Validation of a health literacy screening tool (REALM) in a UK Population with coronary heart disease

Background and purpose. Little information relating to cholesterol levels and screening for hypercholesterolemia in inner-city children exists. For this study, given the disrupted family backgrounds of many of our patients and the unreliability of family histories, our hypothesis was that in comparison with other samples, family history of coronary heart disease would be a poor screening tool for the identification of children with elevations in total serum cholesterol (TSC). Subjects and methods. During 15 months, more than 400 pediatric outpatients, 2 through 14 years old, were screened for a family history of atherosclerotic disease. These children were attending a clinic serving a disadvantaged black and Hispanic population at Kings County Hospital Center. Nonfasting TSC levels were measured in 300 children. Positive risk for coronary heart disease was determined by the presence of a family history of coronary heart disease (defined as angina, stroke, or myocardial infarction in any parent or grandparent) at less than 55 years age. Results. The mean TSC level was 4.27 mmol/L (SD ± 0.85) (165.0 mg/dL [SD ± 32.81]). The 29.4% of this population with a history suggestive of high risk for hypercholesterolemia had a mean TSC of 4.48 mmol/L (SD ± 0.971) (173.2 mg/dL [SD ± 37.5]), and those with no risk history had a mean TSC of 4.18 mmol/L (SD ± 0.750) (161.4 mg/dL [SD ± 29.91) (P < .005). Use of family history of coronary artery disease as a screening tool had a sensitivity of 39.3%, a specificity of 74.5%, and a positive predictive value of 39.8% for detection of moderate hypercholesterolemia (TSC ≥ 4.66 mmollL [180 mg/dL]). Conclusions. This population's mean TSC level did not differ (P > .10) from those obtained in multiple large studies of average North American populations, and the predictive value and sensitivity of family history as a screening tool was comparable, although the prevalence of a positive family history was greater. The findings may be due to a greater prevalence of coronary artery disease at a young age in these families. In this population, a positive risk history is an important indicator for further evaluation of these children.

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Characteristics of people with low health literacy on coronary heart disease GP registers in South London: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2012-001503 ◽

2013 ◽

Vol 3 (1) ◽

pp. e001503 ◽

Cited By ~ 21

Author(s):

Gillian P Rowlands ◽

Anita Mehay ◽

Sally Hampshire ◽

Rachel Phillips ◽

Paul Williams ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Health Literacy ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Low Health Literacy

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Health literacy of Icelandic patients with coronary heart disease

European Journal of Cardiovascular Nursing ◽

10.1093/eurjcn/zvab060.110 ◽

2021 ◽

Vol 20 (Supplement_1) ◽

Author(s):

B Ingadottir ◽

A Ketilsdottir ◽

MH Svavarsdottir

Keyword(s):

Mental Health ◽

Coronary Heart Disease ◽

Heart Disease ◽

Health Literacy ◽

Patient Education ◽

Basic Education ◽

Self Care ◽

Educational Needs ◽

Short Version ◽

Related Factors

Abstract Funding Acknowledgements Icelandic Nurses" Assoc., Landspitali Univ Hosp., Icelandic Reg Dev Instit, Univ of Akureyri, Akureyri Hosp, OnBehalf KRANS Background Sufficient health literacy (HL) is vital for patients to effectively manage their chronic disease. There are indications that around 50% of the public have limited HL, which can lead to difficulties in self-care, such as medication adherence and lifestyle management. In order to develop effective patient education for patients with coronary heart disease (CHD) and support their self-care, more knowledge is needed on their HL. This is one of the first studies on HL in Iceland and the first on HL in the cardiac patient population. Purpose To describe HL and related factors in patients, 6 months after hospital admission for their CHD. Methods Data was collected from patients with questionnaires (in 2018-2019), six months following an acute or elective treatment for their CHD. Patients answered the European Health Literacy Survey Questionnaire- short version (HLS-EU-Q16), a 16 items instruments with scores ranges from zero (low/no HL) to 16 (high HL). A score of 0 to 8 is considered an indicator of "insufficient" HL, a score from 9 to 12 as "limited" health literacy, and a score of 13 or more as "sufficient" HL. Data on educational needs (on 19 CHD related topics), disease-related knowledge (CADE-Q SV), general (mental and physical) health (SF-12V2) and self-care (SC-CHDI) were collected from patients as background data. Results Preliminary data analysis shows that patients (N = 376, mean age 65 (SD 8.9), 80% male, 30% with basic education only) had a mean HL score of 13.7 (SD 2.5). Sufficient HL was observed in 71.7% of patients, limited HL in 24.5% and 3.8% had insufficient HL. Health literacy was inversely associated with educational needs (odds ratio (OR) 0.58 (0.35;0.98). An increase in HL level was associated with an increase in knowledge (OR 1.13 (0.01; 1.26), self-care maintenance (OR 1.03 (1.01; 1.06), self-care confidence (OR 1.03 (1.01; 1.04) and mental health (OR 1.02 (1.01;1.04). Conclusions The health literacy of patients in this study is satisfactory. Their HL is associated with their disease-related knowledge, educational needs, confidence, mental health and self-care maintenance. HL should be assessed when planning patient education for patients with CHD and the education tailored to individual needs.

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Improving Medication Adherence Through a Health Literacy-based Intervention for Coronary Heart Disease Patients

Case Medical Research ◽

10.31525/ct1-nct04004546 ◽

2019 ◽

Author(s):

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Medication Adherence ◽

Health Literacy

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