Construction and Validity of Chinese Translation of the Universal Mental Health Literacy Scale for Adolescents

Background:In this study,the Universal Mental Health Literacy Scale for Adolescents(UMHL-A)was revised and tested for its reliability and validity in Chinese middle school students,thus establishing a useful tool for assessing the mental health of individuals in this occupation.Methods:Our sample comprised 1208 junior high school students(58.85%male),aged between 11 and 15 years old.The Chinese version of the scale includes a mental health attitude subscale and mental health knowledge subscale,including attitudes towards seeking help,attitudes related to stigma,general mental health knowledge,and knowledge about specific mental illnesses,encapsulated in a total of 17 items.A series of psychometric analyses such as exploratory factor analysis(EFA),confirmatory factor analysis(CFA),and internal consistency reliability estimation were carried out in this study.Results:The results of the CFA indicated that the two-factor model had an acceptable model fit(Attitude(UMHL-A Likert):χ^(2)/df=4.107;RMSEA=0.072;SRMR=0.045;TLI=0.932;CFI=0.954;Knowledge(UMHL-A T/F):χ^(2)/df=3.647;RMSEA=0.066;SRMR=0.044;TLI=0.923;CFI=0.945).The Cronbach’s alpha coefficient of subscales of the Chinese version UMHL-A were 0.80 and 0.78,respectively.Conclusion:In general,the Chinese version of the Universal Mental Health Literacy Scale for adolescents has good reliability and validity and can be used as a tool to measure the mental health literacy of Chinese adolescents.

Association between Mental Health Literacy and Workplace Well-Being of Chinese Grassroots Civil Servants:The Chain Mediating Effects of Regulatory Emotional Self-Efficacy and Resilience

This study aimed to investigate the relationship between mental health literacy(MHL)and workplace well-being(WWB)of Chinese grassroots civil servants,with regulatory emotional self-efficacy(RESE)and resilience as mediating variables.A questionnaire survey was conducted among Chinese grassroots civil servants,with a valid sample size of 2673 after excluding missing values and conducting relevant data processing.The PROCESS was used to examine the relationship between MHL,RESE,resilience,and WWB.The study found that MHL among grassroots civil servants was positively and significantly correlated with WWB(r=0.73,p<0.01).RESE partially mediated the relationship between MHL and WWB(β=0.25,95%CI[0.22,0.28]).Resilience partially mediated the relationship between MHL and WWB(β=0.22,95%CI[0.19,0.26]).MHL had a positive effect on WWB through the chain mediating effect of RESE and resilience(β=0.05,95%CI[0.03,0.07]).There is a close relationship between MHL and WWB,where Chinese grassroots civil servants with higher levels of MHL can develop stronger RESE and resilience,leading to higher WWB.The results of this study remind organizational institutions of Chinese grassroots civil servants that enhancing MHL,RESE,and resilience is an important pathway to promoting their WWB.

An Experimental Study on the Effectiveness of Individualized Online Intervention for Mental Health Literacy of Community Residents

Background:Understanding how to improve mental health literacy is conducive to maintaining and promoting individuals’mental health and well-being.However,to date,interventions for mental health literacy primarily depend on traditional education and contact interventions,which have limitations with regard to pertinence and individualization.Artificial intelligence(AI)and big data technology have influenced mental health services to be more intellectual and digital,and they also provide greater technical convenience for individualized interventions for promoting mental health literacy.However,there is relatively little research on the effectiveness of individualized online intervention for mental health literacy in the literature.This study aims to fill this void.To verify whether individualized online intervention can improve the level of mental health literacy.Methods:We conducted a pretest–post-test control experiment.The participants were recruited from a large community located in central China.A total of 152 participants completed the research.We use mixed linear model estimation and paired t-tests to analyze the data.Results:Individualized online intervention can effectively improve the mental health literacy level of participants.Specifically,we found that compared with the control group,the mental health literacy in the experimental group was significantly improved after receiving individualized online intervention.Likewise,the mental health literacy of the control group has also improved after receiving individualized online intervention.In addition,we compared the mental health literacy level of the experimental group at Time 3 to those at Time 2 and found that the mental health literacy level at Time 3 had not decreased one month later.This shows that individualized online intervention was not only momentarily effective,but also had long-term efficacy.Conclusion:This study illustrates that the individualized online intervention has both great momentary and long-term effectiveness in improving community residents’mental health literacy.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Study on the Relationship between Mental Health Literacy and Psychological Symptoms of University Students: Mediating Effect of Grit

