Abstract 12039: Health Literacy Mediates the Relationship Between Perceived Control and Cardiac Event-free Survival in Patients With Heart Failure
Introduction: Lower levels of perceived control and health literacy are independently associated with morbidity (higher levels of anxiety and depression or rehospitalizations) in individuals with heart failure (HF). However, little is known about the interrelationship of these two predictors. Low health literacy impairs engagement in the health care process and in doing so may play a role between perceived control and outcomes.
Objective: The purpose of this study was to examine the relationships among perceived control, health literacy and cardiac event-free survival in patients with HF.
Methods: This was a prospective study of 575 rural patients with HF (female 41%, age 66±13, married 57%). Perceived control was assessed using the Control Attitude Scale-Revised. Health literacy was measured by the Short Test of Functional Health Literacy in Adults. Cardiac events were followed for 24 months by patient/family interview and hospital database review. Linear/logistic regression and survival analyses were used to examine the associations among health literacy, perceived control, and cardiac event-free survival.
Results: Patients with higher perceived control had higher health literacy. Higher perceived control and higher health literacy were associated with better cardiac event-free survival before and after adjusting for covariates (e.g. age, marital status, B-type Natriuretic Peptide) (p <.05). Perceived control was not a significant predictor of health outcomes (p=.10) after entering health literacy (p <.001) in the model demonstrating mediation (Figure).
Conclusions: Lower perceived control was associated with worse outcomes and health literacy was a mediator between perceived control and health outcomes. Our results suggest that interventions intended to improve health outcomes in adults with HF need to increase their perceived control of HF care and also take into account patients’ level of health literacy.
Author Disclosures: J. Wu: Research Grant; Modest; NIH/NINR K23. J.L. Miller: None. D.K. Moser: None.
- © 2016 by American Heart Association, Inc.