Abstract
BackgroundLow health literacy is generally associated with poor health outcomes; however, health literacy has received little attention in multiple sclerosis (MS).ObjectiveThe aim of this study was to investigate the health literacy of persons with MS using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry.MethodsIn 2012, we conducted a cross-sectional study of health literacy among NARCOMS participants. Respondents completed the Medical Term Recognition Test (METER) which assesses the ability to distinguish medical and nonmedical words, and the Newest Vital Sign (NVS) instrument which evaluates reading, interpretation, and numeracy skills. Respondents reported their sociodemographic characteristics, health behaviors, comorbidities, visits to the emergency room (ER), and hospitalizations in the last 6 months. We used logistic regression to evaluate the characteristics associated with functional literacy, and the association between functional literacy and health care utilization.ResultsOf 13,020 eligible participants, 8934 (68.6%) completed the questionnaire and were US residents. Most of them performed well on the instruments with 81.04% (7066/8719) having functional literacy on the METER and 74.62% (6666/8933) having adequate literacy on the NVS. Low literacy on the METER or the NVS was associated with smoking, being overweight or obese (all P<.001). After adjustment, low literacy on the METER was associated with ER visits (OR 1.28, 95% CI 1.10-1.48) and hospitalizations (OR 1.19, 95% CI 0.98-1.44). Findings were similar for the NVS.ConclusionsIn the NARCOMS cohort, functional health literacy is high. However, lower levels of health literacy are associated with adverse health behaviors and greater health care utilization.
Highlights
The elements of general literacy include the knowledge and skills to comprehend and use written information, to locate and use information captured in documents such as maps, and numeracy
Lower levels of health literacy are associated with adverse health behaviors and greater health care utilization. (Interact J Med Res 2014;3(1):e3) doi:10.2196/ijmr
Given that the three instruments used to assess health literacy have not been used in the multiple sclerosis (MS) population previously, we report the internal consistency for the two multi-item instruments (NVS, eHealth Literacy Scale (eHEALS)) as measured using Cronbach’s alpha [28]
Summary
The elements of general literacy include the knowledge and skills to comprehend and use written information, to locate and use information captured in documents such as maps, and numeracy. Individuals need to be able to understand written health information and to communicate verbally about health, so that they can make decisions about health promotion, health protection, disease http://www.i-jmr.org/2014/1/e3/ XSLFO RenderX. A growing literature suggests that lower health literacy is associated with higher rates of health care utilization and mortality, lower rates of health promoting activities, lower adherence to therapy and less successful disease control [1,3-7]. Despite this recognition in other populations, and the frequent interactions with the health system required by affected people [8,9], the issue of health literacy has received little attention in multiple sclerosis (MS) population [10]. Low health literacy is generally associated with poor health outcomes; health literacy has received little attention in multiple sclerosis (MS)
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