Создание руководства поддержано Советом по терапевтическим наукам отделения клинической медицины Российской академии наук.

Among the world’s 272 million international migrants, more than 25 million are from the former Soviet Union (FSU), yet there is a paucity of literature available about FSU immigrants’ health literacy. Besides linguistic and cultural differences, FSU immigrants often come from a distinct healthcare system affecting their ability to find, evaluate, process, and use health information in the host countries. In this scoping review and commentary, we describe the health literacy issues of FSU immigrants and provide an overview of FSU immigrants’ health literacy based on the integrated health literacy model. We purposefully consider the three most common locations where FSU immigrants have settled: the USA, Germany, and Israel. For context, we describe the healthcare systems of the three host countries and the two post-Soviet countries to illustrate the contribution of system-level factors on FSU immigrants’ health literacy. We identify research gaps and set a future research agenda to help understand FSU immigrants’ health literacy across countries. Amidst the ongoing global population changes related to international migration, this article contributes to a broad-scope understanding of health literacy among FSU immigrants related to the system-level factors that may also apply to other immigrants, migrants, and refugees.

Грамотность в вопросах здоровья (ГЗ) — это знания, мотивация и навыки, необходимые человеку для поиска, понимания, оценки и применения информации о здоровье. В Европейском регионе уже более 12 лет ведутся исследования по изучению ГЗ среди населения. Подобное исследование по изучению ГЗ на популяционном уровне проведено в России впервые. ЦЕЛЬ ИССЛЕДОВАНИЯ Изучить уровень грамотности населения в вопросах здоровья и выявить ассоциации ГЗ с демографическими и социально-экономическими характеристиками населения в трех регионах Российской Федерации. МАТЕРИАЛ И МЕТОДЫ Проведено кросс-секционное популяционное исследование на случайной репрезентативной выборке населения в возрасте 18 лет и старше в Новосибирской области, Республике Карелия и Республике Татарстан. Использован метод личных интервью в домохозяйствах при помощи адаптированной версии международного вопросника HLS₁₉-Q22-RU. Были сформированы четыре уровня ГЗ: низкий, проблематичный, достаточный, отличный. Применены методы частотного и корреляционного анализа (коэффициент корреляции Спирмена, корреляции Пирсона χ²), линейная регрессия. РЕЗУЛЬТАТЫ Анализ данных произведен среди 5560 респондентов (средний возраст 48,0±17,9 года), которые дали ответы на не менее 80,0% вопросов. Среди них 3022 (53,4%) опрошенных имели достаточный уровень ГЗ, 434 (7,7%) — отличный, а 1467 (25,9%) и 737 (13,0%) респондентов — проблематичный и низкий уровень ГЗ соответственно. Многофакторная модель линейной регрессии показала, что 5 социальных детерминант общей ГЗ объясняют 22,0% вариаций ГЗ в общей выборке: финансовые ограничения являются самым сильным предиктором ГЗ (β= –0,20), затем следует социальный статус (β=0,16). ЗАКЛЮЧЕНИЕ В изученной популяции РФ 38,9% имеют недостаточный уровень ГЗ. Наиболее сильным предиктором ГЗ является социально-экономический статус населения. Таким образом, выявлен социальный градиент ГЗ, что указывает на необходимость сокращения социального неравенства в отношении доступности информации о здоровье и разработки целенаправленных вмешательств для выявленных уязвимых групп населения.

Health literacy is recognized as one of the most important determinants of health on the global level. International comparative population-based surveys on measuring health literacy using unified methodological approaches contribute to decisive national instruments on measurement, monitoring and improvement of health literacy in a population. These studies also contribute to the adaptation of the measures, taking into account the level of health literacy of vulnerable groups in particular. Until today, there was no instrument in the Russian Federation for measuring health literacy at the population level providing internationally comparable data. We attempted to adapt the HLS19 questionnaire developed within the international Health Literacy Survey in 2019 for use in Russia. The adaptation of the questionnaire was based on the European methodology which was tested in several countries of Europe and Asia and included 5 stages: translation from English into Russian, back translation from Russian into English, focus group, expert assessment and field testing. In spite of the fact that the instrument has already been translated into the Russian language and tested in some countries for the Russian-speaking population, a substantial adaptation of the questionnaire was needed taking into account the cultural and linguistic characteristics of the Russian population.

The Russian language is the eighth most spoken language in the world. Russian speakers reside in Russia, across the former Soviet Union republics, and comprise one of the largest populations of international migrants. However, little is known about their health literacy (HL) and there is limited research on HL instruments in the Russian language. The purpose of this study was to adapt the Health Literacy Questionnaire (HLS₁₉-Q) developed within the Health Literacy Survey 2019–2021 (HLS₁₉) to the Russian language to study HL in Russian-speaking populations in Germany, Israel, Kazakhstan, Russia, and the USA. The HLS₁₉-Q was translated either from English or from a national language to Russian in four countries first and then critically reviewed by three Russian-speaking experts for consensus. The HLS₁₉ protocol and “team approach” method were used for linguistic and cultural adaptation. The most challenging was the adaptation of HLS₁₉-Q questions to each country’s healthcare system while general HL questions were flexible and adaptable to specific contexts across all countries. This study provides recommendations for the linguistic and cultural adaptation of HLS₁₉-Q into different languages and can serve as an example of international collaboration towards this end.

INTRODUCTION: Health literacy (HL) is a key factor that determines the effectiveness of decisions made by people with regard to a healthy lifestyle, prevention, and treatment of diseases. In addition, high-quality, updated, and comparable data are required to comprehensively understand the overall situation and identify specific areas for intervention. Therefore, the WHO suggests the regular measurement of HL in accordance with the WHO Action Network on Measuring Population and Organizational Health Literacy. AIM: This study aimed to develop a comprehensive system for measuring HL in the prevention and treatment of noncommunicable diseases and in health promotion among the population aged 18 and older. MATERIAL AND METHODS: A cross-sectional study was conducted. The questionnaire HLS19-Q-22-RU_Russian on measuring HL, which was adapted for the Russian population, was used to ensure the reliability and comparability of the data at the international level. Internal consistency and reliability of the questionnaire were studied using Cronbachs alpha coefficient. Participants of the study aged 18 years and older in three regions of the Russian Federation were selected using multistage random sampling. The population survey was conducted through personal interviews in households from November to December 2019. Health literacy levels were formed by calculating the sum of dichotomous elements, which were standardized in the range of 0 to 100. Cut-off points of 50.066.683.3 were used as threshold values for determining HL levels. The resulting HL levels were labeled as inadequate, problematic, sufficient, and excellent. RESULTS: Based on the HLS19 international research standards for measuring HL, the design of the first population study in Russia was developed, which included five stages: adaptation of the questionnaire, sampling procedure, training of interviewers and supervisors, conducting a population study, and data analysis. The assessment of the internal consistency and reliability of the questionnaire using Cronbachs alpha showed a high value for the Russian questionnaire (=0.9). Consequently, an international methodology for measuring HL, adapted for the Russian population, was applied. CONCLUSION: The findings can be used by researchers, disease prevention, public health promotion, and decision-makers when selecting methods for comprehensive measurements of adult HL at the population level.