Background:The occurrence of mental health symptoms is higher in individuals aged between 18 and 24 years than in other age groups.Mental health literacy is derived from health literacy,and focuses on the knowledge,attitudes,and competencies that individuals need to acquire to manage their own health effectively.Low mental health literacy is associated with poorer mental health.Grit is also a known protective factor against mental disorders.Despite a heightened focus on mental health literacy and grit as important factors for decreasing mental health symptoms,knowledge of the effect of mental health literacy and grit on mental health symptoms is very limited.This study aimed to evaluate the relationship between mental health literacy and psychological symptoms and the mediating effect of grit on these relationships.Methods:This cross-sectional descriptive study used survey data from 178 university students in Korea.Data were collected between March and May 2022.The SPSS PROCESS macro(Model 4)was used to analyze the data.Results:Mental health literacy was not directly associated with psychological symptoms.However,an indirect pathway was observed between mental health literacy,depression,and anxiety,through grit.Conclusion:Mental health literacy affects psychological symptoms through grit.Therefore,to improve the mental health of university students,it is necessary to develop programs that increase mental health literacy and grit.

Workplace Wellness,Mental Health Literacy,and Usage Intention of E-Mental Health amongst Digital Workers during the COVID-19

The prevalence of mental health problems in both Malaysian and global workplaces has significantly increased due to the presence of the coronavirus disease(COVID-19)pandemic,globalization,technology advancement in Industry 4.0,and other contributing factors.The pervasiveness of the issue poses a huge challenge to improving the occupational safety and health(OSH)of workers in various industries,especially in the digital industry.The emergence of the innovative industry is evident mainly due to the rapid development of Industry 4.0 and the rele-vant demands of multiple businesses in the digital transformation.Nonetheless,limited studies and academic dis-cussions were conducted on the OSH topic of digital employees.Hence,the current study serves tofill the existing gap and provide academic contributions by scrutinising the perceptions of digital workers regarding their work-place well-being,mental health literacy,and the impression of employing e-mental health.The objectives of this study are:1)To examine the mental health literacy and workplace wellness of digital workers,2)to explore the e-mental health usage intention and actual e-mental health utilization,and 3)to identify digital workers’feedback on e-mental health.In the current context,e-mental health focuses on three dimensions,namely,1)“health in our hand(HIOH)”,2)“interacting for health(IFH)”,and 3)“data enabling health(DEH)”.The present study employed an online cross-sectional survey and received 326 digital workers’completed responses.Variables,such as“mental health literacy(MHL)”,“workplace wellness(WW)”,and e-mental health intention and usage were explicated by analysing the data through descriptive statistics.The study results indicated a moderate to a high level of the MHL and the WW.More than half of the workers possessed a high intention level to employ e-mental health,with the HIOH dimension being the most prevalent domain.Nevertheless,the actual e-mental health usage was very low,owing to the online resources being a new concept amongst digital employees.Numerous confounding factors also existed in affecting the low usage,such as privacy concerns,data security levels,and health verification issues.In addition,the mental health issue has not been openly and widely discussed in Malay-sian workplaces due to stigmatisation.As such,the currentfindings could provide additional insights into the OSH literature;it could serve as a guideline for the OSH decision-makers,employers,and eHealth developers when establishing a feasible framework for the practical adoption of e-mental health services by digital workers.

Systematic evaluation of maternal and infant health literacy assessment tools based on COSMIN guidelines

Background:To systematically evaluate the measurement performance of the maternal and child health literacy scale and the study’s methodological quality and to provide a reference for selecting and developing related health outcome measurement tools.Methods:Databases such as CNKI,PubMed,and Embase were searched,and the search time frame was established until January 2023.The literature was independently screened by two researchers.The methodological quality and measurement performance of the included scales were evaluated using the health measurement tool selection criteria,and the evaluation results were summarized and analyzed using descriptive analysis.Results:A total of six papers were included,covering six specific scales,with significant differences in the methodological quality and measurement performance of their development studies,none of which evaluated hypothesis testing,the validity of scales,cross-cultural validity,measurement error,or responsiveness.Conclusion:The methodological quality and scale measurement performance of the maternal health literacy inventory in pregnancy,the women’s reproductive health literacy in pregnancy questionnaire,and the maternal and infant health literacy scale development studies are relatively high,but the number of studies on maternal and infant health literacy specific scales is relatively insufficient,and more studies should be conducted in the future.

