Abstract
BackgroundWe explored the association between health literacy and self-care behaviors among low-income patients with chronic kidney disease (CKD).MethodsWe used baseline data from the Kidney Awareness Registry and Education trial (n = 137 patients with CKD) and multivariable logistic regressions to cross-sectionally examine the association between health literacy, defined by a validated questionnaire, and healthy behaviors.ResultsStudy participants had a mean age of 55 years, were racially diverse (6% White, 36% Hispanic, 43% Black, 15% Asian) and 26% had low health literacy. Over one-third (38%) had hypertension, 51% had diabetes, and 67% had CKD stage 3 or 4. Compared to individuals with adequate health literacy, those with low health literacy had non-statistically significant higher tobacco use (adjusted odds ratio [aOR] = 2.33; 95% CI 0.90–6.06) and lower consumption of sugary beverages (aOR = 0.50; 0.20-1.23) and statistically significant decreased fast food intake (aOR = 0.38; 0.16-0.93). Health literacy was not associated with differences in medication adherence (0.84; 0.38-1.89) or physical activity (aOR = 2.39; 0.54-10.53).ConclusionsHealth literacy was not uniformly associated with all self-care behaviors important for CKD management. A more nuanced understanding of the association of health literacy and self-care may be necessary to promote participation in behaviors known to slow CKD progression.
Highlights
We explored the association between health literacy and self-care behaviors among low-income patients with chronic kidney disease (CKD)
A greater proportion of individuals with low literacy had diabetes compared to those with adequate health literacy (75% vs. 44%, p < 0.001), though the two groups of participants did not differ with respect to the prevalence of hypertension, prevalence of albuminuria or severity of CKD
We demonstrate that in a low income, safety-net population with CKD, low health literacy is associated with higher tobacco use but statistically significant better dietary habits, and that it is not associated with medication adherence or physical activity
Summary
We explored the association between health literacy and self-care behaviors among low-income patients with chronic kidney disease (CKD). Chronic kidney disease (CKD) is a prevalent health condition that affects nearly 15% of the U.S population [1]. Self-care behaviors are generally associated with improved health among individuals with chronic diseases. Physical activity has been associated with improved cardiovascular outcomes among patients with diabetes and CKD; smoking cessation, decreased alcohol consumption, and maintaining a healthy body mass index have been shown to significantly reduce incidence of proteinuria [3,4,5]. Engaging in self-care activity is commonly regarded as the proximal outcome of awareness/understanding of chronic health conditions [6]. The association between patient awareness of kidney disease and participation in self-care activities, is less clear.
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