This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the limitations of the HLS-EU-Q47 when used under specific conditions of clinical practice. The questionnaire survey and the interviews were conducted with individuals of different health literacy levels who were undergoing inpatient alcohol addiction treatment. The findings indicate that individuals with alcohol addiction might require different types of health information according to their health literacy level in terms of quantity and quality of information to recover from alcohol addiction and improve their overall health. The implications for the clinical practice of addiction treatment as well as recommendations for national and regional policy are also discussed.

Department of Addictology 1st Faculty of Medicine Charles University and General University Hospital Prague Apolinarska 4 128 00 Prague 2 Czech Republic

Faculty of Mining Ecology Process Control and Geotechnologies Technical University of Košice Letna 9 042 00 Košice Slovakia

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Kickbusch I., Pelikan J., Apfel F., Tsouros A. Health Literacy: The Solid Facts. World Health Organization; Copenhagen, Denmark: 2013.

Nutbeam D. Health literacy as a population strategy for health promotion. Jpn. J. Health Educ. Promot. 2017;25:210–222. doi: 10.1093/heapro/dax015. DOI

Sorensen K., Van Der Broucke S., Pelikan J.M., Fullam J., Doyle G., Slonska Z., Kondilis B., Stoffels V., Osborne R.H., Brand H. Measuring health literacy in populations: Illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q) BMC Public Health. 2013;13:948. doi: 10.1186/1471-2458-13-948. PubMed DOI PMC

Sorensen K., Van Der Broucke S., Fullam J., Doyle G., Pelikan J.M., Slonska Z., Brand H. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. doi: 10.1186/1471-2458-12-80. PubMed DOI PMC

Sorensen K., Pelikan J.M., Röthlin F., Ganahl K., Slonska Z., Doyle G., Fullam J., Kondilis B., Agrafiotis D., Uiters E., et al. Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU) Eur. J. Public Health. 2015;25:1053–1058. doi: 10.1093/eurpub/ckv043. PubMed DOI PMC

Kučera Z., Pelikan J., Šteflová A. Zdravotní gramotnost obyvatel ČR—Výsledky komparativního reprezentativního šetření [Health literacy in Czech population—Results of the comparative representative research] Časopis Lékařů Českých. 2016;155:233–241. PubMed

Kučera Z. Zdravotní gramotnost a tvorba Narodního zdravotnického informačního portálu [Health literacy and the creation of National health information portal] Prague Soc. Soc. Med. Healthc. Adm. CzMAJEP. 2019 (Unpublished presentation)

Rolová G., Barták M., Rogalewicz V., Gavurova B. Health literacy in people undergoing treatment for alcohol abuse—A pilot study. Kontakt. 2018;20:e394–e400. doi: 10.1016/j.kontakt.2018.09.003. DOI

Degan T.J., Kelly P.J., Robinson L.D., Deane F.P. Health literacy in substance use disorder treatment: A latent profile analysis. J. Subst. Abus. Treat. 2018;96:46–52. doi: 10.1016/j.jsat.2018.10.009. PubMed DOI

Lincoln A.K., Paasche-Orlow M.K., Cheng D.M., Lloyd-Travaglini C., Caruso C., Saitz R., Samet J.H. Impact of Health Literacy on Depressive Symptoms and Mental Health-related: Quality of Life Among Adults with Addiction. J. Gen. Intern. Med. 2006;21:818–822. doi: 10.1111/j.1525-1497.2006.00533.x. PubMed DOI PMC

Berkman N.D., Donahue K.E., Halpern D.J., Crotty K., Sheridan S.L. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Ann. Intern. Med. 2011;155:97. doi: 10.7326/0003-4819-155-2-201107190-00005. PubMed DOI

Wolf M.S., Gazmararian J.A., Baker D.W. Health Literacy and Functional Health Status among Older Adults. Arch. Intern. Med. 2005;165:1946–1952. doi: 10.1001/archinte.165.17.1946. PubMed DOI

Gazmararian J.A., Williams M.V., Peel J., Baker D.W. Health literacy and knowledge of chronic disease. Patient Educ. Couns. 2003;51:267–275. doi: 10.1016/S0738-3991(02)00239-2. PubMed DOI

Aaby A., Friis K., Christensen B., Rowlands G., Maindal H.T. Health literacy is associated with health behaviour and self-reported health: A large population-based study in individuals with cardiovascular disease. Eur. J. Prev. Cardiol. 2017;24:1880–1888. doi: 10.1177/2047487317729538. PubMed DOI PMC

Bostock S., Steptoe A. Association between low functional health literacy and mortality in older adults: Longitudinal cohort study. BMJ. 2012;344:e1602. doi: 10.1136/bmj.e1602. PubMed DOI PMC

