Preliminary findings of cultural health beliefs and practices that shape health literacy and chronic illness outcomes in four populations

BACKGROUND: Too often, people with the greatest health burdens have limited access to health information and limited ability to process that information. Immigrant and refugee groups as well as low income, ethnic minority populations are at greater risk for increased debilitation due to chronic illnesses such as diabetes and hypertension partly due to such limitations. SIGNIFICANCE: Health literacy is increasingly recognized as an important factor in patient compliance and chronic disease outcomes. While much research has been done on patient literacy and readability of forms such as informed consent and patient education materials, less work has been done that places health literacy in the broader context of socioeconomic and cultural differences between patients and providers that hinder communication and compliance. In an NCI-funded project The Impact of Culture on Health Literacy and Chronic Illness Outcomes, we are exploring cultural factors associated with health literacy and health outcomes. METHODS: We will present data gathered from formative focus groups conducted by bilingual/bicultural interviewers with community members and clinic patients from four ethnic groups that comprise our study sample (White, African American, Latino/Puerto Rican, Vietnamese). These data will identify the cultural factors and associated health beliefs that shape health literacy and corollary behaviors (e.g. health seeking behavior, treatment compliance). We will also present preliminary baseline survey data from participants who are all diagnosed with diabetes, hypertension or both for which they are being treated at an inner city community health center whose mission is to provide health care access to low income and immigrant populations. FINDINGS: Variation in health literacy across ethnic/cultural groups will be discussed and preliminary findings concerning the association between health literacy and chronic disease outcomes/status will also be presented. Special attention will be given to barriers to care identified through qualitative and quantitative data collection efforts. DISCUSSION AND CONCLUSIONS: A further aim of the project is to develop recommendations for primary health care providers on chronic disease management for ethnically diverse patients with limited health literacy. To this end, we will present a preliminary list of recommendations for providers that is intended to facilitate patient-provider communication, maximize patient adherence, and, ultimately, to improve the health status of chronic disease patients.