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Health Literacy's Role in Chronic Illness Self-Management among Adults and Older Adults: A Literature Review
PubMed and PsycInfo were searched, using health literacy, self-management and self-care as keywords, to identify articles with a major focus on the relationship between health literacy and self-management. Eighteen articles were identified. One study focused exclusively on older adults, and all but two were quantitative. Most studies focused on a single chronic illness, including diabetes (7), heart failure (4), asthma (2), HIV (2), COPD (1), and arthritis (1).
Half of the studies demonstrat that higher health literacy is related to better self-management, but the remaining studies show either no relationship, or opposite results. Certain components of health literacy, such as communicative health literacy and numeracy, are more relevant for self-management than others, and self-management behaviors may be enacted differently by individuals with higher health literacy. Results suggest that health literacy influences certain self-management behaviors more than others, and that its effects vary by illness, and among racial/ethnic groups. Older adults exhibit lower health literacy levels.
Although the relationship is not straightforward, health literacy appears to play an important role in self-management in certain contexts. This review highlights specific areas for further research that will illuminate the nuances of this relationship, and enhance the effectiveness of self-management interventions.
Learning Areas:
Chronic disease management and preventionLearning Objectives:
Explain the relationship between health literacy and chronic illness self-management.
Compare the role of health literacy in chronic illness self-management across different illnesses, and between adults and older adults.
Identify how self-management interventions could be enhanced with attention to health literacy.
Keyword(s): Chronic Disease Management and Care, Health Literacy
Qualified on the content I am responsible for because: I have twenty years of experience conducting research on chronic illness self-management, and have received funding for my work from federal, state, and foundation sources. Specifically, my interests focus on the psychosocial influences on chronic illness self-management and self-care, especially among older adults.
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.