Challenges in Navigating the Health Care System: Development of an Instrument Measuring Navigation Health Literacy

Lennert Griese, Eva-Maria Berens, Peter Nowak, Jürgen M. Pelikan and Doris Schaeffer
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Lennert Griese: School of Public Health, Interdisciplinary Centre for Health Literacy Research [ICHL], Bielefeld University, 33615 Bielefeld, Germany
Eva-Maria Berens: School of Public Health, Interdisciplinary Centre for Health Literacy Research [ICHL], Bielefeld University, 33615 Bielefeld, Germany
Peter Nowak: Department Health and Society, The Austrian Public Health Institute [GÖG], 1010 Vienna, Austria
Jürgen M. Pelikan: WHO-CC Health Promotion in Hospitals and Health Care, The Austrian Public Health Institute [GÖG], 1010 Vienna, Austria
Doris Schaeffer: School of Public Health, Interdisciplinary Centre for Health Literacy Research [ICHL], Bielefeld University, 33615 Bielefeld, Germany

IJERPH, 2020, vol. 17, issue 16, 1-17

Abstract: Due to their rapid expansion and complexity, it is increasingly difficult for patients to orient themselves in health care systems. Therefore, patients require a high degree of health literacy, or more precisely, navigation health literacy (HL-NAV). The actual extent of HL-NAV of patients and citizens is still largely unknown due to the lack of adequate measurement instruments. Thus, within the new international Health Literacy Population Survey 2019 (HLS 19 ), one aim was to develop a suitable instrument for measuring HL-NAV in the HLS 19 the HL-NAV-HLS19. The item development was conducted by an international working group within the HLS 19 Consortium led by the first and last authors. Methodologically, it is based on a scoping literature review, development of a conceptual framework for HL-NAV, and first item formation, as well as an evaluation by experts, stakeholders, focus groups, pre-test interviews, and continuously feedback from the HLS 19 Consortium. HL-NAV was defined as the ability to access, understand, appraise, and apply information on navigational issues, drawing on ten selected publications and the health literacy definition of the HLS-EU Consortium. Main tasks of HL-NAV at the system, organization, and interaction level were identified, to which first related items were assigned. Based on the feedback from experts, the focus group discussions, and the HLS 19 Consortium, the instrument was slightly revised. Finally, twelve items proved to be feasible in the pre-test. The instrument will be used for the first time in the HLS 19 survey and will provide first data on HL-NAV in general populations for the countries participating in HLS 19 . It is suited for cross-country comparisons and monitoring, as well as for intervention development. However, the instrument should be translated into and validated in further languages and countries for population samples.

Keywords: health literacy; hls-eu; navigation; orientation; health care system; instrument development; questionnaire; validation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (6)

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