Promoting Health Literacy Research to Reduce Health Disparities

Paasche‐Orlow, Michael K.; Wolf, Michael S.

doi:10.1080/10810730.2010.499994

Cited by 146 publications

(88 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is noteworthy that lower (vs. higher) HL smokers in this study were more than three times as likely to relapse, even after controlling for the effects of established predictors of relapse. These results support prior research suggesting that HL is a crucial SES-related factor essential in understanding health disparities [4,14,32,34]. …”

Section: Discussionsupporting

confidence: 90%

Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status

et al. 2014

View full text Add to dashboard Cite

BackgroundNearly half of U.S. adults have difficulties with health literacy (HL), which is defined as the ability to adequately obtain, process, and understand basic health information. Lower HL is associated with negative health behaviors and poor health outcomes. Racial/ethnic minorities and those with low socioeconomic status (SES) are disproportionately affected by poor HL. They also have higher smoking prevalence and more difficulty quitting smoking. Thus, lower HL may be uniquely associated with poorer cessation outcomes in this population.MethodsThis study investigated the association between HL and smoking cessation outcomes among 200, low-SES, racially/ethnically diverse smokers enrolled in smoking cessation treatment. Logistic regression analyses adjusted for demographics (i.e., age, gender, race/ethnicity, relationship status), SES-related characteristics (i.e., education, income), and nicotine dependence were conducted to investigate associations between HL and smoking relapse at the end of treatment (3 weeks post quit day).ResultsResults indicated that smokers with lower HL (score of < 64.5 on the Rapid Estimate of Adult Literacy in Medicine [REALM]) were significantly more likely than those with higher HL (score of ≥ 64.5 on the REALM) to relapse by the end of treatment, even after controlling for established predictors of cessation including demographics, SES, and nicotine dependence (OR = 3.26; 95% CI = 1.14, 9.26).ConclusionsFindings suggest that lower HL may serve as an independent risk factor for smoking relapse among low-SES, racially/ethnically diverse smokers enrolled in treatment. Future research is needed to investigate longitudinal relations between HL and cessation outcomes and potential mechanisms of this relationship.

show abstract

Section: Discussionsupporting

confidence: 90%

Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Poor health literacy likely plays a predominant role in HIV treatment outcomes and health disparities. (42) Results from the current study encourage screening patients for basic health literacy skills in risk assessments for difficulties adhering to treatment. Patients who do not experience difficulty reading as well as those who are less proficient readers may benefit from brief skills-based adherence counseling.…”

Section: Discussionmentioning

confidence: 77%

Randomized Clinical Trial of HIV Treatment Adherence Counseling Interventions for People Living With HIV and Limited Health Literacy

Kalichman

Cherry

Kalichman

et al. 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background Limited health literacy is a known barrier to medication adherence among people living with HIV. Adherence improvement interventions are urgently needed for this vulnerable population. Purpose This study tested the efficacy of a pictograph-guided adherence skills building counseling intervention for limited literacy adults living with HIV. Methods Men and women living with HIV and receiving antiretroviral therapy (ART, N=446) who scored below 90% correct on a test of functional health literacy were partitioned into marginal and lower literacy groups and randomly allocated to one of three adherence-counseling conditions: (a) pictograph-guided adherence counseling, (b) standard adherence counseling, or (c) general health improvement counseling. Participants were followed for 9-months post-intervention with unannounced pill count adherence and blood plasma viral load as primary endpoints. Results Preliminary analyses demonstrated the integrity of the trial and more than 90% of participants were retained. Generalized estimating equations showed significant interactions between counseling conditions and levels of participant health literacy across outcomes. Participants with marginal health literacy in the pictograph-guided and standard-counseling conditions demonstrated greater adherence and undetectable HIV viral loads compared to general health counseling. In contrast and contrary to hypotheses, participants with lower health literacy skills in the general health improvement counseling demonstrated greater adherence compared to the two adherence counseling conditions. Conclusions Patients with marginal literacy skills benefit from adherence counseling regardless of pictographic tailoring and patients with lower literacy skills may require more intensive or provider directed interventions.

show abstract

“…These studies support the need to train health professionals in communicating with patients with low health literacy. Furthermore, it has been argued that the barriers caused by limited health literacy in a clinical context may be as much a problem of insufficient clinician competence to reduce unnecessary complexity and improve communication skills as they are a problem of limited health literacy skills in patients [36]. Implementing clinical practice sensitive to patients’ health literacy, as proposed in the conceptual model of health literacy as a risk, might be an important step to reduce these barriers in clinical encounters.…”

Section: Discussionmentioning

confidence: 99%

Effects of the Conceptual Model of Health Literacy as a Risk: A Randomised Controlled Trial in a Clinical Dental Context

Stein

Bergdahl

Pettersen

et al. 2018

IJERPH

View full text Add to dashboard Cite

Numerous conceptual models of health literacy have been proposed in the literature, but very few have been empirically validated in clinical contexts. The aim of this study was to test the effects of the conceptual model of health literacy as a risk in a clinical dental context. A convenience sample of 133 Norwegian-speaking adults was recruited. Participants were randomly allocated to an intervention group (n = 64, 54% women, mean age = 50 years) and a control group (n = 69, 49% women, mean age = 46 years). Clinical measurements were conducted pre-intervention and six months post-intervention. In the intervention group, communication regarding patients’ oral health was tailored to their health literacy levels using recommended communication techniques, whereas the control group received brief information not tailored to health literacy levels. The ANCOVA showed significant between-group effects, finding reduced post-intervention mean gingival (p < 0.000) and mean plaque (p < 0.000) indices in the intervention group when controlling for baseline index scores. The adjusted Cohen’s d indicated large effect sizes between the intervention group and the control group for both the mean gingival index (−0.98) and the mean plaque index (−1.33). In conclusion, the conceptual model of health literacy as a risk had a large effect on important clinical outcomes, such as gingival status and oral hygiene. The model may be regarded as a suitable supplement to patient education in populations.

show abstract

Promoting Health Literacy Research to Reduce Health Disparities

Cited by 146 publications

References 24 publications

Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status

Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status

Randomized Clinical Trial of HIV Treatment Adherence Counseling Interventions for People Living With HIV and Limited Health Literacy

Effects of the Conceptual Model of Health Literacy as a Risk: A Randomised Controlled Trial in a Clinical Dental Context

Contact Info

Product

Resources

About