Determinants of health literacy among older adults in Saboba district in Ghana: a cross-sectional study

加纳萨博巴地区老年人健康素养的决定因素:一项横断面研究

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Abstract

BACKGROUND: Patient health literacy (HL) is increasingly recognized as a critical factor affecting healthcare outcomes. People with inadequate or limited health literacy are more likely to misunderstand their disease and treatment, which subsequently leads to incorrect use of medications or failure to follow prescribed treatment regimens, resulting in poor outcomes. Therefore, this study assessed the level of health literacy, and the factors associated with health literacy among older adults in Saboba District in the northern region of Ghana. METHOD: An analytical quantitative cross-sectional design was used. The study participants (420) were selected through a multistage sampling technique. Data were collected using a structured questionnaire and analyzed with Stata Version 16.0. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported to indicate the presence of statistically significant factors associated with older adults' health literacy. Variables with p values less than 0.05 were considered significant. RESULTS: The overall health literacy (HL) score was 15.34 ± 4.88. Among the health literacy domains, the healthcare HL domain had the highest mean score (16.78 ± 2.17), whereas the disease prevention HL domain had the lowest mean score (14.45 ± 4.38). Multiple linear regression analysis indicated that age, religion, and educational attainment were significant predictors of health literacy among elderly participants. Compared with those aged 65-69 years, participants aged 70-79 years presented a reduction in the general HL score of -0.87 units (95% CI: -1.54; -0.20, p = 0.011). Similarly, traditionalists had a -0.79-unit reduction in the HL score (95% CI: -1.47; -0.10, p = 0.024) compared with Christian participants. In contrast, significantly higher HL scores were observed among older adults with education levels of J.H.S. (β = 4.08, 95% CI: 2.87; 5.29), S.H.S. (β = 7.72, 95% CI: 5.90; 9.54), and tertiary (β = 10.79, 95% CI: 8.75; 9.54) than among those with no formal education. CONCLUSIONS: The study found that overall health literacy levels among older adults in the Saboba district were suboptimal. Age, religious affiliation, and educational attainment were significant predictors of higher health literacy scores. These findings underscore the need for sustained, targeted interventions aimed at improving health literacy among older populations, particularly in underserved rural settings.

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