Health Literacy Assessment Of Government School Teachers Of District Attock By: DR MOAZZAM ALI KHAN BSC.BDS.MSPH.

1. HEALTH LITERACY ASSESSMENT OF
GOVERNMENT
SCHOOL TEACHERS OF DISTRICT
ATTOCK
A CROSS SECTIONAL STUDY
PRESENTED BY: DR MOAZZAM ALI KHAN
SUPERVISOR: DR SHAHZAD ALI KHAN

2. CONTENTS
 INTRODUCTION
 RATIONALE
 AIM & OBJECTIVES
 METHODOLOGY
 RESULTS
 RECOMMENDATIONS/ ENABLING
FACTORS

3. INTRODUCTION
1. LITERACY IS ABALITY TO
 Read
 Write
 Use numbers
 Handle information
 Express ideas and opinions
 Make decisions
 Solve problems

4. HEALTH LITERACY
 Health literacy defined as ”
Health literacy is the ability to
obtain, read, understand and
use healthcare information to
make
appropriate health decisions and
follow instructions for
treatment”
 A person has advanced literacy
skills their ability to obtain,
understand and apply health
information in a specific health
context may be poor
TYPES
 General health literacy
 Conceptual health literacy
 Functional health literacy

5. WHY HEALTH LITERACY
In the public health perspective the Health literacy is very
important to combat the upcoming challenges in health care
system
 Access to health care services, use of services
 Self care of chronic conditions
 Active role in health care Decision and management
 Maintenance of health and wellness

6. HEALTH LITERACY AND SCHOOL
SETTINGS
 Schools are essential in achieving health literacy
 The school is a fundamental institution in building the
wealth and health of countries,
 Schools throughout the world contribute to the
achievement of public health goals

7. TEACHERS HEALTH LITERACY
IN SCHOOL SETTINGS
 Teacher’s abilities and knowledge regarding health.
 Understand the severity of health issues.
 Teacher’s behavior regarding its own health.
 Use of knowledge of health and transform to students
 Resources regarding health information drives.
 socioeconomic and demographic awareness of students of
school
 Equal attention should be given to teachers own health
literacy.

8. RATIONALE
 Health literacy of teachers is an important aspect in school sittings.
Equal attention should be given to teacher health literacy. The capacity
of teachers to obtain, interpret, and understand basic health
information and services, more it would be beneficial for students.
Survey will enable us to understand the level of health literacy in
teachers and helps in designing of further interventions to increase the
literacy level

9. AIM & OBJECTIVES
 Aim
To improve the health literacy of teachers to promote health
education
 Objectives
1- To assess the current health literacy level in school teachers of
district Attock.
2- To explore the factors (demographic, functional, social and
economic and personal health information) related to health literacy
of teachers of District, Attock.

10. METHODOLOGY
 Study Design: a cross sectional study
 Study Area: Attock ,Punjab
 Study Population: Government school teachers
 Duration of Study: Two (02) months
 Sampling technique: simple random sampling
 Sample Size: sample size 295 + 10%=325 questionnaire were prepared to
 for data collection but only 290 return filled

11.  Data Collection:
 Quantitative
 Data collection tool:
 health literacy survey Asia tools of assessment a project Taipei medical
university, Taiwan
Data Analysis tool
 Microsoft excel .SPSS 20

12. Data analysis method
 descriptive analysis of variables
 Health literacy indices health literacy indices is based on the European
health literacy survey (HLS-EU) indices
 Formula for indices is Index = (mean - 1) * (50/3)
 Scale is between 1-50 for convenient calculations of literacy level
 Correlations analysis. Spearman’s rho Correlation is used for analysis of
association of several economic factors.
 Relation between health literacy, and gender the Chi square test is applied
 95% confidence interval with a significance level of p-value <0.05 is used
for all analyses.

