Assessing the credibility of health information is a major challenge. Health literacy and clear communications from trusted sources support access to valid information.

Context

Health information should be accurate, relevant, timely, up to date, and transparent. All people should have equal opportunities to access and receive it. It should be easy to understand.

Access to valid health information includes the ability to extract, compare and analyse health information from different sources, to have genuine opportunities to comprehend and to use it. This contributes to the knowledge and awareness needed for individuals to decide on choices of care, to exercise self-management of health.

Digital health information complements information provided by health professionals. It can support peoples’ understanding of, and ways to promote, their health. Access to valid health information is also an important protective measure, acting a means of prevention against disease panic.

Challenges

In Europe, one in four adolescents has difficulties in assessing the credibility of health information as well as comparing it information from different sources. One in five adolescents has difficulties in finding health related information that is easy for them to understand. Between 25-72% of the adult population report difficulties in judging the reliability of health information.

Finding offline information has become more difficult. As regards digital health information, one in four Europeans considers that their national authorities do not make it easy to find information without using the Internet, in contrast with one in every six Europeans able to find health information.

The validity of information not only relates to its accuracy but to its applicability to one’s life and current needs. Limited health literacy to find, understand, appraise, and use information hinders genuine access to trusted knowledge, depriving individuals from understanding their health, the ways to promote and sustain it, and when and how to seek help.

Access to valid health information is necessary when faced with the rapid spread of misinformation and disinformation via social media and other internet tools and services. This phenomenon - known as ‘infodemic’, coupled with limited health literacy, makes it challenging for individuals to find reliable information from trusted sources, increasing the risks of noncompliance with protective measures and late access to relevant care. People with limited health literacy are more likely to trust information from social media and friends than from health authorities and medical professionals. Poverty-stricken communities suffer more from misinformation due to lower levels of trust in health authorities and health care service providers which, coupled with lower levels of immunisation against other prevalent illnesses, results in disease panic and a lack of access to medical services.

The ability to use and understand numbers (i.e., numeracy) plays an important role in how information is displayed and communicated. However, the complexity of numerical information about health risks and benefits may not always be easily understood. Consider, for example, numerical information on treatment risks and effectiveness, lifestyle benefits, and side effects from medication. In this regard, many people, including older persons, the less affluent, the less educated, and those suffering from cognitive impairments or language difficulties, are more likely to experience difficulties.

Actions

Available information should be shared by trusted sources. Access to valid health information supports the ability of individuals to seek and develop a comprehensive understanding of their health. Abilities to assess the validity of health-related information can be developed from a young age through the school curriculum. Health literacy school education in all countries contributes to narrowing the disparities at regional and global level.

 

Individuals need

Systems have the responsibility to offer
  • to seek and find health information from different sources
  • to compare, synthesise and appraise health information from different sources
  • to reflect the usefulness and applicability of information from one’s personal perspective
  • information in a manner that secures information access of people with differing needs, such as those related to learning disabilities or hearing and seeing impairments
  • easily available health information in all relevant languages, through different channels and in different formats
  • information that is easy to understand, culturally sensitive and empathetic, by using different communication strategies
  • updated and valid health information from trusted sources
  • information that is relevant and adaptable to the daily lives of individuals with differing needs

 

Good practice

Health literacy for children to promote healthy lifestyles – Romania

Obesity is one of the most serious public health challenges. Obesity, as well as associated diseases, are largely preventable if acted upon from childhood. Preventing childhood obesity is therefore a priority.

 Aims and objectives:

The “Granny's Health Bag. Healthy traditions for healthy children” initiative was launched in Iasi (Romania) in 2012. It is a community-based program to encourage healthy behaviours via the promotion of cultural traditions, this includes campaigns in kindergartens and schools to encourage healthy behaviours in children and original educational resources based on scientific evidence.

The main learning tool is the “Health Bag”. Children learn about the elements of a healthy lifestyle helped by a magic bag, namely “Granny’s Health Bag”. Illustrated with folk tale characters (the goat, the three kids, the bad wolf, etc.); children learn to recognise what is good and what is bad for their health.

 Method:

  • training courses for teachers to teach the 2020-2021 optional course "Granny’s Health Bag";
  • information campaigns - for example, the campaign “Body rhythms: traditions and health”, in which 20,000 children from Iași County participated;
  • workshops for children, parents and teachers;
  • introducing in schools the optional discipline of healthy lifestyle training which, in September 2020, led to the enrolment of 4,000 children aged between 5 and 10 years;
  • development of teaching materials for the training of healthy behaviours in children;
  • the conference "Prevention of childhood obesity", which is organised annually in Iasi, was last held in June 2021, and focused on "Childhood obesity during Covid-19 - the evolution of family habits". The conference took place online and had speakers from 10 countries.

