Cross-sectional study to measure health literacy among the population over 18 years old in selected regions of the Russian Federation: relevance and study design

INTRODUCTION: Health literacy (HL) is a key factor that determines the effectiveness of decisions made by people with regard to a healthy lifestyle, prevention, and treatment of diseases. In addition, high-quality, updated, and comparable data are required to comprehensively understand the overall situation and identify specific areas for intervention. Therefore, the WHO suggests the regular measurement of HL in accordance with the WHO Action Network on Measuring Population and Organizational Health Literacy.

AIM: This study aimed to develop a comprehensive system for measuring HL in the prevention and treatment of noncommunicable diseases and in health promotion among the population aged 18 and older.

MATERIAL AND METHODS: A cross-sectional study was conducted. The questionnaire HLS₁₉-Q-22-RU_Russian on measuring HL, which was adapted for the Russian population, was used to ensure the reliability and comparability of the data at the international level. Internal consistency and reliability of the questionnaire were studied using Cronbach’s alpha coefficient. Participants of the study aged 18 years and older in three regions of the Russian Federation were selected using multistage random sampling. The population survey was conducted through personal interviews in households from November to December 2019.

Health literacy levels were formed by calculating the sum of dichotomous elements, which were standardized in the range of 0 to 100. Cut-off points of 50.0–66.6–83.3 were used as threshold values for determining HL levels. The resulting HL levels were labeled as “inadequate,” “problematic,” “sufficient,” and “excellent.”

RESULTS: Based on the HLS₁₉ international research standards for measuring HL, the design of the first population study in Russia was developed, which included five stages: adaptation of the questionnaire, sampling procedure, training of interviewers and supervisors, conducting a population study, and data analysis. The assessment of the internal consistency and reliability of the questionnaire using Cronbach’s alpha showed a high α value for the Russian questionnaire (α=0.9). Consequently, an international methodology for measuring HL, adapted for the Russian population, was applied.

CONCLUSION: The findings can be used by researchers, disease prevention, public health promotion, and decision-makers when selecting methods for comprehensive measurements of adult HL at the population level.