Functional Health Literacy Levels Research Articles

Functional Health Literacy in An Urban Primary Care Clinic

The purpose of this study was to determine the level of functional health literacy in a sample of patients treated in 1of our 5 primary care clinics. A total of 92 randomly selected adults (mean age = 59 years) completed the TOFHLA while waiting for a scheduled appointment. Twenty eight percent of the sample had less than adequate levels of functional health literacy. Income, car ownership and education were significant and independent predictors of literacy level in this sample. Low levels of functional health literacy limit a patient's ability to read, understand and act on health information. It is essential that nurse practitioners and clinical nurse specialists use relevant cues to assess for illiteracy and modify their methods of providing health information when appropriate. 1 College of Nursing, Wayne State University 2 John D. Dingell Veterans Medical Center Citation: Artinian, N. T., Lange, M. P., Templin, T. N., Stallwood, L. G., & Hermann, C. E. (2003). Functional Health Literacy in an Urban Primary Care Clinic. The Internet Journal of Advanced Nursing Practice, 5(3). doi:10.5580/deb

Relationship of functional health literacy to patients' knowledge of their chronic disease. A study of patients with hypertension and diabetes.

Inadequate functional health literacy is common, but its impact on patients with chronic diseases is not well described. To examine among patients with hypertension or diabetes the relationship between their functional health literacy level and their knowledge of their chronic disease and treatment. We conducted a cross-sectional survey of patients with hypertension and diabetes presenting to the general medicine clinics at 2 urban public hospitals. Literacy was measured by the Test of Functional Health Literacy in Adults. Knowledge of their illness was assessed in patients with diabetes or hypertension using 21 hypertension and 10 diabetes questions based on key elements in educational materials used in our clinics. A total of 402 patients with hypertension and 114 patients with diabetes were enrolled. Mean (+/- SD) knowledge scores for patients with hypertension with inadequate (n = 189), marginal (n = 49), or adequate (n = 155) literacy were 13.2 +/- 3.1, 15.3 +/- 2.2, and 16.5 +/- 2.3, respectively (range, 4-20; P < .001). A total of 92% of patients with hypertension and adequate literacy levels knew that a blood pressure reading of 160/100 mm Hg was high compared with 55% of those in the lowest reading level (P < .001). Mean (+/- SD) knowledge scores for patients with diabetes with inadequate (n = 50), marginal (n = 13), or adequate (n = 51) literacy were 5.8 +/- 2.1, 6.8 +/- 1.9, and 8.1 +/- 1.6, respectively (range, 1-10; P < .001). A total of 94% of patients with diabetes and adequate functional health literacy knew the symptoms of hypoglycemia compared with 50% of those with inadequate literacy (P < .001). Inadequate functional health literacy poses a major barrier to educating patients with chronic diseases, and current efforts to overcome this appear unsuccessful.

Diabetes in urban African Americans: functional health literacy of municipal hospital outpatients with diabetes.

Functional health literacy was assessed in 63 patients from the diabetes outpatient clinic, 20 from the general medicine clinic, and a total of 48 from two satellite medical clinics. All patients received a demographic questionnaire, visual screening, and the Test of Functional Health Literacy in Adults, an instrument with good validity and internal consistency used to measure the ability to read and understand medical instructions. Functional health literacy was adequate in only 47% of new patients at the diabetes clinic and only 25% of established patients at all sites. There were no significant differences in functional health literacy among established patients across all sites. Overall, patients' mean functional health literacy level was inadequate to marginal. Of the patients with inadequate functional health literacy, 43% denied difficulty in reading. Patient education strategies and materials are needed to address this important barrier to healthcare delivery.