Health literacy and self care behaviors in people with limited English skills : A study of hypertension in Korean immigrants

Background: Little is known about the magnitude and impact of health literacy on chronic disease management among people with limited English skills. Moreover, no study has focused on the relationship between high blood pressure (HBP) -specific health literacy with multiple HBP-related outcomes.

The purpose: To examine the effect of high blood pressure -specific health literacy on factors related to self-care skills, including BP knowledge, health care utilization, and BP outcomes in first-generation Korean American seniors with HBP.

Methods: Baseline data from an ongoing health literacy -focused self-care behavioral education intervention program for Korean American seniors with high blood pressure were utilized. Eligibility criteria for entry into this community-based, prospective controlled trial were: 60 years of age or older; systolic BP (SBP) > 140 mm Hg and/or diastolic BP (DBP) > 90 mm Hg on two separate occasions or being on antihypertensive medication; and self-identification as a Korean American senior. Results: 440 first-generation Korean American seniors with HBP were enrolled (69.5% females; mean age, 70.9 ± 5.5 yr). Multivariate regression analysis showed that the HBP-specific health literacy score was significantly and positively associated with the three predictors, HBP knowledge, depression, and health care utilization (adjusted R2 =.52), after controlling for the demographic variables gender, years of education, and years in the US. HBP-specific health literacy however was not independently associated with BP level or BP control status.

Conclusion/Discussion: The findings of this study indicated that health literacy is essential to self-management in HBP, since several important precursors of self-care behavior such as HBP knowledge, mood state, and health care utilization were positively related to HBP -specific health literacy. Our findings also highlight the need for measuring and integrating disease-specific health literacy into the self-management of chronic illnesses, such as high blood pressure, in the Korean immigrant population.