Skip to main content

Advertisement

SpringerLink
Log in

Gesundheitskompetenz/Health Literacy

Das Konzept und seine Operationalisierung

Health literacy

An introduction to the concept and its measurement

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Gesundheitskompetenz (engl. Health Literacy) fand in den letzten zwei Jahrzehnten vielfältige Beachtung. Anfänglich verstanden als individuelle Fähigkeit, krankheitsrelevante Informationen in der von medizinischen Experten vorgesehenen Form zu verstehen, entwickelte sich in relativ kurzer Zeit ein breites Verständnis von Gesundheitskompetenz als einer personengebundenen Ressource für gesundheitsförderliches Handeln in Alltagssituationen und klinischen Kontexten. Gesundheitskompetenz wird heute - je nach Anwendungskontext - unterschiedlich definiert und operationalisiert. Der vorliegende Beitrag gibt einen Überblick über aktuelle Definitionen von Gesundheitskompetenz, liefert am Beispiel der soziologischen Perspektive von Structure-Agency einen kurzen Einstieg in theoretische Grundlagen und berichtet über den Stand der Operationalisierungen von Gesundheitskompetenz. Stärken und Schwächen der derzeitigen Ansätze zum Konzept und zur Messung von Gesundheitskompetenz werden skizziert. Der vorliegende Artikel möchte so einen Beitrag leisten zur zielgerichteten Weiterentwicklung des Konzepts, insbesondere im Bereich Public Health und Gesundheitsförderung.

Abstract

Over the last 20 years, health literacy (German: Gesundheitskompetenz/health competency) has become a popular concept in research and health policy. Initially defined as an individual’s ability to understand medical information, the definition has quickly expanded to describe individual-based resources for actions or conduct relevant to health, in different socio-cultural or clinical contexts. Today, researchers and practice experts can draw on a wide variety of definitions and measurements. This article provides an overview of the definitions, briefly introduces the “structure and agency” approach as an example of theorizing health literacy, and shows different types of operationalization. The article presents the strengths and shortcomings of the available concepts and measures and provides starting points for future research in public health and health promotion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Simonds SK (1974) Health education as social policy. Health Educ Monogr 2:1–10

    Article  Google Scholar 

  2. Bankson HL (2009) Health literacy: an exploratory bibliometric analysis, 1997–2007. J Med Libr Assoc 97(2):148–150

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kondilis BK, Kiriaze IJ, Athanasoulia AP, Falagas ME (2008) Mapping health literacy research in the European Union: a bibliometric analysis. PLoS One 3(6):e2519

    Article  PubMed  PubMed Central  Google Scholar 

  4. World Health Organisation (2013) Health literacy. The solid facts. World Health Organisation, Copenhagen

    Google Scholar 

  5. Abel T, Sommerhalder K, Bruhin E (2011) Health Literacy/Gesundheitskompetenz. In: Blümel S, Franzkowiak P, Kaba-Schönstein L, Nöcker G, Trojan A (Hrsg) Leitbegriffe der Gesundheitsförderung. Bundeszentrale für gesundheitliche Aufklärung BZgA, Köln, S 337–340

    Google Scholar 

  6. Soellner R, Huber S, Lenartz N, Rudinger G (2009) Gesundheitskompetenz – ein vielschichtiger Begriff. Z Gesundheitspsychol 17(3):105–113

    Article  Google Scholar 

  7. Sorensen K, Van den Broucke S, Fullam J et al (2012) Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 12:80

    Article  PubMed  PubMed Central  Google Scholar 

  8. Selden CR, Zorn M, Ratzan SC, Parker R (2000) Health literacy. National Library of Medicine, Bethesda

    Google Scholar 

  9. Kickbusch I, Maag D, Saan H (2005) Enabling healthy choises in modern health societies. European Health Forum, Badgastein (6.–7. October 2005)

    Google Scholar 

  10. Abel T (2007) Cultural Capital in Health Promotion. In: McQueen DV, Kickbusch I (Hrsg) Health and modernity: the role of theory in health promotion. Springer, New York, S 43–73

    Chapter  Google Scholar 

  11. Nutbeam D (1998) Health promotion glossary. Health Promot Int 13(4):349–364

    Article  Google Scholar 

  12. Nutbeam D (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 15(3):259–267

    Article  Google Scholar 

  13. Smith SK, Nutbeam D, McCaffery KJ (2013) Insights into the concept and measurement of health literacy from a study of shared decision-making in a low literacy population. J Health Psychol 18(8):1011–1022

