Stacy N Davis1, Jonathan W Wischhusen2, Steven K Sutton3, Shannon M Christy3, Enmanuel A Chavarria4, Megan E Sutter5, Siddhartha Roy6, Cathy D Meade3, Clement K Gwede3. 1. Health Behavior, Society and Policy, Rutgers the State University of New Jersey, New Brunswick, USA; Formally affiliated with Moffitt Cancer Center, Tampa, USA. Electronic address: stacy.davis@rutgers.edu. 2. Formally affiliated with Moffitt Cancer Center, Tampa, USA; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA. 3. Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Morsani College of Medicine, University of South Florida, Tampa, USA. 4. Formally affiliated with Moffitt Cancer Center, Tampa, USA; School of Public Health, University of Texas Health Science Center at Houston, Brownsville USA. 5. Formally affiliated with Moffitt Cancer Center, Tampa, USA; Department of Population Health, New York University, New York City, USA. 6. Formally affiliated with Moffitt Cancer Center, Tampa, USA; Family and Community Medicine, Penn State College of Medicine, Hershey, USA.
Abstract
OBJECTIVES: Individuals with limited health literacy often experience suboptimal health outcomes. This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older Black Americans. METHODS: Participants (n = 330) enrolled in a community-based intervention to promote colorectal cancer (CRC) screening completed baseline surveys assessing health literacy with the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. RESULTS: Approximately 52% of participants had limited health literacy, the REALM-R score was 5.4 (SD = 2.7). Univariable correlates of limited health literacy were gender, employment, income, prior screening, cancer fatalism, CRC awareness, and PHM constructs (religious beliefs, salience/coherence, perceived susceptibility). Multivariable correlates of limited health literacy were male gender (OR = 2.3, CI = 1.4-3.8), unable to work (OR = 2.8, CI = 1.3-6.1), lower household income (OR = 3.0, CI = 1.6, 5.5), and higher PHM religious beliefs (OR = 1.1, CI = 1.0-1.2). CONCLUSION: Limited health literacy was associated with multiple complex factors. Interventions should incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels. PRACTICE IMPLICATIONS: Future studies are needed to understand the role of health literacy in an individual's health behavior and the provision of effective healthcare.
OBJECTIVES: Individuals with limited health literacy often experience suboptimal health outcomes. This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older Black Americans. METHODS:Participants (n = 330) enrolled in a community-based intervention to promote colorectal cancer (CRC) screening completed baseline surveys assessing health literacy with the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. RESULTS: Approximately 52% of participants had limited health literacy, the REALM-R score was 5.4 (SD = 2.7). Univariable correlates of limited health literacy were gender, employment, income, prior screening, cancer fatalism, CRC awareness, and PHM constructs (religious beliefs, salience/coherence, perceived susceptibility). Multivariable correlates of limited health literacy were male gender (OR = 2.3, CI = 1.4-3.8), unable to work (OR = 2.8, CI = 1.3-6.1), lower household income (OR = 3.0, CI = 1.6, 5.5), and higher PHM religious beliefs (OR = 1.1, CI = 1.0-1.2). CONCLUSION: Limited health literacy was associated with multiple complex factors. Interventions should incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels. PRACTICE IMPLICATIONS: Future studies are needed to understand the role of health literacy in an individual's health behavior and the provision of effective healthcare.
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