Health literacy in people with alcohol addiction – a pilot study

INTRODUCTION: Health literacy (HL) has been identified as one of the key determinants of population health. The research in this area suggests that limited HL may be associated with health risk behaviour such as substance use including alcohol use. The aim of this study was to examine the level of general health literacy (GHL) in people undergoing treatment for alcohol addiction and to determine the most problematic domain of HL according to the HLS-EU-Q47 questionnaire (healthcare, disease prevention, health promotion).

METHODS: This cross-sectional questionnaire survey was conducted between February and May 2018 in two healthcare facilities in the Czech Republic. The data were obtained from 113 inpatients and outpatients who were undergoing addiction treatment at the time of the study. We used the Czech version of the HLS-EU-Q47 questionnaire developed by the European Health Literacy Consortium to measure HL. The data was analysed using IBM SPSS Statistics 23. We examined the internal consistency of the questionnaire using Cronbach’s alpha, descriptive statistics was used to analyse the sociodemographic characteristics of the participants, and Pearson’s chi-squared test to test the independence of variables. The design of this study was approved by the Review Boards and all participants signed informed consent before participating in the study.

RESULTS: The mean score of GHL was 34.1 (out of 50) indicating sufficient level of HL. Almost half of the sample (46.9%) showed limited level of HL. The average GHL score of outpatients and inpatients was 33.9 and 34.3 respectively. The most problematic domain of HL was the health promotion with 50.5% of participants having limited level. We could not refuse independence of the GHL and any of the sociodemographic variables.

DISCUSSION: The health literacy in people with alcohol addiction was similar to the health literacy of Czech population. We hypothesized that given the severity of alcohol addiction, the majority of participants would have limited HL. However, the participants achieved overall better scores than general population. We assume that the reason for this might be associated with the level of education of participants, clinical setting of the study, and motivation of participants. Additionally, the results suggest that the HLS-EU-Q47 questionnaire might not be suitable for using in such a specific population.

CONCLUSIONS: The prevalence of limited health literacy in people with alcohol addiction is relatively high. The interventions to increase the level of HL may improve overall health condition of people with alcohol addiction as well as treatment outcomes and retention in the addiction treatment.