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The Public Health White Paper recognises the need to help individuals to make informed decisions about healthy eating and physical activity. However, one in five people in the UK cannot interpret basic health information. Poor health literacy is associated with socio-economic disadvantage and compounds health inequalities. Interventions to promote informed decision-making for healthy eating and physical activity commonly ignore patient health literacy. Indeed, there is a lack of research into health literacy and lifestyle choices as well as poor understanding of how different population groups seek, interpret, critically analyse and use information to make informed lifestyle decisions. This novel study explored health literacy for healthy eating and physical activity decisions in socio-economically disadvantaged women. We focused on women because they typically have responsibility for family health. Improving health literacy in disadvantaged communities may confer greatest public health benefit.
Eighty five women living in deprived areas of three northern cities were theoretically sampled to provide a diversity of age, ethnicity and educational background. Rootman’s health literacy model provided the theoretical framework for the study. Semi-structured interviews explored how women seek, understand, trust and use healthy eating and physical activity information/advice to make informed decisions. Interviews were recorded, transcribed verbatim and are currently being analysed using the Framework approach.
Emerging themes suggest that women access lifestyle information/advice through various sources including community groups, health centres, media, family and friends. Many report a lack of available information on physical activity. Understanding of the components of healthy eating (eg 5-a-day) and physical activity (eg 5 weekly bouts of 30 minutes) varies markedly across women and is challenged by confusing, mixed messages in the media and health literature. Many women find practical demonstrations, eg of what constitutes a “portion” in combination with oral delivery of information as helpful for understanding. Trustworthy sources of lifestyle information include the NHS, family and friends. Interestingly whilst women were wary of commercially-produced health information, they trusted Weight Watchers. Finally, women talked about how their use of information to make healthy choices is often constrained by issues peripheral to health literacy, eg family circumstances and finance.
These preliminary findings highlight the important role that health literacy plays in the adoption of healthy lifestyles. They also identify potential ways to improve the quality of support and advice provided by health, community and social care professionals.