    Article  PubMed  Google Scholar 

  14. Nutbeam D (2008) The evolving concept of health literacy. Soc Sci Med 67(12):2072–2078

    Article  PubMed  Google Scholar 

  15. Sommerhalder K, Abel T (2007) Gesundheitskompetenz: Eine konzeptuelle Einordnung. Bundesamt für Gesundheit, Bern

    Google Scholar 

  16. Chinn D (2011) Critical health literacy: a review and critical analysis. Soc Sci Med 73(1):60–67

    Article  PubMed  Google Scholar 

  17. Gagné T, Frohlich KL, Abel T (2015) Cultural capital and smoking in young adults: applying new indicators to explore social inequalities in health behaviour. Eur J Public Health pii: ckv069 [Epub ahead of print]

  18. Kamin T, Anker T (2014) Cultural capital and strategic social marketing orientations. J Soc Marketing 4(2):94–110

    Article  Google Scholar 

  19. von Wagner C, Steptoe A, Wolf MS, Wardle J (2009) Health literacy and health actions: a review and a framework from health psychology. Health Educ Behav 36(5):860–877

    Article  Google Scholar 

  20. Soellner R, Huber S, Lenartz N, Rudinger G (2010) Facetten der Gesundheitskompetenz – eine Expertenbefragung. Z Padag 56:104–114

  21. Lenartz N (2012) Gesundheitskompetenz und Selbstregulation. V & R unipress, Göttingen

    Google Scholar 

  22. Paakkari L, Paakkari O (2012) Health literacy as a learning outcome in schools. Health Education 112(2):133–152

    Article  Google Scholar 

  23. Sorensen K, Pelikan JM, Rothlin F et al (2015) Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health, pii: ckv043 [Epub ahead of print]

  24. Abel T, Frohlich KL (2012) Capitals and capabilities: linking structure and agency to reduce health inequalities. Soc Sci Med 74(2):236–244

    Article  PubMed  Google Scholar 

  25. Shim JK (2010) Cultural health capital: a theoretical approach to understanding health care interactions and the dynamics of unequal treatment. J Health Soc Behav 51(1):1–15

    Article  PubMed  Google Scholar 

  26. Haun JN, Valerio MA, McCormack LA, Sorensen K, Paasche-Orlow MK (2014) Health literacy measurement: an inventory and descriptive summary of 51 instruments. J Health Commun 19(Suppl 2) 302–333

    Article  PubMed  Google Scholar 

  27. Altin SV, Finke I, Kautz-Freimuth S, Stock S (2014) The evolution of health literacy assessment tools: a systematic review. BMC Public Health 14:1207

    Article  PubMed  PubMed Central  Google Scholar 

  28. Jordan JE, Osborne RH, Buchbinder R (2011) Critical appraisal of health literacy indices revealed variable underlying constructs, narrow content and psychometric weaknesses. J Clin Epidemiol 64(4):366–379

    Article  PubMed  Google Scholar 

  29. Mancuso JM (2009) Assessment and measurement of health literacy: an integrative review of the literature. Nurs Health Sci 11(1):77–89

    Article  PubMed  Google Scholar 

  30. O'Neill B, Goncalves D, Ricci-Cabello I, Ziebland S, Valderas J (2014) An overview of self-administered health literacy instruments. PLoS One 9(12):e109110

    Article  PubMed Central  Google Scholar 

  31. Murphy PW, Davis TC, Long SW, Jackson RH, Decker BC (1993) Rapid estimate of adult literacy in medicine (realm) – a quick reading test for patients. Journal of Reading 37(2):124–130

    Google Scholar 

  32. Rawson KA, Gunstad J, Hughes J et al (2010) The METER: a brief, self-administered measure of health literacy. J Gen Int Med 25(1):67–71

    Article  Google Scholar 

  33. Parker RM, Baker DW, Williams MV, Nurss JR (1995) The test of functional health literacy in adults – a new instrument for measuring patients literacy skills. J Gen Int Med 10(10):537–541

    Article  CAS  Google Scholar 

  34. Weiss BD, Mays MZ, Martz W et al. (2005) Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med 3(6):514–522

    Article  PubMed  PubMed Central  Google Scholar 

  35. Rudd R, Kirsch I, Yamamoto K (2004) Literacy and health in America. ETS Educational Testing Service, Princeton, NJ

    Google Scholar 

  36. Hahn EA, Choi SW, Griffith JW, Yost KJ, Baker DW (2011) Health literacy assessment using talking touchscreen technology (Health LiTT): a new item response theory-based measure of health literacy. J Health Commun 16:150–162

