Does health literacy affect patients’ receipt of preventative primary care? A multilevel analysis

BMC Family Practice

Research Article

Mark F Harris¹  Sharon Parker¹  Upali W Jayasinghe¹  Jane Lloyd¹  Chandni Joshi²  Chris Del Mar³  Danielle Mazza⁴  Mieke van Driel⁵  Elizabeth Denney-Wilson⁶  Richard Taylor⁷  Grant Russell⁸ 

[1] Centre for Primary Health Care and Equity, University of New South Wales, 2052, Sydney, Australia;Centre for Primary Health Care and Equity, University of New South Wales, 2052, Sydney, Australia;Preventive Evidence into Practice (PEP) Partnership Group, Australia;Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast 4229, Queensland, Australia;Department of General Practice, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia;Discipline of General Practice, School of Medicine, The University of Queensland, Brisbane, Australia;Faculty of Health, University of Technology, Sydney, Australia;School of Public Health and Community Medicine, University of New South Wales, 2052, Sydney, Australia;Southern Academic Primary Care Research Unit, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia;

关键词: Health literacy;    Obesity;    Nutrition;    Physical activity;    Weight;    Primary health care;    Behavioural risk factors;   

DOI  :  10.1186/s12875-014-0171-z

 received in 2014-08-28, accepted in 2014-10-06,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundPeople with limited health literacy are more likely to be socioeconomically disadvantaged and have risk factors for preventable chronic diseases. General practice is the ideal setting to address these inequalities however these patients engage less in preventive activities and experience difficulties navigating health services.This study aimed to compare primary care patients with and without sufficient health literacy in terms of their lifestyle risk factors, and explore factors associated with receiving advice and referral for these risk factors from their GPs.MethodsA mailed survey of 739 patients from 30 general practices across four Australian states was conducted in 2012. Health literacy was measured using the Health Literacy Management Scale. Patients with a mean score of <4 within any domain were defined as having insufficient health literacy. Multilevel logistic regression was used to adjust for clustering of patients within practices.ResultsPatients with insufficient health literacy (n = 351; 48%) were more likely to report being overweight or obese, and less likely to exercise adequately. Having insufficient health literacy increased a patient’s chance of receiving advice on diet, physical activity or weight management, and referral to and attendance at lifestyle modification programs. Not speaking English at home; being overweight or obese; and attending a small sized practice also increased patients’ chances of receiving advice on these lifestyle risks. Few (5%, n = 37) of all patients reported being referred to lifestyle modification program and of those around three-quarters had insufficient health literacy. Overweight or obese patients were more likely to be referred to lifestyle modification programs and patients not in paid employment were more likely to be referred to and attend lifestyle programs.ConclusionPatients with insufficient health literacy were more likely to report receiving advice and being referred by GPs to attend lifestyle modification. Although the number of patients referred from this sample was very low, these findings are positive in that they indicate that GPs are identifying patients with low health literacy and appropriately referring them for assistance with lifestyle modification. Future research should measure the effectiveness of these lifestyle programs for patients with low health literacy.

【 授权许可】

Unknown   
© Joshi et al.; BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creationcommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creationcommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.