The Ability to Read, Understand, and Act on Health Information Is Called
What is the meaning of health literacy? A systematic review and qualitative synthesis
Abstract
The objective of this review was to clarify what health literacy represents. A systematic review with qualitative syntheses was performed (CRD42017065149). Studies concerning health literacy in all settings were included. Studies earlier 15 March 2022 were identified from PubMed, Medline, Embase, Web of Scientific discipline, Scopus, PsycARTICLES and the Cochrane Library. The included literature either had defined the concept of health literacy or made a detailed caption of health literacy. A total of 34 original studies met the inclusion criteria, including thirteen involved in previous systematic reviews and 21 new studies. Health literacy was commonly conceptualised as a set of knowledge, a ready of skills or a bureaucracy of functions (functional-interactive-disquisitional). The construct of health literacy covers iii broad elements: (1) knowledge of wellness, healthcare and health systems; (2) processing and using information in various formats in relation to wellness and healthcare; and (iii) ability to maintain health through cocky-management and working in partnerships with health providers. Health literacy is divers as the ability of an individual to obtain and interpret cognition and data in order to maintain and improve health in a fashion that is appropriate to the individual and organisation contexts. This definition highlights the diversity of needs from different individuals and the importance of interactions between individual consumers, healthcare providers and healthcare systems.
- health literacy
- qualitative inquiry
- public wellness
http://creativecommons.org/licenses/by-nc/4.0/
This is an open access article distributed in accordance with the Creative Eatables Attribution Non Commercial (CC Past-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original piece of work is properly cited, appropriate credit is given, whatsoever changes made indicated, and the utilise is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
- wellness literacy
- qualitative research
- public health
Introduction
Health literacy, as a term first proposed in the 1970s,i mostly concerns whether an individual is competent with the complex demands of promoting and maintaining health in the modernistic order.ii Over the past two decades, increasing attending has been attached to the concept due to its meaning benefits to private and public health and the sustainability of healthcare systems.three–8 It is considered peculiarly important when non-communicable diseases (NCDs) prevail and their corresponding costs are steadily rising,9 highlighting the need for people to take more responsibility in managing their own health with more effective use of health services.ten Inadequate wellness literacy is associated with difficulties in comprehension of health information, express knowledge of diseases and lower medication adherence, which contribute to poor health, loftier risk of mortality, insufficient and ineffective apply of healthcare, increased costs, and health disparities.4 6 xi The existing bear witness seems to suggest wellness literacy equally one of the well-nigh promising and toll-constructive approaches to overcome the NCD challenges.12 13 Many countries have included health literacy as a central priority in their policies and practices, such every bit the U.s.a., Canada, Australia, the European Union and China.14 The WHO recommends health literacy every bit an instrument for achieving several key targets listed in the Sustainable Development Goals.fifteen
Despite the realisation of the importance of wellness literacy to human being health and extensive studies into this expanse over the by few decades, there is all the same a lack of consensus on 'what the concept really represents'.xvi Such an essential enquiry question has frequently been overlooked.13 The concept of wellness literacy seems to be very flexible, which allows anyone to place most whatever one wants equally health literacy. Over 250 dissimilar definitions be in the academic literature.17 The unclear and inconsistent interpretations of health literacy are projected to limit the development of valid and reliable measurements, the accurate evaluation and comparisons of health literacy initiatives, and the synthesis of bear witness to support strategies for improving health literacy.13 xiv xvi–18 Furthermore, the confusion of the concept is probable to produce disjointed and even contradictory findings, jeopardising the evolution and implementation of trustworthy and effective wellness literacy-related interventions and policies.xiii 14 16
This study aimed to analyze 'what health literacy represents' through a systematic review and qualitative synthesis of existing studies beyond dissimilar contexts in relation to this circuitous concept.
Methods
Search strategy and selection criteria
A systematic review post-obit a registered protocol (no: CRD42017065149) was conducted, which followed the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative research) guidelines. The search strategy was adapted based on a previous systematic review,five using a combination of keywords such as 'health literacy', 'definition', 'concept' and so on. We searched PubMed, Medline, Embase, Spider web of Science, Scopus, PsycARTICLES and the Cochrane Library and restricted our search to articles published from 1 Jan 2010 to 15 March 2022 (date of last search) simply because the most recent systematic review analysed literature published before 2010 (details of the search protocol in online supplementary table S3).
