METHOD: This study will comprehensively review full-text papers published between 2013 and 2023. We will search 3 databases, PubMed, SCOPUS, and Web of Science, using the keyword search strategy to find articles related to the issue. Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used to guide the selection of relevant studies. The results will then be assessed using the standard Cochrane Quality assessment method. The outcome is addressed in light of a narrative synthesis that utilizes a theme category and focuses on each component's main conclusions.

RESULT: This protocol describes the planned scope and methodology for the systematic review and meta-analysis that will provide current evidence on; The status of health literacy among the community in protected areas and; The effect of Protected Areas on health literacy according to their types and characteristics.

METHODS: All 132 EDs were requested for a copy of written discharge instruction given to the patients. The mTBI discharge instructions were evaluated using the Patient Education Materials Assessment-Printable Tool (PEMAT-P) for understandability and actionability. Readability was measured using an online readability tool of Malay text. The content was compared against the discharge instructions recommended by established guidelines.

RESULTS: 49 articles were eligible for the study. 26 of the articles met the criteria of understandability, and 3 met the criteria for actionability. The average readability level met the ability of average adult. Most of the discharge instructions focused on emergency symptoms, and none contained post-concussion features.

OBJECTIVE: This study aimed to explore experiences related to health literacy in Asian patients with T2DM.

DESIGN: This is a qualitative study using in-depth interviews and focus group discussions. A framework analysis was used to analyse the data.

SETTING AND PARTICIPANTS: articipants (n = 24) were multi-ethnic patients with T2DM (n = 18) and their primary health-care providers (n = 6). This study was conducted in four primary health-care clinics in Malaysia.

RESULTS: Nine subthemes were identified within the four dimensions of health literacy: accessing, understanding, appraising and applying information.

DISCUSSION: Motivated patients actively sought information, while others passively received information shared by family members, friends or even strangers. Language and communication skills played important roles in helping patients understand this information. Information appraisal was lacking, with patients just proceeding to apply the information obtained. Patients' use of information was influenced by their self-efficacy, and internal and external barriers.

METHODS: A systematic review was conducted according to the PRISMA guidelines. The study protocol was registered with PROSPERO (CRD42017056150). We searched MEDLINE, EMBASE, PsycINFO, CINAHL and ERIC for articles published up to January 2017. Articles that measured HL levels in adult patients with T2DM; that used validated HL tools; and that were reported in English were included. Two reviewers assessed studies for eligibility and quality, and extracted the data. Prevalence of limited HL is calculated from the number of patients with less than adequate HL over the total number of patients with T2DM in the study. Meta-analysis and meta-regression analysis were conducted using the Open Meta-analyst software.

RESULTS: Twenty-nine studies involving 13,457 patients with T2DM from seven countries were included. In total, seven different HL measurement tools were used. The prevalence of limited HL ranged from 7.3% to 82%, lowest in Switzerland and the highest in Taiwan. Meta-regression analysis of all included studies showed the country of study (p<0.001), HL tool used (p = 0.002), and the country's region (p<0.001) contributed to the variation findings. Thirteen studies in the USA measured functional HL. The pooled prevalence of inadequate functional HL among patients with T2DM in the USA was 28.9% (95% CI: 20.4-37.3), with high heterogeneity (I2 = 97.9%, p <0.001). Studies were done in the community as opposed to a hospital or primary care (p = 0.005) and populations with education level lower than high school education (p = 0.009) reported a higher prevalence of limited HL.

DESIGN: A cross-sectional study was conducted from January to March 2018; data on patients' sociodemographic characteristics, diabetes knowledge, perceived social support and health literacy level were collected. Health literacy level was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47).

SETTING: Patients were recruited from four primary care clinics in Perak, Malaysia.

PARTICIPANTS: Adult patients diagnosed with T2DM who attended the study clinics during the study period.

PRIMARY OUTCOME VARIABLE: Patients with HLS-EU-Q47 General Index of ≤33 points were classified as having limited health literacy.