Health Literacy at the Elementary School Level

Health literacy measures are well established in school. Nevertheless, the differences between the offers are immense. From individual days for projects to comprehensive programs and codes of practice, such as good healthy school, one can find a broad range of measures in German school settings. Current research results also show that “school” can be a decisive factor to undermine the psychosocial well-being of teachers, students and other school staff. In this contribution, approaches to health promotion and health literacy in elementary schools are presented from different perspectives, which show that the competence modeling for health literacy in elementary schools remains to be investigated. This contribution introduces approaches to health promotion and health literacy, which are relevant for the school setting at the elementary level, from different perspectives.

Translation and psychometric evaluation of the Chinese version of the Heart Failure-Specific Health Literacy Scale

Objective:Health literacy is closely associated with self-care behaviors in heart-failure patient.A reliable,valid,and practical measuring tool would evaluated the level of health literacy in Chinese patients with heart failure,and provide evidence for individualized education.Aim of this study was to translate Heart Failure-Specific Health Literacy Scale(HF-Specific HL Scale)into Chinese and test the reliability and validity of the Chinese version.Methods:The original HF-specific HL scale was translated into Chinese and modified for cultural adaption.Totally 164 HF inpatients were investigated with the Chinese version of HF-specific HL scale.To test the reliability and validity of the scale,item analysis,exploratory factor analysis(EFA),confirmatory factor analysis(CFA),and correlation analysis were conducted.Result:Cronbach's a value for the scale is 0.87;the correlation coefficients between each item and the total score ranged from 0.61 to 0.91.Three factors was extracted by EFA,which could explain 64.62%of the total variance.The result of CFA also showed that the scale demonstrated an acceptable model fit.The scale was significantly correlated with the Chinese version of the Heart Failure Knowledge Test(C-HFKT).Conclusion:The Chinese version of HF-specific HL scale is reliable and valid,and is suitable for assessment of HL in Chinese HF patients.

Health literacy and health outcomes in hypertension: An integrative review

Objective:The aim of this study was to summarize the evidence of health literacy and health outcomes in hypertensive patients.Methods:Articles published in English were searched from six databases:MEDLINE,CINAHL,Embase,ERIC,psycINFO,and SCOPUS.The articles published up to September 2017 were included.Results:Nineteen publications were included in the review.There was quality and consistent evidence that hypertensive patients with lower literacy had poorer knowledge.There was inconsistent evidence to show the relationship between health literacy and clinical outcomes,of systolic and diastolic blood pressure,and blood pressure control;behavioral outcomes,of self-care,self-efficacy,adherence;patientphysician interactions outcomes,of patient-physician communication,patient trust,involvement in decision making and other outcomes.Conclusion:The person with low health literacy is likely to have poor knowledge of hypertension.However,there is insufficient evidence to suggest that health literacy is associated with outcomes of hypertension independently.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

The effect of health literacy level on health outcomes in patients with diabetes at a type v health centre in Western Jamaica

Objective:To identify the effects of health literacy levels on health outcomes in patients with diabetes in a type V health center in Western Jamaica.Method:A correlational survey design with a random sampling technique was used.An 18-item questionnaire and the Newest Vital Sign tool were administered to 88 consenting adults with diabetes to assess their health literacy levels.Their health outcomes were evaluated with docket review.Data were analyzed using SPSS version 18.Results:The participants were predominantly female(77.3%),aged 51-70 years,married(44%),employed(46%),and diagnosed with diabetes>10 years(42%).Only 13.6%of the study population was adequately health literate.The health literacy scores for gender were not significant(P=0.84).The health literacy scores of the patients with different ages and educational levels were significant(P<0.001).Pearson's correlations revealed no linear relationship between health literacy scores and health outcome(r=0.185,P=0.084).Conclusion:Limited health literacy and high likelihood of limited health literacy are predominant in the study population.Age and educational level are significantly associated with health literacy levels.However,these findings suggest no association between health literacy level and diabetic health outcomes.

Health literacy in kidney disease: Review of the literature and implications for clinical practice

Health literacy is the capacity of an individual to understand information related to a disease in order to make an informed decision. In patients with kidney diseases, studies have reported increasing impact of limited health literacy on health outcomes. Our paper discusses current literature on health literacy in kidney diseases.