Supplemental textile
Championship, abstract and total texts of retrieved records were examined by two authors against the inclusion and exclusion criteria, independently. Discrepancies, if occurred, were resolved through consultations with the third author.
The included literature either had an explicit objective to define the concept of health literacy or made an implicit contribution to people's understanding of health literacy: for example, studies that explored the constructs of health literacy. Studies with an interpretive nature using an existing conceptual framework without making further contributions to the conceptualisation of health literacy, without any theoretical presentation of the concept of health literacy and those that were not written in the English language language were excluded.
Boosted studies were identified at this stage through scrutinising references of the included literature. These included studies published before 2010 simply had been omitted in the two previous systematic reviews.5 xix
Data analysis
A data collection chart (online supplementary table S4) was adult and guided the extraction of the bibliographic data and the results of the conceptualisation of health literacy in the included studies. The bibliographic information covered report objectives and methods, describing why and where the written report was undertaken, who participated in the report, and how data were collected and analysed. The results of the conceptualisation of health literacy focused on the underlying constructs and meaning of health literacy.5 19 2 of the authors extracted information independently. The two sets of chart were crosschecked and eventually amalgamated through group discussions.
A data-driven thematic assay was adopted using a semigrammatical coding approach.xx According to Braun and Clarke,21 this involved four steps: data familiarisation, initial coding, themes searching, and themes reviewing and naming.
In the commencement step, included studies were repeatedly read, and all statements relevant to the inquiry question were identified using the information collection nautical chart, forming a data pool for qualitative syntheses. A total of 570 statements were recorded.
In the 2d pace, each statement was divided into several parts using a semigrammatical coding arroyo, which included cores, actions, objects, aims and others (such as context). For example, Freedman et al22 interpreted wellness literacy as 'the skills necessary to obtain, process, evaluate, and act upon information needed to make public health decisions that benefit the customs'. This statement was coded equally 'necessary skills' (cores), 'to obtain, process, evaluate and act upon' (actions), 'needed information' (objects), and 'to make public health decisions that do good the customs' (aims).
The third step extracted shared common themes. The clustering procedure was mainly based on the codes (n=74) labelled every bit 'cores', simply also considered other codes (actions, objects, aims and others) embodied in each statement.
Finally, the extracted themes were reviewed against the initial coding and information puddle and renamed if necessary. This was to ensure that the data pool was well represented and the relationships betwixt codes and themes were non distorted.
Two reviewers conducted steps ane and ii independently, and their results were crosschecked and reconciled through negotiations. Steps 3 and four were conducted in groups. Consensus was achieved through constant negotiations and discussions inside the research team.
Results
Characteristics of included studies
A total of 6029 records were retrieved from the databases and 2368 duplications were removed. After screening of titles and abstracts, 589 studies were kept for full-text reviewing. The total-text reviews identified 569 studies that failed to run across our inclusion criteria: 394 due to a lack of conceptualisation; 139 due to their interpretive nature for existing conceptual frameworks; 3 due to a lack of interpretations of the concept; and 33 due to language barriers (non-English language publications). We and so added the 13 studies included in the two previous systematic reviews.5 19 One more report was identified from references screening. This resulted in a terminal sample size of 34 for our systematic review (effigy 1).
About ii-thirds of the included studies explored the concept of health literacy in general populations,3–5 xix twenty 22–37 while the others focused on children and adolescents,38–42 elderly people,43 patients with chronic diseases,44–47 gay men,48 cancer caregivers,49 and people with limited English language proficiency.fifty Almost studies adopted a broad and full general concept of health literacy without restricting to a specific health topic. But eight studies placed the concept of wellness literacy nether a particular context, such as public health,22 sexual health,48 tobacco control,41 complementary medicine,37 verbal exchange of data,35 functional health47 and critical thinking34 36 (online supplementary tabular array S1).
Of the 34 included studies, nineteen involved original data4 5 19 20 23 24 26 28 32 35–37 39 41–44 48 49 and xv were theoretical proposals.3 22 25 27 29–31 33 34 38 40 45–47 l The former performed concept analyses,28 32 36 43 concept mapping,23 49 thematic analyses,5 19 24 35 41 42 48 grounded theory analyses,26 35 39 semigrammatical analyses20 or framework analyses44 on qualitative data collected from documents, interviews or focus groups. The latter were largely views from experts, with express data virtually how the conceptualisation was washed. Those theoretical studies were usually published before 2013 during the early stage of arguments well-nigh the concept of health literacy. Since then, the literature has been dominated by empirical studies (online supplementary table S1).
