title: Low literacy: a hidden problem in family planning clinics.
abstract: OBJECTIVE
  Low literacy is highly prevalent among UK adults. This study assessed functional health literacy among family planning clinic clients and whether this was associated with sexual health knowledge and behaviours. It also assessed the readability of patient leaflets.
  
  
  METHODS
  505 female family planning clinic attendees aged 16-35 years were interviewed about their sexual behaviour and knowledge. Their reading age was assessed using a validated test (REALM). The readability of leaflets on contraception supplied to clinic users was measured.
  
  
  RESULTS
  All respondents had a reading age of 12 years and above, 221 (43.8%) between 12 and 14 years and 284 (56.2%) greater than 14 years. Those in the lower literacy group were significantly more likely to have been aged under 16 years at time of first sexual intercourse, and significantly less likely to know the most fertile time of the menstrual cycle, to identify sexually transmitted infections and to know that sexual infections can be transmitted through oral and anal sex. The reading age of information leaflets in the clinics ranged from 11 to 17 years. Thus, clients with a reading level of 12-14 years would have difficulty in understanding some of the leaflets.
  
  
  CONCLUSIONS
  Functional health literacy is related to sexual behaviour and knowledge. Written information should be prepared with this in mind and other routes of communication considered.
authors.affiliation: Institute for Applied Social and Health Research and School of Social Sciences, University of Paisley, Paisley, UK. ruth.holman@aapct.scot.nhs.uk
authors.forename: Jeanne
authors.initials: J
authors.lastname: Rutherford
authors.forename: Ruth
authors.initials: R
authors.lastname: Holman
authors.forename: John
authors.initials: J
authors.lastname: MacDonald
authors.forename: Avril
authors.initials: A
authors.lastname: Taylor
authors.forename: Dominic
authors.initials: D
authors.lastname: Jarrett
authors.forename: Alison
authors.initials: A
authors.lastname: Bigrigg
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D032882:Comprehension; D003376:Counseling; D004522:Educational Status; D005193:Family Planning Services / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D012309:Risk-Taking; D012736:Sex Education; D012725:Sexual Behavior / Q000523:psychology; D006113:United Kingdom