@article{f8a1fe562af147aaae0002fcf87b64e8,
title = "Exploring health literacy in relation to noncommunicable diseases in Samoa: a qualitative study",
abstract = "Background Samoa is suffering from alarming rates of noncommunicable diseases (NCDs). To address this epidemic, tackling health literacy is important. A qualitative study was conducted with the aim to explore health literacy in Samoa in relation to NCDs. Methods Six focus groups were conducted, with a total sample size of 73 participants aged over 18 years. The semi-structured interview guide was based on the conceptual model of the European Health Literacy project (HLS-EU). Data was translated, transcribed, coded, and categorized as part of the qualitative analysis. Results The analysis resulted in one overarching category and seven sub-categories based on 19 themes. It revealed that health literacy in Samoa is strongly influenced by the culture. Personal responsibility is lacking. The family circle is central to health in a community where support is provided through the church and local groupings. Basic knowledge of NCDs was present in the population, but a deeper understanding of chronic disease implications was lacking. Difficulties with regards to medication adherence for chronic diseases arose as a topic, and traditional healers are still strongly embedded in the local society. Finally, the health system's performance, especially primary care services at the local level, is suffering from the high burden of NCDs and has been challenged to respond to the needs of the community it serves. Conclusion The findings of this study show how health literacy in Samoa is influenced by culture and suggest employing participatory, culture-sensitive, public health interventions which address the family as a whole, building on health literacy to address major public health problems like NCDs and remove barriers in the health system.",
keywords = "Health literacy, Public health, Health promotion, Focus groups, Medication adherence, Noncommunicable diseases, Risk factors, Obesity, Diabetes mellitus, Qualitative research, Primary health care, Samoa, CRITERIA",
author = "Caroline Bollars and Kristine Sorensen and {de Vries}, Nanne and Ree Meertens",
note = "Funding Information: We would like to acknowledge our appreciation to all staff, health professionals and participants involved in this study. Special thanks go to the Ministry of Health Samoa, the Ministry of Women Community and Social Development, National Health Service Samoa and village committee members as well as women committee members of involved villages in Samoa. Additionally, we would like to thank the local facilitator of the focus groups, Laufa Lesa, and the translator, Kolisi Viki, as well as the staff of the WHO Country Office in Samoa and the local village committees (Lalomalava and Vaisaulu) for providing the space to hold the focus groups and coordinating between the researchers and the Ministry of Health. Funding Information: The study was funded as part of the contextualization of the WHO Package for Essential Noncommunicable Disease Intervention for primary care in a low-resource setting. Maastricht University provided the academic support. The funding body provided guidance on the study design. Data collection, analysis, interpretation of data and writing of the manuscript was conducted independently by the academic institution, Maastricht University. Funding Information: The study was conducted with support of the Ministry of Health and the WHO Country Office in Samoa. The Ministry of Health and Ministry of Women Community and Social Development guided the researchers in following the ethical guidelines as set out for research in the country and helped them to gain access to the local community. With the oversight of the Ministry of Health, the study complied to the guidelines set out by the Health Sector Plan through the Health Research Committee of the Ministry of Health in Samoa [31]. All participants signed written informed consent. The Ministry of Health provided ethical approval through the Health and Research Committee. Publisher Copyright: {\textcopyright} 2019 The Author(s).",
year = "2019",
month = aug,
day = "22",
doi = "10.1186/s12889-019-7474-x",
language = "English",
volume = "19",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BioMed Central Ltd",
number = "1",
}