|Title||Health Literacy and Related Psychosocial Factors and Measurement Issues: A Qualitative Study and a Secondary Analysis of the Health and Retirement Study|
|Year of Publication||2014|
|University||University of Michigan|
|City||Ann Arbor, MI|
|Keywords||Health Conditions and Status, Methodology|
Purpose: Despite the well-known positive relationship between inadequate health literacy and adverse health outcomes, little is known about the impact of health literacy and health literacy testing on patient psychosocial factors. Meanwhile, experts have advised against routine health literacy screening due to potential for shame-related harm, and providers remain largely unaware of their patients' health literacy and health literacy-related challenges. The purpose of this dissertation was to (1) examine relationships between health literacy and psychosocial factors in a Health and Retirement Study sample of adults, (2) learn about the health literacy-related healthcare experience from the perspectives of African American adults with hypertension, and (3) learn about the health literacy testing experience through cognitive interviewing with African American adults with hypertension. Methods: In a secondary analysis of Health and Retirement Study data, logistic regression was conducted to examine relationships between health literacy and psychosocial and health behavioral variables in a subsample who partook in health literacy testing (n=373). In an original study, qualitative data was collected from a sample of African American adults with hypertension (n=15). Narrative interviews were conducted to explore the health literacy-related healthcare experience, and cognitive interviews were conducted to learn about the cognitive and experiential dimensions of health literacy testing. Results: Quantitative results provided evidence that health literacy is related to breast screening practices, tobacco and exercise behaviors, and perceptions of control over health and social standing in the HRS sample. Qualitative analysis of narrative interviews indicated that health literacy-related experiences in the healthcare setting involve practical challenges (primarily related to medication), negative emotions (feeling of anxiety and stigmatization), and both adaptive and maladaptive coping techniques. Findings from cognitive interviews revealed that participants at times felt discomfort, embarrassment, and stress with each of the instruments used in this study; additionally, findings suggest there may be a potential bias in some of the content of the tests.
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|Short Title||Health Literacy and Related Psychosocial Factors and Measurement Issues: A Qualitative Study and a Secondary Analysis of the Health and Retirement Study|