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Rachel Torres, MPH, CHES Department of Health & Behavior Studies

Rachel Torres, MPH, CHES Department of Health & Behavior Studies Teachers College, Columbia University. Relationships between Health Literacy, Self-efficacy and Knowledge of Hormone Replacement Therapy. Health Literacy.

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Rachel Torres, MPH, CHES Department of Health & Behavior Studies

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  1. Rachel Torres, MPH, CHES Department of Health & Behavior Studies Teachers College, Columbia University Relationships between Health Literacy, Self-efficacy and Knowledge of Hormone Replacement Therapy

  2. Health Literacy • “…the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” • Healthy People 2010

  3. Significance • National objectives that may be addressed by the study include: • Institute of Medicine • Health Literacy: A Prescription to End Confusion, 2004 • Priority Areas for Nation Action: Transforming Health Care Quality, 2003 • Healthy People 2010 • Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

  4. Cost of Poor Health Literacy • $73 billion dollars estimated • Because of • More hospitalizations • Ineffective use of prescriptions • Misunderstanding of treatment plans

  5. Research Design • Cross-sectional design utilizing survey methods • Measurement tools included: • Knowledge about hormone replacement therapy tool • Decision self-efficacy • Efficacy beliefs and outcomes expectations • Shortened Test of Functional Health Literacy in Adults (sTOFHLA) • Instrument reliability • Cronbach’s alpha for all instruments was well above .70

  6. Research Aims • Explore the role of health literacy in a woman’s knowledge about hormone replacement therapy • Identify whether health literacy is an important factor in decision self-efficacy regarding hormone replacement therapy • Explore whether there are differences among efficacy beliefs and outcome expectations between the inadequate, marginal and adequate functional literacy subgroups

  7. Data Collection • English and Spanish speaking women between the ages of 45-65 at the Nagle Family Health Center • Distributed questionnaire after study information sheet • Data collected between August and September 2005 • All collected data was collected by principal investigator and entered into SPSS 13

  8. Data Analysis • Correlation analysis to determine association between health literacy and: • knowledge • decision self-efficacy • Chi square teststo examine differences in categorical data

  9. Select Demographic Characteristics

  10. Aim #1: Explore the role of health literacy in a woman’s knowledge about hormone replacement therapy (n=106) Ho: There is a positive relationship between health literacy and knowledge about hormone replacement therapy Participants with higher health literacy have higher knowledge about hormone replacement therapy r = .819, p<.01

  11. Aim #2: Identify whether health literacy is an important factor in decision self-efficacy regarding HRT (n=106) Ho: There is a positive relationship between health literacy and decision self-efficacy Participants with higher health literacy have higher decision self-efficacy r = .695, p<.01

  12. Limitations • Sample of women at one particular clinic in Northern Manhattan • Study only examined associations between variables of interest • Individuals with low health literacy may have been more likely to refuse participation because of possible literacy burden

  13. Conclusions • Association between health literacy and: • Knowledge about hormone replacement therapy • Decision self-efficacy • Differences with efficacy beliefs but not with outcomes expectations between the three categories of health literacy

  14. Recommendations for Future Research • Patient education materials need to focus on more creative ways of communication instead of just reliance on written materials • Further explore the role of health literacy and decision self-efficacy on actual behavior • Design programs that focus on health literacy and self-efficacy

  15. Implications for Health Education • May highlight the importance of low health literacy on knowledge of risks and benefits in disease management or prevention efforts • May add to limited body of research regarding health literacy and self-efficacy as this affects hormone replacement therapy • May identify areas where effective tools and interventions can be developed to make health care information more accessible to individuals with low literacy levels

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