Health literacy profiling: a snapshot of Tasmania’s challenges and strengths using five domains of the health literacy questionnaire (HLQ)

Background Health Literacy is crucial for making informed decisions about health-related behaviours. Health literacy development is the responsibility of the individual, organisations, services and the broader community. The average health literacy of a population can be measured in general terms, but individuals and communities who contribute to that average will have diverse health literacy needs. Those who experience greater health literacy challenges may not be visible when we only contemplate the average.Aims The study aimed to identify the different health literacy profiles within the relatively small, but varied population of Tasmania, Australia, by investigating health literacy questionnaire clusters and their associated characteristics to create vignettes.Methods An online survey was conducted using a cross-sectional exploratory design. Descriptive statistics were calculated to characterise the sample. A cluster analysis using five domains of the Health Literacy Questionnaire was conducted. Cluster solutions were identified and examined to determine the optimal solution to represents the sample. Each cluster’s specific demographics were explored to identify any associations with differing outcomes in the health literacy scores.Results A total of 232 participants completed the online surveys, they had a mean age of 45.4 years (SD 14.6). Demographics of the study population were that 80% identified as female, 61% were highly educated, and most were Australian citizens (88%) who spoke English at home (97%). From this cohort five distinct clusters were identified, each with their own diverse health literacy profiles, which were used to develop three vignettes. These ranged from a group who were relatively self-confident when engaging with health information and services and possessed strong health literacy assets, through to a group who experienced more health literacy challenges. In those clusters who experienced greater challenges, prominent demographic characteristics included living alone, socio-economic disadvantage and having pre-existing medical/chronic conditions.Discussion It is important to identify the best ways that health services can respond to those who experience more health literacy challenges. The clusters reported here were used to inform the development of vignettes that will support service providers to identify context-specific solutions for these clusters, to address community health inequity and diverse health literacy needs.