The Effectiveness of Health Literacy Based Educational Intervention on Nutritional Outcomes of Elderly

Health literacy is one of the most important social determinants of the elderly health. This study was aimed to determine the effectiveness of educational intervention on knowledge, attitude and nutritional behaviors of the elderly with adequate health literacy and inadequate health literacy.

An experimental study was conducted with the participation of 192 people 60 years and older in Ilam from May to September 2016. The elderly were assigned into four groups (48 subjects in each group) includes two intervention groups with adequate and inadequate health literacy as well as two control groups with adequate and inadequate health literacy. The elderly nutrition education program consisted of four lecture sessions with questions and answers, along with an elderly nutrition manual for the intervention group. The level of health literacy among the elderly was assessed using the Test of Functional Health Literacy in Adults. Also, the level of knowledge, attitude and nutritional behaviors was assessed using a researcher-made questionnaire in two stages before and two months after the educational intervention. The SPSS software version 21 was used for data analysis. Descriptive statistics and Chi-square, paired t-test and Fisherchr('39')s exact test were used for data analysis.

The mean age of the men was 61.24±2.38 years and the mean age of women was 61.35±2.45 years. The majority of men with adequate health literacy were men (84.37%), while the proportion of men and women in those with inadequate health literacy was almost the same. Also, all participants with adequate health literacy and 89.58% of those with inadequate health literacy were married.After the educational intervention, the mean scores of knowledge, attitude and behavior in the intervention group with adequate health literacy increased significantly (p≤0.013), (p≤0.015) and (p <0.001), respectively. In the intervention group with inadequate health literacy, only knowledge mean score after the intervention showed a significant increase, (p≤0.035). However, there was no significant change in the mean scores of knowledge, attitude and behavior in both control groups (p>0.05).

According to the results of the study, the effectiveness of educational intervention in relation to nutrition of the elderly is significantly influenced by the level of health literacy.