Dermota P., Wang J., Dey M., Gmel G., Studer J., Mohler-Kuo M. Health literacy and substance use in young Swiss men. Int. J. Public Health. 2013;58:939–948. doi: 10.1007/s00038-013-0487-9. PubMed DOI

Liu Y.-B., Liu L., Li Y.-F., Chen Y.-L. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese. Int. J. Environ. Res. Public Health. 2015;12:9714–9725. doi: 10.3390/ijerph120809714. PubMed DOI PMC

Angus C., Henney M., Webster L., Gillespie D. Alcohol-Attributable Diseases and Dose-Response Curves for the Sheffield Alcohol Policy Model Version 4.0. ScHARR, University of Sheffield; Sheffield, UK: 2018.

Degenhardt L., Charlson F., Ferrari A., Santomauro D., Erskine H., Mantilla-Herrara A., Whiteford H., Leung J., Naghavi M., Griswold M., et al. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry. 2018;5:987–1012. doi: 10.1016/S2215-0366(18)30337-7. PubMed DOI PMC

Bryman A. Social Research Methods. Oxford University Press; New York, NY, USA: 2016.

Johnson R.B., Onwuegbuzie A.J. Mixed Methods Research: A Research Paradigm Whose Time Has Come. Educ. Res. 2004;33:14–26. doi: 10.3102/0013189X033007014. DOI

Braun V., Clarke V., Hayfield N., Terry G. Thematic analysis. In: Liamputtong P., editor. Handbook of Research Methods in Health Social Sciences. Springer; Singapore: 2019. pp. 843–860.

Van Duong T., Aringazina A., Baisunova G., Nurjanah N., Pham T.V., Pham K.M., Truong T.Q., Nguyen K.T., Oo W., Mohamad E., et al. Measuring health literacy in Asia: Validation of the HLS-EU-Q47 survey tool in six Asian countries. J. Epidemiol. 2016;27:80–86. doi: 10.1016/j.je.2016.09.005. PubMed DOI PMC

Nakayama K., Osaka W., Togari T., Ishikawa H., Yonekura Y., Sekido A., Matsumoto M. Comprehensive health literacy in Japan is lower than in Europe: A validated Japanese-language assessment of health literacy. BMC Public Health. 2015;15:505. doi: 10.1186/s12889-015-1835-x. PubMed DOI PMC

Toci E., Burazeri G., Kamberi H., Brand H., Sorensen K. Concurrent validation of two key health literacy instruments in a South Eastern European population. Eur. J. Public Health. 2014;25:482–486. doi: 10.1093/eurpub/cku190. PubMed DOI

Onwuegbuzie A.J., Collins K.M. A typology of mixed methods sampling designs in social science research. Qual. Rep. 2007;12:281–316.

Malterud K., Siersma V.D., Guassora A.D. Sample size in qualitative interview studies: Guided by information power. Qual. Health Res. 2016;26:1753–1760. doi: 10.1177/1049732315617444. PubMed DOI

Galanti M.R., Siliquini R., Cuomo L., Melero J.C., Panella M., Faggiano F., The EU-DAP Study Group Testing anonymous link procedures for follow-up of adolescents in a school-based trial: The Eudap pilot study. Prev. Med. 2007;44:174–177. doi: 10.1016/j.ypmed.2006.07.019. PubMed DOI

Vacek J., Voňková H., Gabrhelík R. A successful strategy for linking anonymous data from students’ and parents’ questionnaires using self-generated identification codes. Prev. Sci. 2017;18:450–458. doi: 10.1007/s11121-017-0772-6. PubMed DOI

Pelikan J., Röthlin F., Ganahl K. Comparative Report of Health Literacy in Eight EU Member States. [(accessed on 15 February 2019)];2012 Available online: http://ec.europa.eu/chafea/documents/news/Comparative.

World Medical Association Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects. [(accessed on 3 January 2019)];2013 Available online: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ PubMed

International Society of Addiction Journal Editors The Farmington Consensus. [(accessed on 3 January 2019)];2017 Available online: http://www.isaje.net/farmington-consensus.html.

Czech Statistical Office . Statistical Yearbook of Prague 2018. Czech Statistical Office; Prague, Czech Republic: 2018.

Aday L.A., Cornelius L.J. Designing and Conducting Health Surveys: A Comprehensive Guide. John Wiley & Sons; San Francisco, CA, USA: 2006.

Mravčík V., Chomynová P., Gromannová K., Janíková B., Černíková T., Rous Z., Vopravil J. Annual Report on Drug Situation 2011—Czech Republic. Office of the Government of the Czech Republic; Prague, Czech Republic: 2012.

