The effects of health literacy in influenza vaccination competencies among community-dwelling older adults in Hong Kong

Background Poor health literacy was found to be one of the key barriers in older adults' disease prevention practice. However, it has still been unclear how different processes in health literacy play a role in older adult's vaccination-related competencies. By adopting the European Health Literacy Survey (HLS-EU), the current study aimed to examine older adults' competences in accessing, understanding, evaluating and applying health information, as well as how they are related to perceived difficulties in vaccination-related practices. . Methods With a cross-sectional design, a quantitative exploratory study was conducted using structured questionnaires. Four-hundred and 86 community-dwelling older adults aged 65 and above were recruited from non-government organizations in Hong Kong. Health literacy was measured by the Chinese version of 47-item HLS-EU (HLS-Asia-Q), which assesses the competences in accessing, understanding, evaluating and applying health information across the domains of health care, disease prevention, and health promotion. Linear regression was performed to test the association between different aspects of health literacy and vaccination-related information processing. Results The findings showed that the health literacy of Hong Kong older adults has been limited, particularly in information appraisal. Poorer competences in accessing and appraising health information were associated with greater difficulties in making vaccination decision. Conclusions By identifying the health literacy processes associated with vaccination, our findings suggested that health-promotion programs strengthening the appraisal and comparison of vaccination information should be provided for the general public. Meanwhile, health professionals and mass media should reduce the complexity when delivering the health messages, and make it easier for older adults to access and comprehend, thus increasing the inclination to take vaccine and preventing the spread of communicable diseases.