 Added value / Outcome:

The initiative targets children from 3-11 years and their families and has benefitted 100,000 children. In 2021, the prevalence of childhood obesity has decreased from 11% to 7% in the city of Iași. 

There has been considerable international recognition of the initiative, notably:

  • it is part of the international networks for the prevention of obesity among children – EPODE (Ensemble Prévenons l'Obésité Des Enfants) International Network and Youth Health Community;
  • at the Global Obesity Forum (New York, 2012), it was awarded the first prize for the best childhood obesity prevention activity;
  • it was awarded by the European Community with the first prize – the 2020 EU Health Award- category Healthy Lifestyle Cities for the best initiative at the level of community (Iași city) to promote healthy lifestyles.

 Granny's Health Bag. Healthy traditions for healthy children

 

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Health literacy for caregivers of older persons with different levels of dependency – Italy

 Aim and objectives:

Nowadays, many older persons with different levels of physical and/or mental challenges are assisted at home. They need help for a considerable part of their daily living, which is usually provided by a family member or by a person employed to do so.  In both cases, the health literacy for the caregiver is of crucial importance in guaranteeing older persons access to appropriate information and care, which includes the administration of medication, preparing and eating food, help with personal hygiene, and support when accessing and navigating the health system (e.g. programming visits with health professionals, physical examinations, etc.). 
Many family and paid caregivers do not have the requisite levels of health literacy (cognitive, social abilities) to access, understand, and act upon the information needed to take care of dependent older persons.

 Method:

  • measuring caregivers’ health literacy levels in different settings, including at home and in contacts with the health system;
  • assessing caregivers’ health literacy levels in relation to the level of complexity of care needed to assist older persons;
  • targeting training for health care professionals assisting older persons with disabilities, to help them assess the health literacy levels needed for caregivers during different phases of the care pathway for older persons;
  • reviewing the health literacy skills and competencies for caregivers to advise and train them accordingly.

 Outcome:

Being able to assess the health literacy skills and competencies needed for caregivers helps to decide whether a given caregiver has the capability to take care of older persons with comorbidities and/or a high level of care complexity. This assessment plays a key role in reflecting and reviewing the relationships between healthcare professionals to ensure continuity in the care offered, so that the family remains supported. 

 Added value:

The health literacy for caregivers helps to provide appropriate continuous care - formal, managerial and relational care - for older persons with different levels of dependency.

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Teaching digital education and literacy via cross-cutting themes addressed across various subjects – Germany

 Aim and objectives:

Based on the German education sector’s strategy, all schools should prepare pupils for digital transformation. On the state level, digital education and digital literacy strategies translates into the media literacy competence framework and curriculum. 

 Target group:

School pupils

 Method:

Digital education and digital literacy serve as cross-cutting themes that should be addressed across subjects from grades 1-13. Along with learning using digital tools, communicating in digital spaces, data protection and ethics, pupils are taught to develop a critical stance, and to seek, compare and analyse information from various sources. 

 Outcome:

Using health as a subject within a competence framework and curriculum makes it possible to address health literacy and at the same time saves resources.

 Added value:

Education in schools reaches all school-aged children. Health literacy as part of the school curricula, including media and digital literacy, is a promising strategy to support all young people in acquiring the knowledge and skills needed to access valid health information, relevant for their health and wellbeing.

 Teaching digital education and literacy via cross-cutting themes addressed across various subjects – Germany

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Teaching health literacy as a mandatory school subject – Finland

 Aim and objectives:

Health literacy, including critical thinking, is taught through an independent and mandatory school subject called “health education”. 

 Target group:

Pupils in primary and secondary schools.

 Method:

In grades 1–6, health education is taught as an independent component in a cluster of subjects called ‘environmental studies’. In grades 7–9, and general upper secondary school, health education is a stand-alone subject. Already in lower grades, pupils are taught to assess information and to select valid information sources. Then in higher grades they are taught to assess information using several criteria. Later, they are also taught about the reliability of information as well as differences between lay information and scientific information. Health-related competencies, as well as media literacy and digital skills, are taught via crosscutting themes running through all school subjects.

 Outcomes:

The curriculum improves the ability of children and adolescents to access valid health information.

 Added value:

Teaching health literacy as a mandatory subject has the potential to reduce health literacy disparities within schools. 

 Teaching health literacy as a mandatory school subject – Finland

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