What is health literacy?
Wellness literacy was commonly conceptualised as a set of knowledge, a set of skills or a hierarchy of functions (functional-interactive-critical).
Four studies highlighted knowledge as the core in the concept of health literacy. Schulz and Nakamoto25 identified health literacy equally a set of bones literacy, declarative knowledge, procedural knowledge and judgement skills. Declarative knowledge represents people's agreement of factual data well-nigh health, while procedural knowledge represents people's understanding of rules that guide people's reasoned choices and actions. In combination, they enable people to learn and use information in various contexts and govern the competence of different tasks.25 Similarly, Paakkari and Paakkari38 divers health literacy equally a set of theoretical knowledge, applied knowledge and critical thinking, respective to declarative noesis, procedural knowledge and judgement skills proposed by Schulz and Nakamoto.25 In addition, Paakkari and Paakkari38 argued that self-sensation and citizenship also form a function of health literacy considering they represent i'south ability to assess oneself in an informed way and to have responsibility to ameliorate health across a personal perspective. Rowlands et al24 found that health literacy is reflected in people'southward ability to acquire, sympathize and evaluate cognition for health. Shreffler-Grant et al37 specified the knowledge regarding the dosage, effect, prophylactic and availability of medicines as health literacy associated with complementary medicines (online supplementary table S1).
Arguably, the Institute of Medicine (IoM) presented one of the most influential models of health literacy. The IoM model contains four underlying constructs: cultural and conceptual cognition, print health literacy (writing and reading skills), oral wellness literacy (listening and speaking), and numeracy.iv Information technology has a potent focus on the required skills for people to obtain, process and apply information for the purpose of medical care. This model has attracted back up from many researchers. For case, Baker30 refined the contents of health-related print literacy and oral literacy in general populations. Harrington and Valerio35 refined details of verbal exchange of health information, similar to the concept of oral health literacy. Yip50 argued that speaking, reading, writing, listening and numeracy are particularly important for people with limited English proficiency. Squiers et al19 added negotiation skills into oral health literacy and relabelled it as communication skills. Navigation skills were also proposed by Squiers et al19 equally an important element in the eHealth context. Sørensen et al summarised the literature and presented skills to access, sympathise, appraise and apply information and cognition as iv core skills of health literacy, which can embrace all related works that people need to carry on when dealing with health information to better and maintain wellness.5 Mancuso28 and Oldfield and Dreher43 emphasised the importance of comprehension skills. Speros32 further added successful functioning in the patient role equally a cadre construct of health literacy (online supplementary table S1).
Several studies viewed health literacy every bit a hierarchy of functions, which require dissimilar levels of social and cerebral skills. Nutbeam3 first proposed the three-level model: functional health literacy, interactive health literacy and disquisitional health literacy. This model was further clarified and expanded by several researchers.34 36 forty–42 45 47 In Nutbeam's prototypical model, functional wellness literacy refers to 'basic skills in reading and writing to enable individuals to role effectively in everyday situations'; interactive health literacy covers 'more avant-garde skills to extract information and derive significant from different forms of communication, and to apply new information to change circumstances'; critical health literacy requires 'the highest-level of skills to critically analyse and use information to exert greater control over life events and situations'.iii Schillinger47 interpreted functional health literacy as literacy and numeracy. Chinn34 considered critical health literacy as the role of agreement social determinants of wellness and engaging in collective deportment. Sykes et al believed that disquisitional health literacy covers advanced personal skills, health noesis, information skills, effective interactions between service providers and users, informed decision making, and empowerment including political actions.36 Manganello40 added media literacy, the power to critically assess media letters, every bit a dissever construct into health literacy for adolescents to highlight the importance of media apply in the specific population. Liao et al42 examined the meaning of the Nutbeam model in children: functional health literacy—understanding basic health concepts, comprehending the relationship between health behaviours and health outcomes, and performing basic health behaviours; interactive health literacy—maintaining expert relationships with peers, accordingly expressing oneself and responding to others, and sufficiently understanding a diversity of information from the surroundings; critical health literacy—assessing, analysing and predicting the influence of health information of all types and responding accordingly (online supplementary table S1).