Development of Health Literacy for Regular Hemodialysis Patients in Menoufia Governorate: A Cross-Sectional Study

Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian patients, a cross-sectional study from March to September 2020 was conducted at 4 hemodialysis (HD) units on 439 patients. A translated questionnaire including demographic characteristics and health literacy components was conducted. This study adapted Nutbeam’s model incorporating critical health literacy, interactive health literacy, and functional health literacy. Health literacy of hemodialysis patients was satisfactory among 35.5% of the studied patients. The average total score of health literacy questionnaire was (15.53 ± 4.32) distributed as (2.90 ± 1.26) for functional literacy, (3.10 ± 1.26) for basic health knowledge, (1.65 ± 1.21) for communicative literacy, (2.53 ± 0.70) for interactive literacy, (1.75 ± 1.30) for advanced health knowledge, (1.74 ± 0.48) for critical literacy, and (1.83 ± 0.93) for patient safety. It was found that poor health literacy was associated with low income (OR = 2.54, CI 95%: 1.66_3.89, p < 0.001), of increasing age (OR = 0.12 CI 95%: 0.07_0.19, p < 0.001), low education (OR = 1.08, CI 95%: 1.04_1.11, p < 0.001) and the patient did not undergo kidney transplant (OR = 4.19 CI 95%: 1.12_15.62, p = 0.033). There was a prevalent low health literacy among the studied regular hemodialysis patients which was affected by education, age and income and in turn it affected the adherence to treatment. Understanding the linkage between HL and self-care attitudes should enhance efforts to improve hemodialysis outcomes.

Mental Health Literacy of University Students in Vietnam and Cambodia

Mental health literacy(MHL)refers to knowledge and attitudes that shape the recognition,management,and prevention of mental disorders.While the topic has been exhaustively researched in Western countries,research from Southeast Asia still is limited.Previous studies in this field showed a moderate recognition of mental disorders,a high prevalence of stigmatizing attitudes and a low willingness to seek professional help among Southeastern-Asian populations.This study explored the level of MHL among university students from different parts of Vietnam and Cambodia.Correlations with influencing factors(gender,age,study year,educational attainment of the parents,urban/rural origin,ethnicity,personal experiences with mental disorders)were also explored.An online survey,using a 30-item Vietnamese version of the Mental Health Literacy Scale(MHLS),was conducted at six university sites in Vietnam and Cambodia.Data of 1032 students from different study branches were included.The MHL of Vietnamese and Cambodian university students was lower,compared to samples from Australia or the UK.Females and students with a personal experience of mental disorders(self or family)showed a significantly higher MHL.No differences in MHL were found between students from different socioeconomic backgrounds(professional attainment of parents,urban/rural origin).Findings on the influence of ethnicity were inconclusive.MHL needs to be improved among the university students of Vietnam and Cambodia.Mental health promotion should specifically target male students,students from STEM branches,and international students.

Health literacy,behavioral and psychosocial characteristics in coronary artery patients:A hospital-based study in Turkey

Objective:To investigate health literacy,behavioral and psychosocial characteristics in coronary artery patients.Methods:Between March 2019 and 2020 years,275 coronary artery patients aged≥50 years were included in the study.Turkish Health Literacy Scale-32 and Beck Depression Inventory were used to collect the data.Results:General health literacy index score was 31.7 and the prevalence of limited health literacy was 59.3%.Adequate health literacy was 2.8 fold higher in the 50-64 age group,3.1 fold higher among men,3.4 fold higher among married and 5.3 fold higher among those who believed in the necessity of individual protective practices(P<0.05).Significant differences were also found in different working status,living places,perceived economic situation,perceived general health status,comorbidities,family history of coronary artery disease,angiography history,material skills on reading and understanding,level of depressive syptom,commitment to individual protective practices health check-ups,utilizing health services,cigarette and alcohol use,and exercise and nutrition between limited and adequate health literacy(P<0.05).Logistic regression analysis showed that adequate health literacy was significantly higher among younger patients(OR:2.81;95%CI:1.46-5.62),male gender(OR:3.10;95%CI:1.46-6.58),married(OR:3.42;95%CI:1.39-8.44)and those with belief in individual protective practices(OR:5.3;95%CI:1.93-14.96).Conclusions:Health literacy is poor among coronary artery patients and behavioral and psychosocial variables differ with health literacy levels.To keep cardiovascular health among these patients,health literacy-based interventions should be adopted in coronary artery clinics,especially for risky population.

