The Influence of Health-Seeking Behaviors on the Health Literacy of Adolescents With Sickle Cell Disease

Abstract

Background: Health literacy may influence the transition from pediatric care to adult care in adolescents with sickle cell disease (SCD). It is postulated that one influencing factor of health literacy in adolescents with SCD is health-seeking behavior. The purpose of this study was twofold: (1) to explore health-seeking behaviors of adolescents with SCD and (2) to determine if there are significant differences in health literacy levels of adolescents with SCD based upon health-seeking behaviors. Methods: This was a cross-sectional, descriptive study evaluating health-seeking behaviors and health literacy in 110 Black and non-Hispanic adolescents with SCD. Convenience sampling was utilized for recruitment. The inclusion criteria were a diagnosis of one of the four primary genotypes of SCD and age of 10-19 years. Health literacy was evaluated using the Newest Vital Sign (NVS). Frequencies and percentages were calculated for all variables. Independent Samples t-tests were conducted to evaluate differences in health literacy scores based upon differing health-seeking behaviors. Results: The mean age of participants was 14.8 years ( SD = 2.2). The mean NVS score was 2.7 ( SD = 1.6). The two most common responses to “where do you go FIRST for health information?” were the Internet (29.6%; n = 40) and health care providers (27.4%; n = 37). There was no statistical difference in NVS scores between adolescents using the Internet versus health care providers as their first source of health information ( t[75] = − .12; p = .22). Discussion: Knowledge of health-seeking behaviors and health literacy in adolescents with SCD gives insight into the design and evaluation of future interventions to improve health and health literacy in this population.

Health literacy correlates with abbreviated full‐scale IQ in adolescent and young adults with sickle cell disease

“…Our results corroborate previous evidence that there is inadequate HL amongst adolescents and young adults with SCD, [12][13][14][15]30,31 and that sociodemographic factors, including younger age, income less than $35,000, and educational attainment, are associated with inadequate HL. 18,19 We expand prior literature by demonstrating that adequate HL is associated with higher abbreviated FSIQ.…”

“…HL in patients with SCD is suboptimal compared to demographically matched controls without SCD 12–16 . There is a strong association between educational attainment and HL in SCD in adolescents (ages 10–19), such that for every 3‐point increase in HL scores, there is a one unit increase in educational attainment 17 .…”

“…There is a strong association between educational attainment and HL in SCD in adolescents (ages 10–19), such that for every 3‐point increase in HL scores, there is a one unit increase in educational attainment 17 . The risk for lower HL is even more pronounced in patients with poor socioeconomic background and parents with low educational attainment 14,18 . Inequities in social environments are associated with lower global intellectual functioning in children 19 …”

“…HL in patients with SCD is suboptimal compared to demographically matched controls without SCD. [12][13][14][15][16] There is a strong association between educational attainment and HL in SCD in adolescents (ages [10][11][12][13][14][15][16][17][18][19], such that for every 3-point increase in HL scores, there is a one unit increase in educational attainment. 17 The risk for lower HL is even more pronounced in patients with poor socioeconomic background and parents with low educational attainment.…”

“…17 The risk for lower HL is even more pronounced in patients with poor socioeconomic background and parents with low educational attainment. 14,18 Inequities in social environments are associated with lower global intellectual functioning in children. 19 HL plays a pivotal role in health-related decisions and selfmanagement, both of which are crucial during the fragile period of adult care transition when adolescent and young adults are expected to be independent with self-care and navigating the adult care system.…”