273140 Skill set + mind set: Health literacy and activation as public health goals

Monday, October 29, 2012 : 12:30 PM - 12:45 PM

Michael Wolf, PhD, MPH , Northwestern University, Chicago, IL
Health literacy has dominated research agendas over the past two decades. Similarly, patient ‘activation' has increasingly become a variable of interest. While both may predict health outcomes, remediation strategies would significantly differ depending on which was the true cause of failure to adopt/change a specified health behavior. Using the NIH-funded ‘LitCog' Cohort study, the relationship between health literacy, patient activation, health behaviors, and clinical outcomes are investigated among a sample of older adults. Structured interviews were conducted among 1100 primary care patients ages 55 to 74 receiving care at one academic general internal medicine practice and three federally qualified health centers in Chicago, Illinois. In addition to an extensive battery of demographic, socioeconomic, health behavior, health status indicators, both health literacy and patient activation were assessed. In multivariable analyses independent associations between health literacy and patient activation with health task performance, preventive services use, chronic disease outcomes, and quality of life were evaluated. Our findings demonstrate that both health literacy and patient activation significantly predict an array of health outcomes, while being conceptually and statistically distinct from one another. Yet the variance explained was greatest when both health literacy and activation were included compared to either alone. Achieving health behavior change and optimal clinical outcomes requires both improvement in patients' abilities (health literacy) and motivation (patient activation) directed at the intended goals. As such, interventions that solely rely on education/improved health communication, or persuasive techniques will likely fail without a well-integrated combination of both skill set and mind set.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Differentiate between health literacy and patient activation. Identify the associations of health literacy and patient activation in relation to health task performance, preventive services use, chronic disease outcomes, and quality of life. Discuss the need to include both skill set and mind set in interventions to improve outcomes for patients with limited health literacy.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Professor of Medicine and Learning Sciences, Associate Division Chief for General Internal Medicine and Geriatrics, Founder and Director of the Health Literacy & Learning Program at Northwestern University. I have also published several editorials, book chapters, and technical reports. All of my publications are very focused around health literacy.
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.