title: Menopause-specific health literacy in Japanese women.
abstract: OBJECTIVE
  This study proposed a method for assessing menopause-specific health literacy (knowledge and beliefs about menopausal symptoms which aid their recognition, assessment, and management) using a vignette methodology.
  
  
  METHODS
  A cross-sectional web-based survey was conducted in September 2015 among Japanese women aged 30-59 years. Of 1236 women surveyed, 1196 eligible participants who were not under treatment for menopausal symptoms were included.
  
  
  METHODS
  Participants were presented with a vignette describing a woman with menopausal symptoms and were then asked a series of questions to assess their recognition of menopausal symptoms, attitude, subjective norm, perceived behavior control, availability, and intention to seek medical care if they themselves had the problems described in the vignette.
  
  
  RESULTS
  The majority (87%) of participants correctly labelled the vignette as menopausal symptoms and 60% expressed an intention to seek medical care if they had the symptoms presented. Logistic regression showed that attitude, subjective norm, and perceived behavior control were significant predictors of the intention to seek medical care. A structural equation model depicting these relationships with intention to seek medical care revealed acceptable fit indices: goodness of fit index (GFI)=0.948, adjusted goodness of fit index (AGFI)=0.913, comparative fit index (CFI)=0.883, and root mean square error of approximation (RMSEA)=0.089. Subjective norm had the greatest direct effect on intention to seek medical care.
  
  
  CONCLUSIONS
  The assessment of menopause-specific health literacy may be useful for understanding why women hesitate to seek medical care for menopausal symptoms and for developing interventions to improve the coping behaviors of women with menopausal symptoms.
authors.affiliation: Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: suka@jikei.ac.jp.
authors.forename: Machi
authors.initials: M
authors.lastname: Suka
authors.affiliation: Department of Obstetrics and Gynecology, St Marianna University School of Medicine, Kawasaki, Japan. Electronic address: a_taniuchi@marianna-u.ac.jp.
authors.forename: Asako
authors.initials: A
authors.lastname: Taniuchi
authors.affiliation: Department of Obstetrics and Gynecology, St Marianna University School of Medicine, Kawasaki, Japan. Electronic address: iganosuke-10@marianna-u.ac.jp.
authors.forename: Suguru
authors.initials: S
authors.lastname: Igarashi
authors.affiliation: Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: hryanagiswa@jikei.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yanagisawa
authors.affiliation: Rose Ladies Clinic, Tokyo, Japan. Electronic address: ishizuka@marianna-u.ac.jp.
authors.forename: Bunpei
authors.initials: B
authors.lastname: Ishizuka
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008593:Menopause; D008875:Middle Aged; D011795:Surveys and Questionnaires
keywords: Health literacy; Japan; Menopausal symptoms; Questionnaire survey