Academic journal article Journal of Medical Speech - Language Pathology

An Investigation of Health Literacy and Healthcare Communication Skills of African American Adults across the Life Span

Academic journal article Journal of Medical Speech - Language Pathology

An Investigation of Health Literacy and Healthcare Communication Skills of African American Adults across the Life Span

Article excerpt

Keywords: health literacy; African Americans; healthcare communication

Purpose: This study was conducted to obtain information on health literacy and healthcare communication skills of African American adults and to explore the relationship between these skills.

Method: Self-reported measures were used to assess health literacy and healthcare communication skills of 101 African American adults ranging from 25 to 85 years of age. In addition, health literacy was directly assessed using the Short Test of Functional Health Literacy for Adults (STOFHLA). Participants' scores were analyzed using MANOVA and multiple regression analyses.

Results: Significant differences in health literacy and healthcare communication skills emerged for age, education, and health status. However, adequate health literacy levels were identified across groups. Conversely, healthcare communication skills were found to be less than optimal across groups. Results of multiple regression indicated that healthcare communication is a predictor of health literacy skills.

Conclusions: Contrary to frequent reports of low health literacy for African Americans, there is significant variation in this population and general intervention approaches may not be appropriate. However, the present findings support reports of healthcare communication difficulties in the population. Implications and suggestions for working with African American clients and families with speech and language disorders are discussed.

INTRODUCTION

Low health literacy has been reported as a pervasive risk factor for poor health outcomes for many African Americans (Beers, McDonald, & Quistberg, 2003; Bennett et al., 2009; Georges, Bolton, & Bennett, 2004; Donelle & Hoffman-Goetz, 2008; Georges, 2004; Institute of Medicine [IOW 2004; Volandes & Paasche-Orlow, 2007; Williams, Mullan, & Fletcher, 2007). Health literacy is defined as the ability to process, understand, and use health information to improve health status and involves reading, writing, speaking, listening, and simple numeracy skills (TOM, 2004; Ratzan & Parker, 2000). Nutbeam (2000) further conceptualized that health literacy involves not only the ability to read pamphlets and make appointments but also includes the cognitive and social skills that enable a person to gain access to and use information that promotes and maintains good health. However, reports suggest that many African Americans have difficulty in both reading health materials and applying the social, communicative, and cognitive skills that promote and maintain good health (Beers et al., 2003; Bennett et al., 1998; Birru & Steinman, 2004; Cooper & Roter, 2003; Diette & Rand, 2007; Kreps, 2006).

Low literacy levels for comprehending written health materials have been noted for African American patients with a variety of disorders (Beers et al., 2003; Bennett et al., 1998; Georges et al., 2004; IOM, 2004; Nurss et al., 1997; Sharp, Zurawski, Roland, O'Toole, & Hines, 2002; Williams et al., 1995). For example, Nurss et al. (1997) administered the Test of Functional Health Literacy in Adults (TOFHLA) to 131 African American patients with diabetes in three medical clinics. This test contains reading and numeracy items related to medical instructions and prescription labels. The findings from the study indicated that fewer than half (47%) of the new patients had adequate health literacy (Nurss et al., 1997). Sharp et al. (2002) reported similar findings with 130 African American women with cervical cancer using the Rapid Estimate of Adult Literacy in Medicine (REALM), a reading list of common medical terms. A total of 45% of the women had low health literacy according to test indicators (Sharp et al., 2002). Using a modified version of the TOFHLA, Georges et al. (2004) also reported findings of low health literacy in African Americans in acute health settings that were consistent with previous studies. …

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