13.  INCLUSION CRITERIA.
 Male and female Government school teachers of district
Attock whether they are permanent employ or temporary.
Those who will accept the inform consent and have a will
for contribution
 EXCLUSION CRITERIA.
Those who will absent at that day in school

14. Questionnaire
health literacy survey Asia tools of assessment a project
Taipei medical university, Taiwan
Part 1 –
Demographics
Part 2 –
Health Literacy
Part 3 –
Personal Health
Information
Part 4 – Social
and Economic
Information

15. ATTOCK
FATEH
JANG HASSAN
ABDAL HAZRO
JUND
PINDI
GHEB
13.3
22.8
9
11.8
24.1
19
18.1
17.03
10
14.2
21.4
16.7
14
17.25
13.78
10.35
27.58
17.25
QUESTIONNAIR DISTRIBUTION ACCORDING TO AREA, TEACHERS
AND INSTITUTIONS
INSTITUTIONS TEACHERS sample

16. Health Literacy
Acess,obtain
Information
Relevant To Health
Understand
Information
Relevant To Health
Process,appraise
Information
Relevant To Health
Apply, use
Information
Relevant To Health
HEALTH CARE
ABALITY TO ACESS
HEALTH
INFORMATION
ABALITY TO
UNDERSTAND
HEALTH
INFORMATION
ABALITY TO
INTERPRATE HEALTH
INFORMATION
ABALITY TO APPLY
HEALTH
INFORMATION
DISEASE
PREVENTION RISK FACTORS RISK FACTORS RISK FACTORS RISK FACTORS
HEALTH
PROMOTION
UP DATE ONSELF ON
HEALTH ISSUES HEALTH ISSUES HEALTH ISSUES
APPLY PROMOTIONAL
ACTIVITIES

17. RESULTS

18. RELABILITY ANALYSIS OF DATA.
 For internal consistency estimate of data and reliability of
score the Cronbach's alpha test is applied on health literacy
segment of data
Reliability statistics
Cronbach’s Alpha Cronbach’s Alpha
On standardized items
.945 .946

19. variables Number of participant Percentage
Gender
Female 165 56.89%
Male 125 43.10%
Marital status
Not married/ Separated/Divorced/
Widowed
91 32.4%
Married 199 68.8 %
Education
matric 2 7%
University/College and above 63 21%
Master’s degree 225 77%
Data analysis demographic part

20. Ability to pay for medication
Very difficult 18 6%
Fairly difficult 63 21%
Fairly easy 102 34%
Very easy 52 20%
Self-perceived health status
Very Bad
Bad 3 1.0%
Fair 94 32.4 %
Good 140 48.3 %
Very good 53 18.3 %

21. Long-term illness
Yes more than one 14 4.8%
Yes one 45 15.7 %
No 299 79.0 %
Limitation related to health problems
No 98 33.8%
Yes 171 59%
Times to visit DOCTOR over past 12 months
No 108 36.6 %
1-2 times 120 42.1 %
3-5 times 24 8.6 %
6 times and more 12 4.5 %

22. Times to visit DENTIST over past 12 months
No 210 71.2 %
1-2 times 30 10.7 %
3-5 times 27 9 %
6 times or more 6 1.7 %
Smoking status
Never 30 90%
At present time 3 3 %

23. 0 1-2 TIMES 3-5 TIMES 6 TIMES D,NT KNOW
/REFUSE
A Had to contact the emergency
service in the last 2 years
80.3% 5.9% 2.4% 11.4% 2%
B Been to the DOCTOR in the last
12 months
36.6% 42.1% 8.6% 4.5% 8.3%
C Been to the DENTIST in the last
12 months
72.4% 10.7% 9 % 1.7% 6.2%
D Been to the HAKEEM in the last
12 months
76.6% 13.8% 2.1% 3.1% 4.5%
E Used a hospital service in the last
12 months?
64.5% 21.7% 2.4% 7.2% 4.1%
F Used service from other health
professionals, in the last 12
months
53.1% 37.2% 9.7%
G Raised a question during your
doctor appointment?
44.1% 26.9% 12.4% 7.9% 8.6%

24. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PARENTS AND GRANDPARENTS DISEASE
Series 1

25. TREND OF REFRESHERS COURSES
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
Often Some time Rarely Never
education cources
health cources