RESULTS: The prevalence of limited health literacy was 65.3% (n=279). In bivariate analysis, patients' ethnicity (p=0.04), highest education level (p<0.001), monthly income (p=0.003), having health insurance (p=0.007), English language fluency (p<0.001), Malay language fluency (p=0.021), attending diabetes education sessions (p<0.001), perceived social support (p<0.001) and diabetes knowledge (p=0.019) were factors associated with limited health literacy. In logistic regression, not being fluent in English was associated with limited health literacy (OR=2.36, 95% CI 1.30 to 4.30) whereas having high perceived social support (OR=0.52, 95% CI 0.40 to 0.69) and having attended diabetes education sessions (OR=0.42, 95% CI 0.27 to 0.68) were associated with adequate health literacy.

Methods: This cross-sectional study was conducted among 282 stroke patients who provided informed consent and were in follow-up at the Neurology Outpatient Department of Hospital Kuala Lumpur, Malaysia. The study employed a data-collection form that gathered information on sociodemographics, clinical treatment, outcome measures on MUSE, and medication-nonadherence reasons.

Results: The prevalence of poor medication understanding and use self-efficacy among stroke patients was 46.5%, of which 29.1% had poor "learning about medication" self-efficacy, while 36.2% lacked self-efficacy in taking medication. Beliefs about medicine (74.02%) was the commonest reason for medication nonadherence, followed by medication-management issues (44.8%). In the multivariate model, independent variables significantly associated with MUSE were health literacy (AOR 0.2, 95% CI 0.069-0.581; P=0.003), medication-management issues (AOR 0.073, 95% CI 0.020-0.266; P<0.001), multiple-medication issues (AOR 0.28, 95% CI 0.085-0.925; P=0.037), beliefs about medicine (AOR 0.131, 95% CI 0.032-0.542; P=0.005), and forgetfulness/convenience issues (AOR 0.173, 95% CI 0.050-0.600; P=0.006).

MATERIALS AND METHODS: The research method was qualitative using a Delphi technique. The statistical population consisted of 12 specialists in the field of medical library and information science and researchers and healthcare professionals. Eight dimensions and 42 items of patients' rights were identified and were approved by Delphi panel.

RESULTS: Regarding patients' rights to benefit from consumer health information services, eight dimensions including the right to health knowledge, the right to access to health information, the professional behavior of medical librarians with patients, content richness, information seeking skills, awareness of new services and products, the ease of using health information centers, and the professional behavior of healthcare professionals with patients were identified and approved.

METHODS: A cross sectional study was performed in three randomly selected centres that organised pre-marital courses. All Malay Muslim women participants aged 18 to 40 years old were recruited while non-Malaysian, illiterate, and had hysterectomy were excluded. Validated self-administered questionnaires used were European Health Literacy Questionnaire (HLS-EU-Q16 Malay) and Knowledge and attitude towards Cervical Cancer and Pap Smear Questionnaire. The mean percentage score (mean± SD) was calculated, with higher scores showed better outcomes. Multiple linear regression was used to measure the relationship of independent variables with attitude towards Pap smear.

RESULTS: A total of 417 participants were recruited with a mean age of 24.9 ± 3.56 years old. Prevalence of awareness of cervical cancer was 91.6% (n=382, 95% CI: 89.0%, 94.2%) and mean percentage score was 74.7%±7.6. Prevalence of awareness of Pap smear was 59.0% (n=246, 95% CI: 54.2%, 63.8%) and mean percentage score was 80.2% ± 6.5. The health literacy mean score was 13.3±3.6, with minimum score 0 and maximum score 16. The mean percentage score of attitudes towards Pap smear was 64.8%±9.3. Multiple linear regression analysis demonstrated significant relationship between health literacy (p=0.047) and knowledge of Pap smear (p<0.001) with attitude towards Pap smear.

METHODS: In the present study, nine young people (aged 16-23 years) from low-income backgrounds participated in a semi-structured interview about their perspectives on mental health problems, unusual psychological experiences and help-seeking.

