How important is it to be health literate in Norway?

Gode helsevalg, kalt informerte valg, er definert som valg tatt av en person i tråd med egne preferanser og basert på kunnskap. Et nasjonalt mål er å forbedre folkehelsen ved å fremme helsekompetanse

Background
Good health decisions, known as informed choices, are defined as decisions made by individuals in accordance with their own preferences and based on knowledge. The ability to process relevant knowledge is referred to as health literacy. Norwegian healthcare services are obligated to facilitate informed choices by providing information and user support in the decision-making process. A national goal is to improve public health by promoting health literacy. A prerequisite for health literacy is the availability of high-quality information. International evidence-based standards for health information provide recommendations for the development process, selection, and presentation of information that can support informed choices. We have assessed the quality of information on health-related topics available online by Norwegian citizens.

Methods
The project was designed as multiple-cross-sectional studies: the quality of information on 64 health-related topics was assessed through methodologically uniform cross-sectional studies. Available informational material (not targeted at professionals) was identified using structured Google searches for each issue. The material was independently evaluated by three different coders using the MAPPinfo checklist, which operationalizes the recommendations of the guideline for evidence-based health information. Reliability was analysed based on between-coder agreement and final codes build by consensus. The quality scores were calculated as the proportion of fulfilled criteria in a health information material (100% is considered the minimal standard). Additionally, three factors were tested as potential explanations for varying quality: type of decision, target audience, and provider of the information.
Findings
A total of 1948 health information materials was assessed across 1538 unique web pages. The agreement between coders was excellent (mean T-coefficient =.89, SD=.07). Information quality was consistently low across all variables, with an average score of 22% (SD =.09, min=0%, max=73%), regardless of decision type, target audience, or provider category.

Conclusion
Across all 64 topics, and regardless of the provider category, the type of the decision and the target group, Norwegian health information, online available, is not suitable for supporting informed choices. Findings about low health literacy in the Norwegian population should be interpreted with caution in light of our results. The reported difficulties in finding relevant health information may be due to the actual lack of high-quality information. Efforts to improve health literacy in patient groups and the general population may be premature until the quality of health information is adequate.