Background:Health literacy is considered the single best predictor of an individual's health status. However, it often is difficult to assess. As such, our group developed the Literacy in Musculoskeletal Problems (LiMP) questionnaire, a musculoskeletal-specific literacy assessment tool. We hypothesized that the degree of inadequate musculoskeletal health literacy would be higher than the rate of inadequate general healthy literacy, as assessed through the Newest Vital Sign (NVS). Methods:Each of the 65 study participants completed a demographic questionnaire, the NVS and the LiMP survey. The NVS and LiMP scores were assessed using contingency table analysis. Categorical outcome variables as a function of demographic parameters also were compared using w 2 tests. Results:More subjects were found to have inadequate musculoskeletal literacy (60%) as compared with general health literacy (48%). Contingency table analysis showed that at LiMP scores of less than 6, the sensitivity and specificity (0.74 and 0.59, respectively) were optimized for predicting limited literacy, as defined by an NVS score of 3 or less. A significantly higher rate of adequate musculoskeletal literacy was observed in Caucasian patients and those who had previously seen a physician for a musculoskeletal complaint. Conclusions:The LiMP's sensitivity and reliability is in line with prior work on disease and specialty-specific literacy, making it a valid and reliable musculoskeletal literacy assessment instrument. It is only with the ability to identify those lacking the skills crucial to making informed decisions regarding their musculoskeletal health that we can accurately target education campaigns, an approach that will ultimately enhance physician-patient interactions and improve clinical outcomes.

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IntroductionTo evaluate the impact of a simple emergency department (ED)–based educational intervention designed to assist ED providers in detecting occult suicidal behavior in patients who present with complaints that are not related to behavioral health.MethodsStaff from 5 ED sites participated in the study. Four ED staff members were exposed to a poster and clinical guide for the recognition and management of suicidal patients. Staff members in 1 ED were not exposed to training material and served as a comparator group.ResultsAt baseline, only 36% of providers reported that they had sufficient training in how to assess level of suicide risk in patients. Greater than two thirds of providers agreed that additional training would be helpful in assessing the level of patient suicide risk. More than half of respondents who were exposed to the intervention (51.6%) endorsed increased knowledge of suicide risk during the study period, while 41% indicated that the intervention resulted in improved skills in managing suicidal patients.ConclusionThis brief, free intervention appeared to have a beneficial impact on providers' perceptions of how well suicidality was recognized and managed in the ED.

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