Autonomously from the abovementioned models, some researchers attempted to conceptualise wellness literacy from other perspectives. Drawn on experts' views, Soellner et al23 proposed addition of cocky-perception, proactive approach to health, cocky-regulation and cocky-control into the concept of wellness literacy. By contrast, Jordan et al26 examined the views of patients and proposed three dimensions of health literacy: identifying a health issue (knowing when and where to find health information), engaging in information exchange (verbal communication skills, assertiveness and literacy skills) and acting on wellness information (capacity to procedure and retain data, and application skills). Buchbinder et al20 combined the views from both patients and health professionals and summarised health literacy every bit knowledge, attitude, attribute, relationship, skills, actions and context in relation to sixteen aspects such as diseases, health systems, data and others. Several studies emphasised some special elements disquisitional to a particular population: for example, consistency, commitment and contents of data for sexual health of gay men48; cocky-management skills and agile interest in consultations for patients with chronic diseases44; relationships and support systems for cancer caregivers49; patient–provider relationship and preventive care (indicating a proactive approach to health); and the rights and responsibilities (capturing principles of self-efficacy and empowerment to manage one's health surroundings) for adolescents.39 Freedman et al focused on public wellness literacy and proposed civic orientation, indicating skills and resource needed to accost wellness concerns past civic engagement, every bit one of the aspects of health literacy.22 Zarcadoolas et al31 added science literacy (competence with science and technology) and cultural literacy (ability to detect and use diverse beliefs, customs and values) equally common features required for interpreting and interim on health information (online supplementary table S1).
Elements of health literacy
The thematic analysis extracted three key themes that are well representative of the various models adopted in the included studies: (1) knowledge of health, healthcare and health systems; (two) processing and using information in diverse formats in relation to wellness and healthcare; and (3) ability to maintain wellness through self-management and working in partnerships with health providers (online supplementary tabular array S2).
Cognition of health, wellness care and health systems
The theme of knowledge refers to the understanding of factual information nearly health and can exist further divided into iv aspects, namely knowledge of medicine, knowledge of wellness, cognition of health systems and knowledge of science.4 20 22 23 25 31 34 36–39 42–44 49 Knowledge of medicine refers to the understanding of data nether the medical context, such equally medications, treatments and illness states, while cognition of health is focused on agreement information in regard to health under everyday situations, for instance, healthy behaviours, healthy lifestyle, health terms and public health. Knowledge of healthcare systems refers to the understanding of data nearly the bones construction and available services of a health system, which helps people apply the organisation in a more effective and efficient way. Finally, noesis of science refers to the understanding of key scientific concepts and scientific arguments (online supplementary table S2).
Processing and using data in various formats in relation to wellness and healthcare
This theme concerns whether people are able to process and use information in relation to wellness and healthcare finer. Information technology can be further divided into iv subthemes: ability to process and use information to guide health actions, self-efficacy in processing and using health information, provision of health information (active date in broadcasting of consistent data in a language that is appropriate to consumers), and access to resources and back up for processing data.
Ability to procedure and use information to guide health actions
This subtheme refers to the multidimensional skill ready that is necessary for dealing with and applying information in health actions. It has been widely accepted as an essential component of wellness literacy in the existing literature. The skill fix contains full general skills of literacy and numeracy, such every bit reading, writing, numeracy, listening and speaking, equally well equally special skills for obtaining, understanding, appraising, communicating, synthesising and applying health-related information. A health-literate consumer knows when and where to seek, detect and retrieve printed information and whom to talk to for information advice; is able to comprehend the significant of obtained information; and can appraise the brownie and scientific context of the information and its relevance to oneself. The skill set too enables the consumer to share obtained information with others and express her/his own preferences effectively. The ability to compare, contrast, weigh upwards and integrate relevant data is required for the purpose of applying the information in making decisions at the individual level and/or at the societal level (online supplementary table S2).
Cocky-efficacy in processing and using health information
Self-efficacy is a psychological concept which refers to one's conventionalities in i's ability to succeed and subsequent efforts put in executing the tasks.20 23 26 28 36 38 39 49 2 components emerged from the subtheme 'self-efficacy in health actions': self-conviction and accountability. Cocky-confidence indicates the post-obit psychological features: articulating oneself bravely, questioning healthcare providers and ensuring total comprehension of health data by asking for further clarifications. Accountability refers to i'due south attitudes towards her/his ain health and willingness to take responsibilities in managing her/his health. Self-efficacy determines how a person perceives health and applies health information in health actions (online supplementary table S2).