    Article  PubMed  Google Scholar 

  37. Ackermann Rau S, Sakarya S, Abel T (2014) When to see a doctor for common health problems: distribution patterns of functional health literacy across migrant populations in Switzerland. Int J Public Health 59(6):967–974

    Article  PubMed  Google Scholar 

  38. Reavley NJ, Morgan AJ, Jorm AF (2014) Development of scales to assess mental health literacy relating to recognition of and interventions for depression, anxiety disorders and schizophrenia/psychosis. Aust N Z J Psychiatry 48(1):61–69

    Article  PubMed  Google Scholar 

  39. Chinn D, McCarthy C (2013) All aspects of health literacy scale (AAHLS): developing a tool to measure functional, communicative and critical health literacy in primary healthcare settings. Patient Educ Couns 90(2):247–253

    Article  PubMed  Google Scholar 

  40. Sorensen K, van den Broucke S, Pelikan JM et al (2013) Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health 13:948

    Article  PubMed  PubMed Central  Google Scholar 

  41. Osborne RH, Batterham RW, Elsworth GR, Hawkins M, Buchbinder R (2013) The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ). BMC Public Health 13:658

    Article  PubMed  PubMed Central  Google Scholar 

  42. Abel T, Hofmann K, Ackermann S, Bucher S, Sakarya S (2014) Health literacy among young adults: a short survey tool for public health and health promotion research. Health Promot Int [Epub ahead of print]

  43. Ishikawa H, Takeuchi T, Yano E (2008) Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care 31(5):874–879

    Article  PubMed  Google Scholar 

  44. Morris NS, MacLean CD, Chew LD, Littenberg B (2006) The single item literacy screener: evaluation of a brief instrument to identify limited reading ability. BMC Family Practice 7:21

    Article  PubMed  PubMed Central  Google Scholar 

  45. Pleasant A, McKinney J, Rikard RV (2011) Health literacy measurement: a proposed research agenda. J Health Commun 16(Suppl 3):11–21

    Article  PubMed  Google Scholar 

  46. Abel T (2008) Measuring health literacy: moving towards a health – promotion perspective. Int J Public Health 53(4):169–170

    Article  PubMed  Google Scholar 

  47. McCormack L, Haun J, Sorensen K, Valerio M (2013) Recommendations for advancing health literacy measurement. J Health Commun 18(Suppl 1):9–14

    Article  PubMed  PubMed Central  Google Scholar 

  48. Greenhalgh T (2015) Health literacy: towards system level solutions. BMJ 350:h1026

    Article  PubMed  Google Scholar 

  49. Bundesamt für Gesundheit (2013) Die gesundheitspolitischen Prioritäten des Bundesrates. Bundesamt für Gesundheit, Bern

    Google Scholar 

  50. Bundesministerium für Gesundheit (2013) Rahmen-Gesundheitsziele. www.gesundheitsziele-oesterreich.at. Zugegriffen: 13. März 2015

  51. Kickbusch I (2006) Die Gesundheitsgesellschaft. Megatrends der Gesundheit und deren Konsequenzen für Politik und Gesellschaft. Verlag für Gesundheitsförderung, Werbach-Gamburg

    Google Scholar 

  52. Sykes S, Wills J, Rowlands G, Popple K (2013) Understanding critical health literacy: a concept analysis. BMC Public Health 13:150

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Social and Preventive Medicine, Universität Bern, Finkenhubelweg 11, 3012, Bern, Schweiz

    Thomas Abel

  2. Berner Fachhochschule Fachbereich Gesundheit, Bern, Schweiz

    Kathrin Sommerhalder EMPH

Authors
  1. Thomas Abel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathrin Sommerhalder EMPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Abel.

Ethics declarations

Interessenkonflikt

T. Abel und K. Sommerhalder geben an, dass kein Interessenkonflikt besteht.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abel, T., Sommerhalder, K. Gesundheitskompetenz/Health Literacy. Bundesgesundheitsbl. 58, 923–929 (2015). https://doi.org/10.1007/s00103-015-2198-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00103-015-2198-2

Schlüsselwörter

Keywords

Search

Navigation