RESULTS: Four themes were developed using thematic analysis. "Is it that they [have] family problems?" reflected participants' explanatory models of mental health problems. "Maybe in Malaysia" was concerned with perceptions of Malaysian culture as both encouraging of open sharing of problems and experiences, but also potentially stigmatizing. "You have to ask for help" emphasized the importance of mental health help-seeking despite potential stigma. "It depends on the person" addressed the challenges of engaging with psychological therapy.

METHODS: A cross-sectional study was conducted from March to April 2021. An online survey, consisting of socio-demographic characteristics, Internet use, eHealth Literacy Scale and mobile health application utilisation, was distributed amongst pharmacy undergraduates in public and private universities in Malaysia. Data analysis included descriptive statistics, one-way analysis of variance test, Mann-Whitney U test and Kruskal-Wallis test.

RESULTS: A total of 415 participants completed the survey (response rate    =    82.5%). The median eHealth Literacy Scale score (out of 40) was 31.0    ±    3.0 (interquartile range). More than one-third of participants (34.7%) were found to have low eHealth literacy. Many lacked confidence in making health decisions from online information (42.4%) and skills in distinguishing between high-quality and low-quality health resources (35.2%). Only 70.4% of the participants had mobile health applications installed on their smartphones and/or tablets. Some students felt that they were neither knowledgeable nor skilful enough to utilise mobile health applications (24.8%), whereas 23.9% were unaware of the mobile health applications available.

METHODS: Cross sectional analyses of N = 345 adult cancer survivors (5 years post cancer diagnosis) attending follow-ups at University Malaya Medical Centre, Malaysia. Face-to face-interviews were conducted using the 30-item Cancer Health Literacy Test and the Patient-Practitioner Orientation Scale to determine preference for patient-centered care.

METHODS: A total of 322 participants from the MyBFF@home study completed the Newest Vital Sign (NVS) test at baseline. However, only data from 209 participants who completed the NVS test from baseline to WL intervention were used to determine the HL groups. Change of the NVS scores from baseline to WL intervention phase was categorized into two groups: those with HL improvement (increased 0.1 score and above) and those without HL improvement (no change or decreased 0.1 score and more). Independent variables in this study were change of energy intake, nutrient intake, physical activity, anthropometry measurements, and body composition measurements between baseline and WL intervention as well as between WL intervention and WL maintenance. An Independent sample t-test was used in the statistical analysis.

RESULTS: In general, both intervention and control participants have low HL. The study revealed that the intervention group increased the NVS mean score from baseline (1.19 scores) to the end of the WL maintenance phase (1.51 scores) compared to the control group. There was no significant difference in sociodemographic characteristics between the group with HL improvement and the group without HL improvement at baseline. Most of the dietary intake measurements at WL intervention were significantly different between the two HL groups among intervention participants. Physical activity and body composition did not differ significantly between the two HL groups among both intervention and control groups.

OBJECTIVE: The aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge.

METHOD: This study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test-retest reliability of the OHLI-F.

METHODS: The development of the MUAPHQ C-19 was conducted in two stages. Stage I resulted in the generation of the instrument's items (development), and stage II resulted in the performance of the instrument's items (judgement and quantification). Six-panel experts related to the study field and ten general public participated to evaluate the validity of the MUAPHQ C-19. The content validity index (CVI), content validity ratio (CVR) and face validity index (FVI) were analysed using Microsoft Excel.

RESULTS: There were 54 items and four domains, namely the understanding, attitude, practice and health literacy towards COVID-19, identified in the MUAPHQ C-19 (Version 1.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVR for all items was above 0.7, except for one item in the health literacy domain. Ten items were revised to improve the item's clarity, and two items were deleted due to the low CVR value and redundancy, respectively. The I-FVI exceeded the cut-off value of 0.83 except for five items from the attitude domain and four from the practice domains. Thus, seven of these items were revised to increase the clarity of items, while another two were deleted due to low I-FVI scores. Otherwise, the S-FVI/Ave for every domain exceeded the cut-off point of 0.9, which is considered acceptable. Thus, 50-item MUAPHQ C-19 (Version 3.0) was generated following the content and face validity analysis.