Provider recognition of patient health literacy
Dunford, Mary Denise
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Ninety million adults in the United States have low health literacy which leads to higher rates of chronic disease and increased mortality. Some authors suggest that providers do not recognize low health literacy in clinical settings. The Test of Functional Health Literacy in Adults (TOFHLA) provides a reliable measure of patient health literacy but examining the relationship between provider recognition and patient literacy is limited because no measure of provider recognition exists. That gap is addressed by determining whether the Dunford Provider Recognition of Patient Health Literacy tool can be used to predict patients' functional health literacy as measured by their actual scores on the Test of Functional Health Literacy in Adults. A convenience sample (N=130) of emergency department patients was recruited for this cross-sectional study. All subjects' signed informed consent and completed a demographic questionnaire. Subjects' were interviewed to complete the Dunford tool, which was designed to measure provider recognition and then completed TOFHLA to calculate their health literacy score. Data was recorded using SPSS-15 and appropriate statistics reported. Results show that TOFHLA and the Dunford-PROPHL (r = .72) are highly correlated. Education level and number of medical conditions are most likely to predict functional health literacy. Subjects' with more years of education and fewer medical conditions had higher TOFHLA and Dunford-PROPHL scores. Individual items on the Dunford-PROPHL are highly correlated ( r = 91). Medication management and print behaviors are highly correlated with TOFHLA and this finding is significant. Subjects in the study reported an average of three medical conditions and five daily medications. Those with the highest number of health problems also had the lowest levels of functional health literacy. Providers caring for individuals at highest risk for low health literacy must look for specific literacy cues especially use of medication and the ability to comprehend printed materials. Providers who do not recognize patients with low health literacy are more likely to prescribe regimens that exceed the individual's capacity and this may contribute to poor health outcomes. Providers who screen patients with the Dunford-PROPHL can tailor their recommendations to ensure patients achieve optimal health outcomes.