Development of Mental Health Literacy Scale for Depression Affecting the Help-Seeking Process in Health Professional Students

Despite depression being a global mental health disorder,many people with depression do not seek psychiatric help.In particular,it has been reported that only 15.7%of medical students seek treatment.A longer duration of untreated illness(DUI)leads to clinically poor results.To shorten the DUI,the mental health literacy(MHL)with regard to depression needs to be improved,although it is unclear which MHL components will improve the help-seeking process.Additionally,the existing MHL scale for depression is poorly validated for structural validity.Therefore,the purpose of this study was to develop an MHL scale for depression with verified reliability and validity(particularly structural validity)and verify its relationship with the help-seeking process.For this purpose,we adapted the mixed research method.First,we conducted a systematic literature review on MHL scales for depression to prepare a draft scale with content validity.Second,we conducted semi-structured interviews on MHL with outpatients with depression.Consequently,78 questions on MHL for depression were extracted.Third,to develop our scale,we verified the reliability and validity of these questions with 782 health professional students.The sample size was 780 and data collection was performed by collective survey method.It was conducted in 2018 in Japan.To verify the factor structure,exploratory and confirmatory factor analyses were conducted.We also examined the internal consistency,test-retest reliability,and criterion-related validity.The exploratory factor analysis revealed a three-factor structure(recognition of depression symptoms,helpseeking preferences,and depression onset possibility)with 10 items.According to the confirmatory factor analysis results,the goodness of fit indicators had a good fit.The internal consistency,test-retest reliability,and criterion-related validity had good values.Fourth,the relationship between the MHL of depression and other factors affecting the help-seeking process was examined using structural equation modelling.The same sample size(as above)was applied.All three components of the MHL of depression influenced‘recognition of depression’.In particular,depression onset possibility had the greatest impact on the help-seeking process.Whereas,the MHL of depression had little or no influence on‘intention of consultation’and‘psychiatric consultation’(second and third steps of help-seeking).The largest influence on psychiatric consultation was the recommendation of consultation from others.The multiple correlation coefficients were the recognition of depression,R2=0.33;intention of consultation,R2=0.43;and psychiatric consultation,R2=0.36;and the model was a good fit.This study identified the specific components of the depression MHL that influence the help-seeking process.Subsequently,it is necessary to provide specific MHL education to health professional students,their families,university staff,and teachers.

Functional Health Literacy and Doctor-Patient Communication: Experiences of HIV/AIDS Patients in Homa Bay County, Kenya

Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to effective doctor-patient communication, which has an adverse effect on health outcomes. This study aimed at investigating the association of functional health literacy and doctor-patient communication among HIV/AIDS patients in Homa Bay County, Kenya. It was a cross-sectional hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay county. Data was collected using a self-administered structured questionnaire. Cronbach’s alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while Logistic regression logistic analysis was used to measure the association between functional health literacy and doctor-patient communication. 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. The respondents’ functional health literacy levels were inadequate at weighted means scores of 3.23 [SD 1.31]. The study further established that functional health literacy significantly influenced doctor-patient communication [Nagelkerke R square = 0.318]. There is, therefore, a need to document the determinants of functional health literacy to improve it and make doctor-patient interaction an enjoyable and meaningful experience.

The Role of Collectivist Culture and Mental Health Literacy in Mental Illness Stigma Among University Students in Indonesia

Mental illness stigma is a social construct which involves labelling individuals with mental illness which in turn discredits and results in the loss of dignity of the individual,as well as causing the individual concerned to experience discrimination,marginalization,and isolation.Mental illness stigma can be influenced by various factors.Factors that can affect mental illness stigma are collectivist culture and mental health literacy.This study used quantitative methods with the aim to investigate the role of collectivist culture and mental health literacy in mental illness stigma.The subjects in this study were 160 undergraduate students at tertiary institutions in Indonesia.The instruments used in this study were the mental illness stigma scale,collectivist culture scale,and mental health literacy scale.The data analysis technique used in this study is multiple regression.The results of multiple regression tests showed a regression coefficient value of 0.239 and a coefficient of determination value of 0.057.The significance value of mental health literacy is 0.022(p<0.05)with a standardized beta coefficient of-0.189 and the significance value of collectivist culture is 0.232(p>0.05)with a standardized beta coefficient value of-0.098.These results indicate that both collectivist culture and mental health literacy simultaneously play a role in reducing the mental illness stigma of university students in Indonesia.Mental health literacy has a significant role in reducing mental illness stigma among university students in Indonesia,whereas collectivist culture does not have a significant role in reducing mental illness stigma.