Journal of health communication
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Randomized Controlled Trial
Limited health literacy and decline in executive function in older adults.
Limited health literacy is associated with worse executive function, but the association between limited health literacy and decline in executive function has not been established because of a lack of longitudinal studies. The authors aimed to examine this association by studying a prospective cohort in the setting of a randomized controlled trial to promote walking in older adults. Participants were community-dwelling older adults (65 years of age or older) who scored 2 or more on the Mini-Cog, without depression (score of less than 15 on the 9-item Patient Health Questionnaire), and who completed baseline and 12-month evaluations (n = 226). ⋯ Limited health literacy was associated with reduced performance on all 3 executive function tests. In fully adjusted models, limited health literacy was associated with greater 12-month decline in performance on the TMT than higher health literacy (p = .01). In conclusion, older adults with limited health literacy are at risk for more rapid decline in scores on the TMT, a measure of executive function.
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Media interventions are one strategy used to promote physical activity, but little is known about their effectiveness with children. As part of a larger evaluation, the purpose of this study was to assess the short-term effect of a private industry sponsored media literacy campaign, Long Live Kids, aimed at children in Canada. Specifically, we investigated children's awareness of the campaign and its correlates. ⋯ Active children (≥3 days/week) were twice as likely to have recalled the campaign compared with inactive children (<3 days/week), whereas children living in high-income households (>$60,000/yr) were between 3.5 to 5 times more likely to have campaign recall compared with children living in a low-income households (<$20,000/yr). These findings suggest that media campaigns developed by industry may have a role in promoting physical activity to children although our findings identified a knowledge gap between children living in high- and low-income households. Future research needs to examine how children become aware of such media campaigns and how this mediated information is being used by children.
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Randomized Controlled Trial
Using health literacy and learning style preferences to optimize the delivery of health information.
Limited patient understanding of hypertension contributes to poor health outcomes. In 2 sequential randomized studies, the authors determined the impact of administering information tailored to health literacy level alone or in combination with preferred learning style on patients' understanding of hypertension. Patients with high blood pressure were recruited in an academic emergency department. ⋯ To measure learning, the authors compared scores on a hypertension assessment administered during the emergency department visit and 2 weeks after discharge. Participants who received materials tailored to both health literacy level and learning style preference showed greater gains in knowledge than did those receiving information customized for health literacy level only. This study demonstrates that personalizing health information to learning style preferences and literacy level improves patient understanding of hypertension.
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During and after the 2011 Republican presidential debate, a candidate questioned the safety of HPV vaccine. The authors aimed to determine the effect of these comments on parents. A national sample of 327 parents with adolescent sons ages 11-17 years completed online surveys in fall 2010 (baseline, about 1 year before the debate) and 2011 (follow-up, about 1 month after the debate). ⋯ Parents aware of the comments had a larger increase between baseline and follow-up in the belief that HPV vaccine might cause short-term health problems compared with parents who were not aware. Although the candidate's comments may have increased some parents' beliefs about the short-term harms of HPV vaccine, the comments had no effect on other beliefs, willingness to vaccinate, or behavior. Having accurate information about HPV vaccine that is readily available to the public during such controversies may diminish their effect.
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In this article, the authors argue that the association between socioeconomic status and motivation for a health-literate health care system has implications for health policymakers. As Ireland now undergoes health care reform, the authors pose the question, "Should policymakers invest in health literacy as predominately a health inequalities or a public health issue?" Data from 2 cohorts of the Survey of Lifestyle, Attitudes and Nutrition (1998 and 2002) were used to construct a motivation for a health-literate health care system variable. Multivariate logistic regressions and concentration curves were used in the analyses of this variable. ⋯ No discernible trend emerged from the main independent variables-social class grouping, medical card eligibility, level of education, and employment-in the regression analyses. The concentration curve, for 2002 data, graphically showed that the motivation for a health-literate health care system is spread equally across the income distribution. This analysis and more recent data suggest that health literacy in Ireland should be viewed predominately as a public health issue with a policy focus at a system level.