents had limited CHL, and about four of ten had reported poor health and/or having refrained from seeking healthcare. Limited CHL was associated with having reported poor health and having refrained from seeking healthcare.ConclusionsA considerable proportion of the refugees in Sweden have limited CHL, and report less than good health and impaired well-being, or that they have refrained from seeking healthcare. Furthermore, CHL is associated with the above-mentioned factors. Efforts are needed to promote refugees’ CHL, optimal health-seeking behavior, and health.

2.11-P1Experiences of the health examination for asylum seekers - focus group discussions with Arabic and Somali speaking refugees in Sweden

Experiences of the HealthExamination for Asylum Seeker : Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden

Experiences of the Health Examination for Asylum Seekers - Focus Groups with Refugees in Sweden

Experiences of the Health Examination for Asylum Seekers - Focus Groups with Refugees in Sweden