Assessing Health Literacy and Health Information Needs of Persons at Risk for Cardiovascular Disease

Background: Individuals with limited health literacy have poorer health outcomes and encounter challenges in understanding health information. The overall aim of this study was to investigate the experiences of, and preferences, for receiving health information from individuals with varying health literacy and numeracy abilities.

Methods: Patient-level quantitative and qualitative data were collected from adults, age 40 years and older, who received care at either an HMO or safety-net institution, and had two or more risk factors for CVD. All 150 (75 from each organization) participants provided data on health literacy ability, numeracy ability, sociodemographics, health status, patient activation, illness perception, and information related to their experiences with accessing, using, and understanding health information. We conducted in-depth interviews with 28 participants to further explore experiences with health information. In-depth interviews were also conducted with 9 health educators to understand how health information is currently shared with patients.

Results: The majority of participants had adequate functional health literacy, while 65% had low numeracy skills. Regardless of health literacy or numeracy ability, participants preferred to receive health information during a face-to-face conversation with a health care provider, primarily to receive immediate answers to their questions. Individuals with limited health literacy did not prefer to receive information via written or impersonal modalities. Conclusions: While patients overwhelmingly prefer to receive health information during face-to-face encounters with their health care providers, having multiple modalities available in plain, clear language is key to patients' understanding and applying information to health behavior.