The role of functional health literacy in long-term treatment outcomes in psychosocial care for adolescents

Abstract Although among adolescents with psychosocial problems low health literacy may increase the risk of poor treatment outcomes, the contributing mechanisms within treatment remain unclear. A better understanding of these mechanisms could contribute to improved treatment processes and outcomes. This study aims to examine the relationship between functional health literacy, treatment processes (treatment adherence, learning processes), and treatment outcome (level of psychosocial problems) in adolescents in psychosocial care. We used data from a prospective cohort study among adolescents aged 12–18 (N = 390), collected in four successive measurements: at entry into care, and 3, 12, and 24 months thereafter. We used a mixed effect model to investigate the association between level of functional health literacy (adequate vs. inadequate) and treatment processes (treatment adherence, learning processes) and treatment outcome (level of psychosocial problems). Between adolescents with adequate and inadequate functional health literacy, we found no differences or change over time in adherence or learning processes. The level of psychosocial problems significantly declined over time (β = − 1.70, 95% CI [− 2.72, − 0.69], p = .001) to a similar degree in both groups, though, in all measurements, the level was consistently higher for adolescents with inadequate health literacy. We conclude that health literacy levels did not affect change in treatment processes nor in outcomes of psychosocial treatment. However, the consistently higher level of psychosocial problems among adolescents with inadequate health literacy suggests an unaddressed need in psychosocial care.

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Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179316 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9316

Author(s):

P. V. Asharani ◽

Jue Hua Lau ◽

Kumarasan Roystonn ◽

Fiona Devi ◽

Wang Peizhi ◽

...

Keyword(s):

Physical Activity ◽

Health Literacy ◽

Chronic Conditions ◽

Functional Health ◽

Bivariate Analysis ◽

Functional Health Literacy ◽

Unhealthy Lifestyle ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Inadequate Health Literacy

Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions (p < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.

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Functional health literacy in hypertensive elders at primary health care

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0897 ◽

2019 ◽

Vol 72 (suppl 2) ◽

pp. 266-273

Author(s):

Victor Roberto Santos Costa ◽

Polyana D’arc Rezende Costa ◽

Eduardo Yoshio Nakano ◽

Daniel Apolinário ◽

Alfredo Nicodemos Cruz Santana

Keyword(s):

Blood Pressure ◽

Health Care ◽

Primary Health Care ◽

Health Literacy ◽

Skin Color ◽

Functional Health ◽

Functional Health Literacy ◽

Cross Sectional ◽

Primary Health ◽

Inadequate Health Literacy

ABSTRACT Objective: to assess the relationship between inadequate functional health literacy and inadequate blood pressure control in older people with hypertension in Primary Health Care. Method: a cross-sectional study with sample calculated at 392. SAHLPA-18 tool was used for functional health literacy; blood pressure was measured; sociodemographic and clinical data were collected. Hierarchical logistic regression was used. Results: (high) inadequate blood pressure and (low) functional inadequate health literacy were present in 41.6% and 54.6% of the people, respectively. Factors associated with inadequate blood pressure were: inadequate functional health literacy, black-brown skin color, overweight-obesity, hypertension diagnosis time, non-adherence to exercise/diet, drug treatment. Schooling had no association with inadequate blood pressure Conclusion: hypertensive elderly people with inadequate health literacy were more likely to have inadequate blood pressure. Thus, health professionals need to value functional health literacy as a possible component to control blood pressure.

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Effects of an eHealth Intervention on Patient-Provider Interaction and Functional Health Literacy in Adults With Hypertension

SAGE Open Nursing ◽

10.1177/23779608211005863 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110058

Author(s):

Ronald L. Hickman ◽

John M. Clochesy ◽

Marym Alaamri

Keyword(s):

Health Literacy ◽

Community Dwelling ◽

Attention Control ◽

Functional Health ◽

Self Management ◽

Functional Health Literacy ◽

Convenience Sample ◽

Management Interventions ◽

Modifiable Factors

Introduction Hypertension is a life-limiting, chronic condition affecting millions of Americans. Modifiable factors, quality of the patient-provider interaction and functional health literacy, have been linked to effective hypertension self-management. However, there has been limited interventional research targeting these modifiable factors. Electronic hypertension self-management interventions, in particular those incorporating virtual simulation, may positively influence the quality of the patient-provider interaction and functional health literacy status of adults with hypertension. Yet there is a dearth of evidence examining the efficacy of eHealth interventions targeting these modifiable factors of hypertension self-management. Objective Evaluate the effects of two electronic hypertension self-management interventions on the quality of the patient-provider interaction and functional health literacy in adults with hypertension. Methods A convenience sample of community-dwelling adults (>18 years) with hypertension were recruited and randomized to an avatar-based simulation (eSMART-HTN) or a video presentation on hypertension self-management (attention control). Participants were administered questionnaires to capture demographic characteristics, the quality of the patient-provider interaction, and functional health literacy. Questionnaire data were collected at baseline, and then monthly across three months. Two separate repeated measures analysis of covariance models were conducted to assess the effects of the interventions across the time points. Results The sample included 109 participants who were predominately middle-aged and older, nonwhite, and female. Scores for the quality of the patient-provider interaction demonstrated significant within-group changes across time. However, there were no significant differences in the quality of the patient-provider interaction or functional health literacy scores between experimental conditions while adjusting for covariates. Conclusion An avatar-based simulation (eSMART-HTN) intervention proved to have a positive effect on patient-provider interaction compared to an attention control condition. Although the results are promising, future research is needed to optimize the effectiveness of eSMART-HTN and enhance its efficacy and scalability in a larger cohort of adults with hypertension.

