Assessing health literacy in the Arab world. Validation of three measurement tools
Health literacy is a central concept today. With this term, we mean not only the knowledge about a disease or the behaviors that can help us stay health, but also the abilities to count, read and understand information about health, and the capacity to make a sound decision in different health contexts. In fact, several studies have shown that having a good level of health literacy can help us live longer and healthier, avoid behaviors which are dangerous for our health, and manage our health conditions better. Knowing the level of health literacy can help health education instructors design more tailored programs, and medical professionals to adjust the way to communicate with patients so that they can better understand information on their health condition and remember instructions and suggestions.
The picture emerging from assessing the general public health status of the Arab world is at the same time “markedly diverse and inhomogeneous” (Jabbour, 2013). The Arabic speaking region, which includes 22 countries stretching from Morocco to Oman, hosts some of the richest and poorest states in the world, resulting in remarkable disparities in terms of people’s quality of life, health status and health outcomes. Relatively little research has been carried out in the area so far, and local authorities mostly do not regard healthcare as a priority, spending as little as 8.2% of the total budget on public health, compared to 17% in OECD countries (Semlali, 2013; The World Bank, 2013). This is due, on the one hand, to political reasons whose outcomes have further deteriorated in the last few years, and on the other, to a number of cultural trends that are now causing some of the world records for tobacco consumption, obesity, depression, and road safety-related deaths. In the light of the critical circumstances which are peculiar to this socio-political moment, much attention must be paid by local governments and non-governmental stakeholders in order to address people’s desire for changes in their health system.
Our aim is to validate in Arabic a set of three instruments that can be used to assess the level of health literacy in Lebanon and, with small changes according to the healthcare system, in other Arab countries as well. These instruments, namely the S-TOFHLA, the REALM, and three Chew screening questions, have been used in several linguistic and cultural contexts (mainly Europe and the American continent) and have proved to be effective in their scope. Our research question is: “Can our validated tools prove to be a valid instrument to assess the level of health literacy of the Lebanese population?” As in previous similar studies, we expect to find higher levels of health literacy in younger and educated participants.