Higher Functional Literacy Research Articles

Examining Functional, Interactive, and Critical Health Literacy and eHealth Literacy Among Chinese Women with Young Children (P04-099-19)

ObjectivesTo assess functional, interactive, and critical health literacy and eHealth literacy among Chinese women with young children; to examine the relationships between personal characteristics and different categories of health literacy. MethodsWe used a cross-sectional online survey to reach a sample of Chinese women with children under three years old. The All Aspect Health Literacy Scale was used to assess functional, interactive, and critical health literacy. The eHealth Literacy Scale was used to assess functional, interactive, and critical eHealth literacy. Student’s t-test, one-way ANOVA, Pearson’s and Spearman’s correlations were used to examine relationships between personal factors and health literacy levels. ResultsMean age of the women (N = 382) was 30.3 ± 3.9 years; 73.8% completed college or higher education. Mean functional, interactive, and critical health literacy scores were 2.22 ± .48, 2.79 ± .33, and 2.53 ± .38, respectively (1 - 3, higher score indicates higher literacy). Mean functional, interactive, and critical eHealth literacy scores were 2.92 ± .92, 3.64 ± .65, and 3.95 ± .61, respectively (1 - 5, higher score indicates higher literacy). Education level was associated with higher critical health literacy (rs = .19, P < .001) and functional eHealth literacy (rs = .19, P < .001). Household income level was positively correlated with functional (rs = .11, P < .001), interactive (rs = .14, P < .05), and critical health literacy (rs = .11, P < .001), and functional (rs = .17, P < .001) and critical eHealth literacy (rs = .16, P < .001). Women who engaged in health-related jobs had higher functional literacy (2.58 ± .47 vs. 2.14 ± .44, P < .001) and functional eHealth literacy (3.76 ± .78 vs. 2.75 ± .85, P < .001) compared to those who were unemployed or had other jobs. ConclusionsThere is room for improvement in all three categories of health literacy and eHealth literacy in this highly educated population. Education, occupation, and household income appear to positively impact some, but not all types of health literacy and eHealth literacy. Funding SourcesThis research was funded by the University of Massachusetts Amherst School of Public Health and Health Sciences.

Health and Functional Literacy in Physical Rehabilitation Patients.

Background:People with disabilities, who face multiple barriers to care, experience health disparities, yet few studies have measured health literacy in this population.Objective:This study evaluated functional literacy, health literacy, fluid cognitive function, and self-reported health in people who live in community dwellings with spinal cord injury, stroke, or traumatic brain injury.Methods:Participants with a traumatic spinal cord injury, stroke, or traumatic brain injury, one-year postinjury, and age 18 to 85 years, completed a battery of instruments at three medical centers in the Midwestern U.S.: functional literacy (word recognition, vocabulary knowledge), health literacy (comprehension of prose, document, and quantitative health information), fluid cognitive function (memory, executive function, and processing speed), and patient-reported outcomes (mobility, fatigue, sadness, anxiety, social function, and overall health).Key Results:There were strong correlations between functional literacy, health literacy, and fluid cognitive function. After adjustment for sociodemographic and clinical characteristics, higher health literacy was associated with better mobility, less anxiety, and better overall health; higher functional literacy was associated with less anxiety and better overall health; and higher fluid cognitive function was associated with better mobility, less sadness, better social function, and better overall health.Conclusions:To effectively address limited health literacy among people with spinal cord injury, stroke, and traumatic brain injury, and ensure that they are able to be informed partners in their health care, intervention is required at the level of patients, providers, and health care delivery systems. A special consideration is to ensure that health information is both well-targeted to people's health literacy levels and accessible for people with a range of physical, cognitive, and sensory limitations. The multimedia self-administered health literacy measure used in this study could be useful to rehabilitation providers and designers of health information and interfaces. [Health Literacy Research and Practice. 2017;1(2):e71–e85.]Plain Language Summary:Health literacy represents people's abilities to obtain, understand, and use health information to make informed decisions about their health and health care. People with disabilities face physical, attitudinal, economic, and structural barriers to care. Consideration of health literacy in rehabilitation practice can enhance the effectiveness of the patient-clinician relationship and help address the needs of this population.