Provision of health information (active engagement in dissemination of consistent information in a linguistic communication that is appropriate to consumers)
Consumer communication and participation is important in all levels of health deportment.twenty 30 39 48 49 Baker argued that the complication of health data tin can go a serious barrier for people to engage in healthcare.30 At that place is a consensus that consumers need to participate in the generation and dissemination of health information in order to ensure the simplicity, consistency and accuracy of the presentation and dissemination of wellness information. The approach to provision of data may help or hinder people's understanding, processing and utilise of data.
Access to resource and support for processing and using information
Resource and back up are essential not just for realising ane'due south ain ability in processing and using knowledge and information in wellness actions, but also for complementing one's shortcomings in processing and using information. Statements in relation to this subtheme were first treated every bit a component of wellness literacy by Freedman et al.22 The contents of this subtheme were farther clarified by several other researchers,twenty 24 36 49 covering four aspects: access to health data and information infrastructure (eg, library and online services), information back up from healthcare providers, data back up from social networks (family unit, friends, colleagues and community organisations), and external resources (eg, financial resources and time committed to processing and use of information) (online supplementary table S2).
Ability to maintain health through cocky-direction and working in partnerships with wellness providers
This theme refers to one's ability of using her/his knowledge and information skill set to effectively manage health and illness conditions.20 23 28 38 42 This often involves both self-management and working in partnerships with wellness providers, requiring abilities of cocky-regulation, goal achieving and interpersonal skills. Self-regulation encompasses self-perception (awareness of one'due south own situation and preferences), self-reflection (critical analysis of oneself) and cocky-command (power to control oneself). Self-regulation is disquisitional to enable one to obtain private-tailored information and apply the information in a way that is appropriate to oneself. The power of goal achieving refers to a series of skills, based on which people tin set meaningful wellness goals, adapt strategies and eventually attain the goals. Interpersonal skills are associated with one's ability to understand, respect, listen and respond to others, and to build and maintain a harmonious relationship with them (online supplementary tabular array S2).
Discussion
In this study, we synthesised the results of 34 studies and institute that health literacy has been normally viewed as a set of knowledge, a set of skills or a hierarchy of functions (functional-interactive-critical). Three themes emerged from the 34 studies in regard to the concept of health literacy: (1) knowledge of health, healthcare and health systems; (2) processing and using information in diverse formats in relation to wellness and healthcare; and (three) ability to maintain wellness through self-direction and working in partnerships with health providers.
Health literacy started equally a concept associated with the individual ability in obtaining information and knowledge to support wellness deportment. Non surprisingly, all of the included studies examined the concept of health literacy from the 'data and noesis' perspective. The power of an individual to process and use information to guide health actions has been a major business organisation of those studies.
Health literacy has been commonly interpreted as an ability to use general literacy skills (reading, writing, numeracy, listening and speaking) in obtaining, understanding, appraising, synthesising, communicating and applying health-related data. The previous systematic review identified 'accessing, agreement, appraising, communicating and applying' health information as the five cadre components of health literacy.5 But it ignores the central role of full general literacy skills,four which can actually shape the needs and the way of i obtaining and using health-related data. For case, a person with a high level of knowledge and writing skills may not necessarily be able to convey information finer in verbal conversations. The literature also suggests that 'information synthesising' is missing in the previous systematic review.5 xix 'Information synthesising' is particularly important in the information era, where people are inundated with enormous amount of data. Under such circumstances, people should exist able to compare, counterbalance upwardly and integrate various information to brand an informed decision.
Cognition tin can exist considered as a result of data translation, or a precursor that determines how information is processed and used.25 38 Schulz and Nakamoto25 and Paakkari and Paakkari38 categorised cognition into declarative/theoretical noesis and procedural/applied cognition. In this report, the latter one is grouped into the theme 'processing and employ of information', while the declarative/theoretical knowledge covers cognition of medicine, knowledge of wellness, cognition of healthcare systems and noesis of scientific discipline.
