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The "DNVF Memorandum Health Literacy (Part 2): Operationalization and Measurement of Health Literacy from the Perspective of Health Services Research" of the German Network for Health Services Research represents the continuation of the memorandum "DNVF Memorandum Health Literacy (Part 1): Background, Subject and Issues in Health Services Research". In addition to the general requirements for the measurement of health literacy, this memorandum also deals with the specific requirements, such as the differentiation of health literacy from related constructs, the differences between performance-based and self-assessment methods, the differences between generic and specific instruments, the use of screening instruments, and the measurement of health literacy in special populations. Furthermore, special considerations about the measurement of digital health literacy, potentials of qualitative and participatory research approaches as well as research ethics in the measurement of health literacy will be elaborated on. A special emphasis is placed on practical relevance for health services researchers. Finally, the authors will give an outlook on challenges and research desiderata in connection with the measurement of health literacy in the context of health services research., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Aim: The aim is to investigate the association between sociodemographic characteristics and the interactive health literacy and the time to treatment of social anxiety disorder., Methods: An online survey of N = 311 patients was carried out (response rate 54.1 %). Descriptive statistical analysis and a logistic regression analysis were carried out., Results: The respondents are on average 46 years old (20-81), 59 % are women. Older age (OR 2,579), not living in partnership (OR 1,963), fear of personal contact (OR 5,716) and low (OR 3,585) or moderate (OR 3,144) interactive health literacy were significantly associated with the time to treatment., Conclusion: The data suggest that social inequalities exist regarding the use of psychotherapeutic or pharmacological interventions in people with social anxiety disorder., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

More than half of the German population has difficulties in dealing with health information. It is an important task of health services research to examine how healthcare professionals and health care organizations can meet this challenge. The DNVF Memorandum Health Literacy (Part 1) defines the terms of individual and organizational health literacy, presents the national and international state of research and ethical aspects of health literacy research in health care settings. The relevance of health literacy research is worked out in different phases of life, for different target groups and in different healthcare contexts. Central research topics and future research desiderata are derived., Competing Interests: Dr. Christoph Kowalski ist Mitarbeiter der Deutschen Krebsgesellschaft. Alle anderen Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Aim of the Study: Male breast cancer is a rare disease, for which, however, available care is from highly specialized care structures intended for female patients. So far, it is unknown whether the focus of care structures for women leads to deficits in the care for men. Therefore, the aim of the present study was to identify possible deficits in male breast cancer care from the perspective of the health care professions involved., Methods: Semi-structured interviews with n=23 participants and 2 focus group discussions with n=7 and n=9 participants were conducted. The transcripts of the interviews and focus group discussions were analyzed by qualitative content analysis using MAXQDA., Results: Some participants felt insecure and uniformed in terms of treatment recommendations for men with breast cancer. Often, responsibilities were vague or unknown. Many participants felt a lack of interdisciplinary cooperation, especially in follow-up care. Some respondents complained of a lack of rehabilitation centers for men with breast cancer., Conclusion: Male breast cancer patients benefit from the advanced structures for breast cancer care. However, some health care problems were identified. Our results together with representative data can help develop practical recommendations for improving the quality of care of male breast cancer patients., Competing Interests: Christoph Kowalski ist Mitarbeiter der Deutschen Krebsgesellschaft., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background and Objectives: Health literacy denoted as the ability to search for, understand and use health related information in health care decision-making is becoming increasingly important for complex chronic diseases such as cancer. There is growing evidence that limited health literacy has a negative impact on individual cancer prevention and disease coping behavior suggesting that interventions for quality assurance in cancer care should consider the health literacy of the target population. This poses the question of how cancer literacy should be operationalized and measured., Methods: We conducted a systematic review on available instruments to measure cancer literacy. The review was performed according to the PRISMA guideline. Relevant instruments were categorized and evaluated in regard to construct definition, operationalization approach and psychometric properties., Results: Overall, N=12 publications reporting on the development and validation of a cancer literacy instrument could be identified. Cancer literacy is defined as the ability to search for, understand and use health related information in health care decision-making (health literacy) or as the knowledge a layperson needs to understand the information and advice the health system offers with regard to preventing, diagnosing and treating cancerous conditions. In most cases, cancer literacy is operationalized by using cancer knowledge tests across distinct knowledge areas. The analysis of the psychometric properties yields the finding that only every second paper (N=6) is reporting reliability and validity data. Altogether, reliability data is quite satisfactory whereas construct and criterion validity data demonstrates low to moderate correlations between the instruments developed and external criteria as well as comparative instruments., Conclusion: The aspect of cancer literacy is gaining relevance in terms of its contribution to quality assurance and patient safety. Currently, there are a limited number of cancer literacy instruments available. Definitions of constructs and instrument conceptions mostly rely on the aspect of cancer knowledge making it difficult to differentiate cancer literacy from cancer knowledge. Prospective studies should take greater account of more sophisticated measurement approaches used to assess health literacy., (Copyright © 2015. Published by Elsevier GmbH.)