Community-based Skill Building Intervention to Enhance Health Literacy Among Older Rural Adults.
Jean Shreffler-Grant, Elizabeth G Nichols, Clarann Weinert
PMID 32940145WHAT IT FOUND
Older rural adults who attended a health literacy program reported better confidence and complementary therapy knowledge right after, but those gains faded later.
A nutrition label score kept improving, so not all literacy gains were short lived.
Key findings
01CAM health literacy scores were higher immediately after the program and then decreased somewhat at five months.
02Confidence in filling out medical forms rose after the program and fell somewhat by five months.
03The nutrition label measure did not follow that pattern; scores were higher after the program and higher than baseline later, so one general literacy outcome did not match the study hypothesis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
There was no control group, so changes cannot be firmly attributed to the sessions alone. The sample was a convenience sample of older adults who chose to attend, and the participants were mostly white non-Hispanic, so results may not apply to more diverse populations. Many participants dropped out: 127 attended the initial session, 67 completed the post-intervention questionnaire, and 52 completed the five-month questionnaire. Outcomes were questionnaire scores, not tested changes in actual health decisions or medication use. Some participants attended three rather than all four sessions, and missing questionnaire answers were partly replaced with the mode. There were no published standards for interpreting the single-item confidence score or the CAM health literacy scale. The two general health literacy measures moved differently over time, so the finding is not a single clear effect on general health literacy.
Declared interests
The authors declared no potential conflicts of interest. The article is tagged as supported by NIH extramural research.
The easy way to misread this
Do not conclude that this program has been shown to improve health literacy in older rural adults. The study had no control group, relied on questionnaire scores, and one general literacy measure did not support the expected pattern, so the observed changes are not definitive evidence of benefit.