Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Stacy N Davis, Jonathan W Wischhusen, Steven K Sutton and 6 others
PMID 31466881WHAT IT FOUND
In 330 Black adults aged 50-75 not up to date with colorectal cancer screening, 171 (51.8%) had limited health literacy on a 0-8 word test.
Men, income under $25,000, unable to work, and higher religious-belief scores were associated.
Key findings
01In the 330 participants, 171 (51.8%) scored 6 or less on the health literacy test, indicating limited health literacy.
02Male gender, being unable to work, household income less than $25,000, and higher religious belief scores were significant independent correlates of limited health literacy in the final model.
03In the psychosocial multivariable model, lower salience and coherence, higher perceived susceptibility, and higher religious beliefs were associated with limited health literacy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were cross-sectional, so the associations do not show that limited health literacy caused lower screening or that changing literacy would change screening. The REALM-R measures pronunciation of eight medical words, not comprehension of health information. The sample was older Black Americans from the Tampa Bay area, so results may not apply to Black Americans in other regions or to other populations. Education and colorectal cancer awareness were not included in the multivariable models because they overlapped strongly with the health literacy score. Participants had to speak, read, and write English, so people with more severe literacy or language difficulties may not be represented.
Declared interests
The supplied article type lists NIH extramural and non-U.S. government research support. The supplied text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that limited health literacy causes missed colorectal cancer screening or that low-literacy materials will increase screening; this was a cross-sectional baseline analysis, and the REALM-R measures word pronunciation rather than understanding.