Abstract ED04-03: Health literacy and health information technology: Promises and pitfalls.

Abstract

Abstract Studies of cancer disparities would benefit from attention to health literacy limitations. Both inadequate (i.e., very low) and marginal health literacy (HL) appear to be important factors in the causal pathway to health disparities, especially in low income patients with chronic diseases. Patients with poorer health literacy skills are at greater risk for increased HgA1c & retinopathy, late stage presentation of cancer, depression/anxiety, poor self-rated health status, hospitalization, and mortality. Given the high prevalence (46% of the US population) of inadequate (i.e., very low) plus marginal HL, often described as limited HL and limited literacy's association with poor health outcomes, there has been great interest in including HL assessments in epidemiologic and clinical research. There are several standard health literacy measures including REALM TOFHLA, Newest Vital Sign, and sTOFHLA. Chew and colleagues developed three self-reported HL screening questions and found that a single item (“How confident are you filling out medical forms by yourself?”) may be sufficient to detect patients. As health information technology is burgeoning it is important to consider health literacy implications. A study by Sarkar et al. found that across each function of a patient portal, those reporting limited health literacy were consistently less likely to complete each function. Ensuring universal internet and computer access will become more important than ever. As services migrate to the internet, those most at risk for poor health outcomes are at risk of falling further behind as health systems increasingly rely on patient portal health service functions and limit the alternative modes of access and communication. Additionally, improving the usability of internet-based patient portals, such that those with limited health literacy can navigate them effectively, is critical to realizing health benefits. The internet has potential, via use of audio, graphic, video, and multiple languages, to greatly expand the capacity and reach of health care systems (Institute of Medicine, 2009). However, in the real world, that potential has yet to be realized. Barriers to internet-based health care services require improved technology access as well as tailoring of design and services to reach those with limited health literacy. In summary, interventions to address disparities in cancer screening and treatment should attend to the health literacy limitations of populations in order to improve their reach and effectiveness. Citation Format: Urmimala Sarkar. Health literacy and health information technology: Promises and pitfalls. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr ED04-03.