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HEALTH LITERACY OF INDIVIDUALS UNDERGOING DIALYSIS THERAPY

Texto & Contexto - Enfermagem ◽

10.1590/1980-265x-tce-2017-0418 ◽

2019 ◽

Vol 28 ◽

Author(s):

Jéssica Naylla de Melo Bezerra ◽

Sara Rebeca de Oliveira Lessa ◽

Marcelo Francisco do Ó ◽

Givaneide Oliveira de Andrade Luz ◽

Anna Karla de Oliveira Tito Borba

Keyword(s):

Health Literacy ◽

Univariate Analysis ◽

Cross Sectional Study ◽

Functional Health ◽

P Value ◽

Functional Health Literacy ◽

Cross Sectional ◽

Exact Test ◽

Independent Variables ◽

Adequate Health Literacy

ABSTRACT Objective: to assess the functional levels of health literacy in individuals undergoing dialysis. Method: a cross-sectional study with 42 patients of the Nephrology Unit of a public hospital in Recife, Brazil, from May to August 2016. Data were collected through scripted interviews and chart analysis. Functional health literacy was measured using the Brazilian version of the Short-Test of Functional Health Literacy in Adults questionnaire. Data analysis was performed using the Statistical Package for Social Sciences (SPSS®) software, version 18.0, with a univariate analysis to verify the association between independent variables and functional health literacy levels using Fisher's exact test. Results: 80.9% of the patients presented inadequate health literacy and 19.1% presented adequate health literacy. The number of correct answers remained between 0-18 in the reading comprehension and in the scheduling appointment card. Among the independent variables, only marital status (p-value=0.018) and personal income (p-value=0.009) were factors associated with the worst scores in the test, indicating that these variables influence the increase in inadequate literacy. Conclusion: the prevalence of inadequate functional literacy was high, reflecting difficulties in understanding and processing health information, which may interfere with therapeutic management and self-care.

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Validation of the Test of Functional Health Literacy in Adults in a Danish population

Scandinavian Journal of Caring Sciences ◽

10.1111/scs.12186 ◽

2015 ◽

Vol 29 (3) ◽

pp. 573-581 ◽

Cited By ~ 7

Author(s):

Lisa Korsbakke Emtekaer Haesum ◽

Lars Ehlers ◽

Ole K. Hejlesen

Keyword(s):

Health Literacy ◽

Functional Health ◽

Functional Health Literacy ◽

Danish Population

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Functional health literacy can affect patient perception for the need for liver imaging for HCC screening

Journal of Hepatology ◽

10.1016/s0168-8278(17)31273-4 ◽

2017 ◽

Vol 66 (1) ◽

pp. S448-S449

Author(s):

J. Shaw ◽

K. Patidar ◽

N. Dharel ◽

C. Driscoll ◽

D. Heuman ◽

...

Keyword(s):

Health Literacy ◽

Patient Perception ◽

Functional Health ◽

Liver Imaging ◽

Functional Health Literacy

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Interaction between functional health literacy and telehomecare: Short-term effects from a randomized trial

Nursing and Health Sciences ◽

10.1111/nhs.12272 ◽

2016 ◽

Vol 18 (3) ◽

pp. 328-333 ◽

Cited By ~ 3

Author(s):

Lisa Korsbakke Emtekaer Haesum ◽

Lars Ehlers ◽

Ole K. Hejlesen

Keyword(s):

Health Literacy ◽

Randomized Trial ◽

Functional Health ◽

Functional Health Literacy ◽

Short Term ◽

Short Term Effects

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Differential Item Functioning Related to Age in the Reading Subtest of the Test of Functional Health Literacy in Adults

Journal of Aging Research ◽

10.1155/2013/654589 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Raymond L. Ownby ◽

Drenna Waldrop-Valverde

Keyword(s):

Reading Comprehension ◽

Health Literacy ◽

Differential Item Functioning ◽

Older Persons ◽

The Elderly ◽

Functional Health ◽

Functional Health Literacy ◽

Response Format ◽

Age Related ◽

Item Functioning

Differential item functioning (DIF) occurs when items in a measure perform in ways that are different for members of a target group when the different performance is not related to the individual’s overall ability to be assessed. DIF may arise for a number of reasons but is often evaluated in order to ensure that tests and measures are fair evaluations of a group’s abilities. Based on observations when administering the test, we developed the hypothesis that some items on the reading comprehension subtest of the Test of Functional Health Literacy (TOFHLA) might be differentially more difficult for older adults and the elderly due to its use of the cloze response format, in which the participant is required to determine what word, when placed in a blank space in a sentence, will ensure that the sentence is intelligible. Others have suggested that the cloze response format may make demands on verbal fluency, an ability that is reduced with the increasing age. Our analyses show that age-related DIF may present in a nearly one-half of reading comprehension items of the TOFHLA. Results of this measure in older persons should be interpreted cautiously.

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