The concept of health literacy has been evolving over the past decade. Information technology started with a doubt near the usefulness of 'information and knowledge', simply because a highly knowledgeable person may non exist able to materialise the benefits of caused information/knowledge.20 23 26 49 As a upshot, some researchers recommended the addition of cocky-efficacy equally a component of health literacy. Cocky-efficacy reflects the confidence and willingness of ane in using data/knowledge for health actions. Some researchers proposed further expansion of the concept of health literacy, pushing it beyond the confinement to individual abilities.20 30 48 49 Health knowledge is commonly produced by health professionals, while consumers are seen every bit passive recipients of knowledge. The linguistic communication and clauses used by health professionals are frequently difficult, if not impossible, for consumers to empathize.48 This has resulted in a groovy deal of frustration in the interaction between health providers and consumers, prompting calls for increasing engagement of consumers in the synthesis and broadcasting of noesis information.
The conceptual expansion of health literacy came as a result of empirical enquiries into the meaningfulness of health literacy. Several studies explored the meaning of health literacy from the perspectives of different populations. Dissimilar the theoretical analyses at an early stage, these studies present empirical evidence for advocating a change in the concept of health literacy.12 18 The ability to maintain health using caused data and knowledge is the utmost goal of the development of health literacy. This requires one to understand her/his own power and state of affairs and work in partnerships with others for achieving the all-time possible outcomes. Testify from the UK shows that most patients, caregivers and health workers consider health literacy every bit a 'whole organisation outcome' rather than an attribute of individuals.51 Edwards et al52 argued that i can acquire knowledge from others without necessarily going through the unabridged information processing process. When a person is looked after by a group of people from the family, the workplace, the health facility and the community, group health literacy appears to be even more than of import than private wellness literacy. Access to resources and support can serve as a proxy indicator of 'group health literacy'.
This study makes a significant contribution to the conceptualisation of health literacy. Pleasant13 points out that none of the existing definitions of wellness literacy were generated through a robust and rigorous scientific approach. The widely used original definition of wellness literacy, based on the individual ability to process and use information for health gains, has failed to find its evidence support from an increasing body of contempo empirical studies. We advise a renewed definition of health literacy, incorporating all relevant themes identified from the existing studies. Health literacy is "the ability of an individual to obtain and translate noesis and data in order to maintain and better health in a manner that is appropriate to the private and system contexts'. This definition highlights the diversity of needs from different individuals and the importance of interactions betwixt individual consumers, healthcare providers and healthcare systems for maintaining health. The whole-organization view tin can help people improve understand the function of health literacy and what needs to exist done for improving wellness literacy. Such a whole-organisation view has been advocated past more and more researchers and practices.53 54
Limitations
At that place are several limitations to this report. First, the included literature was express to those published in English. Second, the quality of the publications was not assessed as at that place was, in general, a lack of detailed descriptions of methods in the publications, which included some highly cited and influential publications.three 4 22 29–31 33 47 A small number of the included studies did endeavour to provide data to ensure quality, including clear recruitment strategies of participants,26 36 39 41 42 44 49 detailed data collection process,41 justification of why a specific method/pattern was adopted,24 36 41 44 and critical examination of the researcher's own role in their studies.41 55 Along with more studies apropos 'health literacy' with detailed descriptions of methods published, further synthesis of qualitative studies adopting quality assessment would be soon achievable. Third, the proposed definition of health literacy via systematic review in the current study is only the outset step; further studies adopting a Delphi process and/or consensus development conference are warranted to generate a refined and consensus for the definition and conceptualisation of health literacy.
Conclusions
Health literacy has been commonly conceptualised equally a gear up of cognition, a set of skills or a hierarchy of functions (functional-interactive-critical). We propose to define health literacy equally the 'ability of an individual to obtain and translate cognition and information in social club to maintain and ameliorate wellness in a way that is appropriate to the individual and system contexts'. Such a definition tin can cover the essence of the three broad themes identified from the literature review: (1) knowledge of wellness, healthcare and wellness systems; (ii) processing and using information in diverse formats in relation to health and healthcare; and (three) ability to maintain health through self-management and working in partnerships with health providers.
Request Permissions
If you wish to reuse any or all of this article please use the link below which volition take you to the Copyright Clearance Center's RightsLink service. You lot will be able to get a quick price and instant permission to reuse the content in many different means.
Copyright information:
© Author(due south) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-utilise. Run into rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/four.0/ This is an open up access commodity distributed in accordance with the Creative Commons Attribution Not Commercial (CC BY-NC iv.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on unlike terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/four.0/.
Source: https://fmch.bmj.com/content/8/2/e000351
Post a Comment for "The Ability to Read, Understand, and Act on Health Information Is Called"