244140 Effect of poor health literacy on eye examination behavior

Tuesday, November 1, 2011: 12:30 PM

Nancy J. Ellish, DrPH , Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
Renee Royak-Schaler, PhD , Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
Health literacy affects many aspects of health including poorer health outcomes, less frequent screening, poorer medicine compliance, and poor communication. We examined the effects of health literacy on knowledge, attitudes, and beliefs about eye health, stage of change for dilated fundus examinations (DFEs), and patient-physician communication, in a population of community-dwelling African Americans ages 65 and older. Health literacy was assessed using the REALM-R, a shortened version of the Rapid Estimate of Adult Literacy in Medicine (REALM) word recognition test. Of the 328 study participants, 63% were classified as having poor health literacy. We found statistically significant differences by health literacy score for gender, education, income, and behavioral intention. Males (P=.0002), those with less than a high school education (P<.0001), people with incomes less than $20,000 (P<.0001), and participants who had decided not to have a DFE or were still deciding (P=.03) were more likely to have poor health literacy scores. Those with poor health literacy had lower general eye knowledge scores than those with adequate literacy (P <.001), although no differences were observed for glaucoma or diabetic eye disease knowledge scores. Participants with poor health literacy reported more barriers to getting DFEs compared to those with adequate health literacy (P<.004). We found a statistically significant difference in medical decision-making preference by health literacy status (P=.006); people with poor health literacy were more likely to prefer that the doctor make medical decisions and less likely to prefer making the decisions themselves compared with participants with adequate health literacy.

Learning Areas:
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe the association between health literacy and knowledge, attitudes, and beliefs about eye health. Explain the association between health literacy and readiness for getting eye exams. Explain the effect of health literacy on doctor-patient communication.

Keywords: Health Literacy, Vision Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an associate professor with a DrPH in epidemiology and was Principal Investigator for the study on which this data is based.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.