Online Program

333481
Health literacy universal precautions tools used in chronic disease self-management interventions: A systematic review


Sunday, November 1, 2015

Samantha Paige, MPH, Department of Health Education and Behavior, University of Florida, Gainesville, FL
Michael Stellefson, Ph.D., University of Florida, Gainesville, FL
Julia Alber, PhD, MPH, Center for Health Behavior Research, University of Pennsylvania, Philadelphia, PA
Charkarra Anderson-Lewis, PhD MPH, Department of Health Education & Behavior, University of Florida, Gainesville, FL
Background: According to the Health Literate Care Model, healthcare services that adopt health literacy universal precautions (HLUP) enable more effective navigation and utilization of healthcare services for all patients, regardless of health literacy level. While research has examined methods used to improve health literacy of patients with chronic disease, no studies have systematically reviewed the direct application of HLUP tools in chronic disease self-management interventions.

Objective:  To evaluate the application of HLUP tools in chronic disease self-management interventions.

Method: Garrard’s Matrix Method guided the systematic literature review of 14 peer-reviewed articles describing RCTs that tested chronic disease self-management interventions from 2005-2013. The use of 16 HLUP tools aligned with the Health Literate Care Model’s construct of self-management support were evaluated in each reviewed intervention.

Results: HLUP tools used most often in reviewed studies included: making action plans for individual patients (n=11), coordinating patient follow-up (n=9), and implementing strategies to facilitate clear communication (n=9). Ten studies used less than half of the available HLUP tools. Four tools promoting community-based support systems and patient-provider spoken language were not included in any of the reviewed interventions. Health educators (n=4) and registered nurses (n=6) facilitated over 70% of the self-management interventions that applied HLUP tools.

Discussion: Several HLUP tools are not being utilized in chronic disease self-management interventions. Because HLUP tools are known to be essential for delivering health literate services, researchers and policymakers should consider exploring strategies to overcome barriers to consistently apply HLUP tools for self-management support.

Learning Areas:

Chronic disease management and prevention
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify the quantity and type of health literacy universal precautions tools used in chronic disease self-management interventions Discuss how the application of HLUP tools varies when patient health literacy is assessed prior to chronic disease self-management intervention delivery.

Keyword(s): Chronic Disease Management and Care, Health Literacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student at the University of Florida, where I serve as a graduate research assistant for the Department of Health Education and Behavior. In this capacity, I am actively involved in the development of systematic literature reviews and research manuscripts related to topic areas such as chronic disease self-management (e.g., COPD), eHealth literacy, health literacy, and plain language.
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.