26. MEDICAL RELATED TV PROGRAMS
Often 13.8% Sometimes 41.7% Rarely 19.3% Never 25.2%

27. INFORMATION THROUGH INTERNET
Often 13.1% Sometime 30.3% Rarely 22.%8 Never 33.8%

28. COMPARING YOURSELF TO OTHER PEOPLE
IN YOUR AGE AND GENDER

29. SPOUSE AND OWN INCOME GRAPH.
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
less then 35000 pkr above then 35000 pkr no answer
own
incom
spouse
incom

30. MEDICAL BILLS AND DOCTOR VISIT.
Very easy Fairly easy Fairly difficult Very difficult
Pay for
medication if
needed to manage
your own health?
20 % 34 % 21 % 06 %
Are you able to
afford to see the
doctor in regard
to time,
16 % 24 % 29 % 10 %

31. 0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
BALANCE BETWEEN HEALTH AND
WORK
Series 1

32. HEALTH LITERACY INDICES
 To standardize the health literacy survey results construct a health literacy indice.health literacy indices is
based on the European health literacy survey (HLS-EU) indices .linkert scale is used for answering the
health literacy questions the higher value of answer very easy is 4
 Scale is between 1-50 for convenient calculations of literacy level.
 Formula for indices is

 Index = (mean - 1) * (50/3)

 Index = specific calculation
 Mean = mean of each individual each item
 1 = minimum possible value of mean
3 = range of mean
 50 = maximum value of scale

33. Health Literacy
47 Questions
Acess,obtain
Information Relevant
To Health (13)
Understand
Information Relevant
To Health (11)
Process, appraise
Information Relevant
To Health (12)
Apply, use
Information Relevant
To Health (11)
HEALTH
CARE
16 QUESTIONS
ABALITY TO ACESS
HEALTH
INFORMATION (4)
ABALITY TO
UNDERSTAND HEALTH
INFORMATION (4)
ABALITY TO
INTERPRATE HEALTH
INFORMATION (4)
ABALITY TO APPLY
HEALTH
INFORMATION (4)
DISEASE
PREVENTION
15 QUESTIONS
RISK FACTORS (4) RISK FACTORS (3) RISK FACTORS (5) RISK FACTORS (3)
HEALTH
PROMOTION
16 QUESTIONS
UP DATE ONSELF ON
HEALTH ISSUES
(5)
HEALTH ISSUES
(4)
HEALTH ISSUES
(3)
APPLY PROMOTIONAL
ACTIVITIES (4)

34. 0 5 10 15 20 25 30 35 40 45 50
Health Care
Disease Prevention
Health Promotion
Health literacy general
Health Care Disease Prevention Health Promotion Health literacy general
Inadequate HL score 1-25
Problematic HL score 25-33 33 30 33
Sufficient HL score 33-42 35
Excelent HL score 42 -50
DISTRIBUTION OF HEALTH LITERACY ON HEALTH
LITERACY INDICES

35. RELATIONSHIP BETWEEN
GENDER AND HEALTH LITERACY.
 From the top row of the table of Chi-square test, Pearson Chi-Square statistic, the probability of
the chi-square test statistic (chi-square=167.618) was p=0.000, less than or equal to the alpha
level of significance of 0.05.Therefore, the null hypothesis(Ho=female gender is not associated
with health literacy) is rejected. That means alternative hypothesis (Ha= female gender is
associated with health literacy) is accepted and supported by this analysis.
Variables Value df Asymp. Sig. (2-
sided)
Pearson Chi-Square 167.618a 52 0.000
Likelihood Ratio 223.675 52 0.000
N of Valid Cases 290

36. CORRELATIONS ANALYSIS
 Spearman’s rhoCorrelation is used for analysis of association of several economic
factors is done
 Spearman’s rho Pay for
medication
Affordability to
doctor
Payment of
utility bills
income
Pay for
medication
1 .820** .462** _0.25
Affordability to
doctor
1 -4.52 -0.42
Payment of
utility bills
1 0.79
Income 1
Correlation is significant at the 0.01 level (2-tailed).*

37. RECOMMENDATIONS/ ENABLING
FACTORS
 Monitoring an evaluation of teachers health literacy
 Health and education courses should be mandatory for teachers
during their carrier
 Public health campaign or at least one week in a year should be
introduced in school by the coordination of health and education
ministries.
 Social media can play far better role in this field

38. THANK YOU