Tourangeau R., Rips L.J., Rasinski K. The Psychology of Survey Response. Cambridge University Press; Cambridge, UK: 2000.

Storms H., Claes N., Aertgeerts B., Van den Broucke S. Measuring health literacy among low literate people: An exploratory feasibility study with the HLS-EU questionnaire. BMC Public Health. 2017;17:475. doi: 10.1186/s12889-017-4391-8. PubMed DOI PMC

Trujols J., Iraurgi I., Oviedo-Joekes E., Guardia-Olmos J. A critical analysis of user satisfaction surveys in addiction services: Opioid maintenance treatment as a representative case study. Patient Prefer. Adherence. 2014;8:107. doi: 10.2147/PPA.S52060. PubMed DOI PMC

Von Wagner C., Knight K., Steptoe A., Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J. Epidemiol. Community Health. 2007;61:1086–1090. doi: 10.1136/jech.2006.053967. PubMed DOI PMC

Tsai T.-I., Yu W.-R., Lee S.-Y.D. Is health literacy associated with greater medical care trust? Int. J. Qual. Health Care. 2018;30:514–519. doi: 10.1093/intqhc/mzy043. PubMed DOI

Aboumatar H.J., Carson K.A., Beach M.C., Roter D.L., Cooper L.A. The impact of health literacy on desire for participation in healthcare, medical visit communication, and patient reported outcomes among patients with hypertension. J. Gen. Intern. Med. 2013;28:1469–1476. doi: 10.1007/s11606-013-2466-5. PubMed DOI PMC

Wolf M.S., Davis T., Cross J., Marin E., Green K., Bennett C. Health literacy and patient knowledge in a southern us HIV clinic. Int. J. STD AIDS. 2004;15:747–752. doi: 10.1258/0956462042395131. PubMed DOI

Fage-Butler A.M., Nisbeth Jensen M. Medical terminology in online patient–patient communication: Evidence of high health literacy? Health Expect. 2016;19:643–653. doi: 10.1111/hex.12395. PubMed DOI PMC

Cline R.J., Haynes K.M. Consumer health information seeking on the internet: The state of the art. Health Educ. Res. 2001;16:671–692. doi: 10.1093/her/16.6.671. PubMed DOI

Berland G.K., Elliott M.N., Morales L.S., Algazy J.I., Kravitz R.L., Broder M.S., Kanouse D.E., Muñoz J.A., Puyol J.-A., Lara M., et al. Health Information on the Internet: Accessibility, Quality, and Readability in English and Spanish. JAMA. 2001;285:2612–2621. doi: 10.1001/jama.285.20.2612. PubMed DOI PMC

Champlin S., Mackert M., Glowacki E.M., Donovan E.E. Toward a Better Understanding of Patient Health Literacy: A Focus on the Skills Patients Need to Find Health Information. Qual. Health Res. 2016;27:1160–1176. doi: 10.1177/1049732316646355. PubMed DOI

Diviani N., Putte B.V.D., Giani S., Van Weert J.C.M., Ghaddar S., Castaneda D. Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature. J. Med. Internet Res. 2015;17:e112. doi: 10.2196/jmir.4018. PubMed DOI PMC

Miller T.A. Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis. Patient Educ. Couns. 2016;99:1079–1086. doi: 10.1016/j.pec.2016.01.020. PubMed DOI PMC

Divine R.L., Lepisto L. Analysis of the healthy lifestyle consumer. J. Consum. Mark. 2005;22:275–283. doi: 10.1108/07363760510611707. DOI

Cayci H.M., Erdogdu U.E., Demirci H., Ardic A., Topak N.Y., Taymur I. Effect of Health Literacy on Help-seeking Behavior in Morbidly Obese Patients Agreeing to Bariatric Surgery. Obes. Surg. 2017;28:791–797. doi: 10.1007/s11695-017-2882-4. PubMed DOI

Domanska O.M., Firnges C., Bollweg T.M., Sørensen K., Holmberg C., Jordan S. Do adolescents understand the items of the European Health Literacy Survey Questionnaire (HLS-EU-Q47)—German version? Findings from cognitive interviews of the project “Measurement of Health Literacy among Adolescents” (MOHLAA) in Germany. Arch. Public Health. 2018;76:46. doi: 10.1186/s13690-018-0276-2. PubMed DOI PMC

Wium-Andersen I.K., Vinberg M., Kessing L.V., McIntyre R.S. Personalized medicine in psychiatry. Nord. J. Psychiatry. 2016;71:12–19. doi: 10.1080/08039488.2016.1216163. PubMed DOI

Young Adults and Sick Leave Length of Mental Illnesses