Abstract 12414: Are Functional Literacy Scores Time Dependent in Rural Heart Failure Patients?
Purpose: Levels of literacy, determined from the Shortened-Test of Functional Health Literacy in Adults (S-TOFHLA) scores, have important implications for health interventions and outcomes. Despite its wide use, little is known about the usefulness of S-TOFHLA for heart failure (HF) patients, some of whom may have cognitive dysfunction. We investigated the relationship between the S-TOFHLA % correct scores at 7 minutes and with no time limit (NTL)
Methods: In this prospective study, 612 rural-dwelling adults diagnosed with HF (mean age: 66±13 years, 41% female, 89% White) were recruited from multiple sites in three states. Paired t-tests, Pearson correlations and multiple regression were used in the analyses.
Results: Patients improved their % correct scores from 71% to 86% (mean change = 15.1 ± 18.1) between the 7-min. and NTL scores. Additionally, 27% of patients improved by at least one literacy level with NTL scores (p<.001); 17% of patients went from ‘Inadequate’ to ‘Marginal’ and 10% went from ‘Inadequate’ to ‘Adequate’ literacy levels. Demographic variables (age, gender, education, income) were entered into a multiple regression and explained 24.2% of the variance in % correct scores in the 7-min. score analysis and only 11% of the variance in % correct scores in the NTL score analysis. In the 7-min analysis, all four demographic variables made unique contributions to the model (p <. 001). Females scored 8% more correct than males; younger patients scored higher than older patients with each year accounting for almost 1% more correct; patients with higher education scored 7% more correct than patients with less education, and patients with higher income scored 4% more correct than patients with lower income. Knowledge about HF, Self Care, the Charlson Comorbidity Index, and the Basic Symptom Inventory were not associated significantly with health literacy scores (p>.01).
Conclusions: Published work using the S-TOFHLA has associated the assessment of limited health literacy to less health knowledge and poorer health outcomes. These associations differ in patients with HF. More research is needed on the S-TOFHLA to determine why 27% of HF patients scored significantly better when given more time to complete the test.
- © 2010 by American Heart Association, Inc.