Journal of Modern Medical

Introduction
Health literacy is one of the important factors that affect the quality of life. Health literacy refers to the knowledge of health-related information, making appropriate decisions in disease management, and finding the best health services. According to the World Health Organization, health literacy enables people to participate more in society to take care of themselves and others. Health literacy is an important factor in individual health behaviors and health outcomes. Inadequate health literacy is one of the main problems in the world. The results of studies have shown that hospitalization is lower in people with health literacy, and health literacy is closely related to the use of preventive health care. Many studies have been conducted in the world on the health literacy of different population groups. College students, regardless of age and health, face various challenges when changing their living environment and lifestyle which can lead to dangerous social and health behaviors and health risks. Proper education can be useful in increasing their health literacy and making them aware of the health status of themselves, their families, and society. This study aims to determining the level of health literacy in students of allied medical sciences in Hormozgan University of Medical Sciences (HUMS), Hormozgan, Iran.
Methods
This is a descriptive-analytical study with a cross-sectional design conducted in 2019. The study population consists of all students of the School of Allied Medical Sciences in HUMS (n=447). Of these, 218 were selected by stratified random sampling method. They were studying in six fields of health information technology (HIT), emergency medicine, radiography, laboratory science, operating room, and anesthesia. The Health Literacy for Iranian Adults (HELIA) questionnaire was used to collect the data. Its Cronbach’s alpha was obtained 0.81. It has 33 items assessing dimensions of health literacy including access to health information (6 items), reading skills (4 items), comprehension skills (7 items), evaluation (4 items), and decision making (12 items). The items are rated on a five-point Likert scale. The total score ranges from 33 to 165. A higher score indicates better health literacy.
The Kolmogorov-Smirnov test was first used to examine the normality of data distribution. Since the data had abnormal distribution, non-parametric tests (Mann-Whitney U test and Kruskal Wallis test) were used for data analysis in SPSS v. 16 software. A post hoc test was used to compare the variables of health literacy dimensions and years of education.
Results
In this study, 218 students aged 18-26 years (mean age=21 years) participated; 61.5% were female and 90.8% were single. The majority of them (73.9%) reported that the Internet was their source of health information. Comparing the means of health literacy dimensions in terms of demographic variables, results showed a significant difference in comprehension skills (P=0.008) and reading skills (P=0.015) between male and female students, where female students had better scores. There was also a significant difference in decision making (P=0.000) and comprehension skills (P=0.000) between students with different years of education. Table 1 shows the results of Kruskal-Wallis test.


The results showed an increasing trend in the level of health literacy in the second-year students.
Dissection
The findings of the research indicated a moderate level of health literacy among the students of the School of Allied Medical Sciences in HUMS. Female students had higher literacy in reading and comprehension skills. This shows that female students care more about their own and their family’s health issues and spend more time reading and understanding health related materials. However, in overall, with the advancement of technology and the increasing importance of health and disease prevention in all people, the mean health literacy of students has improved equally in both male and female students. The level of health literacy among anesthesia students in reading skills and access to health information, among emergency medicine students in comprehension skills, among radiography students in evaluation, and among laboratory science students in decision making were higher than among students in non-clinical fields such as HIT. This can be due to the existence of clinical practice units and numerous internships for these study groups. To improve the level of health literacy, educational workshops related to health issues are recommended for students in allied medical sciences with any fields of study. Incorporating a targeted curriculum in disciplines such as HIT in all faculties of HUMS especially the Allied Medical Sciences, is useful in promoting the students’ health literacy.

Ethical Considerations
Compliance with ethical guidelines
This descriptive cross-sectional study was approved by the Ethics Committee of Hormozgan University of Medical Sciences (HUMS) numbered IR.HUMS.REC.1399.223. Participation in this study was voluntary and anonymous. All participants in this study signed the written consent form before participation. 

Funding
This study is funded by a research grant from the Hormozgan University of Medical Sciences (HUMS: 980396). The funding body HUMS didn’t have any role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript

Authors' contributions
Conceptualization and presenting idea and designing the study and writing  review & editing and supervision the projet: Parvin Lakbala; Methodology & Original draft: Parvin Lakbala, Fatemeh Mazemmat, Zahra Arzaghi, Narges Miri; Data collction and investigation and analysis: Fatemeh Mazemmat, Zahra Arzaghi, Narges Miri.

Conflicts of interest
The authors declare that they have no competing interests.

Acknowledgements
We would like to express our gratitude to the HUMS students who patiently completed the HELIA questionnaire. The authors of the article would like to thank the Research and Technology Vice-Chancellor of Hormozgan Medical University for the financial support of this research.
 

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