Health literacy, nutrition knowledge, and health care transition readiness in youth with chronic kidney disease or hypertension: A cross-sectional study

Abstract

This study evaluates the associations of nutrition knowledge and health literacy with health care transition (HCT) readiness and self-management in adolescents and young adults (AYAs) with chronic kidney disease (CKD) or hypertension. Chronically ill AYAs with poor HCT or self-management skills are less likely to achieve favorable health outcomes as they enter adulthood. Health literacy and nutrition knowledge, which are identified as important contributors to health outcomes, may suggest important points of interventions to improve self-management skills. For the study, we enrolled 59 consecutive patients ages 12–29, with a diagnosis of CKD or hypertension at pediatric- and adult-focused clinics in the United States. Participants completed measures of nutrition knowledge, health literacy, and the Self-management and Transition to Adulthood with Rx = treatment (STARx) questionnaire. Correlation tests and multivariate regressions were employed for data analysis. The findings show that health literacy was positively associated with self-management skills ( p = .050), communication with providers ( p = .002) and overall HCT ( p = .001) after adjusting for key variables. Disease-specific nutrition knowledge positively predicted communication with providers ( p = .002) and overall HCT ( p < .001) after adjusting for key variables. Therefore, health literacy and nutrition knowledge predicted self-management and transition readiness. Testing for these skills should be considered in clinics and HCT preparation for AYAs with chronic conditions.

The Role of Health Literacy in Health Behavior, Health Service Use, Health Outcomes, and Empowerment in Pediatric Patients with Chronic Disease: A Systematic Review

“…Overall, 6 of the 11 studies described significant correlations between health literacy and considered outcomes comprising four of eight categories designed by Sørensen et al ( Table 4 ) [ 52 , 55 , 57 , 58 , 59 , 60 ]. Regarding health behavior, one of three studies on health behaviour had data showing significant associations between health literacy and self-management in an underaged population with chronic kidney disease.…”

How to tackle health literacy problems in chronic kidney disease patients? A systematic review to identify promising intervention targets and strategies

“…LHL was associated with worse control of blood pressure [ 55 , 61 ], lower medication adherence confidence [ 44 , 53 ] and lower quality of life [ 56 ]. For worse treatment and self-care knowledge [ 7 , 41–43 , 49 , 52 , 53 , 79 ], worse self-care behaviours [ 7 , 40 , 43 , 51 , 55 ], including lifestyle [ 40 , 50 , 51 ] and adherence problems [ 8 , 38 , 46 , 51 , 53 ] some studies found an association with LHL, while others did not. LHL was not associated with CKD awareness [ 33 , 47 ], treatment preferences [ 67 ], disaster preparedness [ 57 ] and phosphate regulation [ 54 ].…”

“…CKD patients did not perceive engaging with providers as their greatest HL problem [ 37 , 42 , 45 ]. However, in adolescents ˃18 years, one study showed that LHL was associated with several behaviours related to communication [ 43 ]. Another study showed an association of these behaviours with perceived general health [ 68 ].…”

Transition of Chronic Pediatric Nephrological Patients to Adult Care Excluding Patients on Renal Replacement Therapy with Literature Review

“…Obesity and obesity-related hypertension are increasing in adolescents, which can lead to cardiovascular events and CKD earlier in adult life. At the point of transition, these at-risk patients should be recognized, followed up, and treated before complications develop [ 42 , 43 , 44 ]. Patients with urinary incontinence are also a neglected group of adolescents that very often receive suboptimal care in adult life.…”