Education, literacy, and health: Mediating effects on hypertension knowledge and control
Education, literacy, and health: Mediating effects on hypertension knowledge and control
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DOI：
10.1016/j.pec.2009.04.006
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发表时间：
2009-06-01
影响因子：
3.5
通讯作者：
Wolf, Michael S.
中科院分区：
文献类型：
--
作者：
Pandit, Anjali U.;Tang, Joyce W.;Wolf, Michael S.
目的：为了确定是否识字中介教育，高血压知识和control.Methods之间的关联：在人的访谈与识字评估和图表审查进行了330例高血压患者从6个初级保健安全网诊所。中介分析被用来测试的识字技能在解释教育和高血压知识和control.Results之间的关系的作用：在多变量分析，没有作出调整的其他变量，无论是较低的教育程度和更有限的识字被发现是显着的独立预测因素较差的高血压知识和控制。当识字率进入仅包括教育的模型时，教育与知识之间的关联完全减弱，不再显著（1-8年级：β =-0.30，95%CI = -1.44-0.83），而教育与血压控制之间的关系仅轻微降低（AOR 2.46，95%CI 2.10-2.88）。在最终的模型中，文化程度越低，高血压控制越好（AOR 2.68，95% CI 1.54-4.70）。结论：文化程度在高血压知识与文化程度之间起中介作用。识字是一个重要的独立预测血压控制，但只有最低限度地解释教育和血压之间的关系。实践影响：健康素养是至关重要的教育工具，以提高知识的获取设计。然而，为了影响健康结果，未来的健康素养研究还应解决其他心理社会因素影响的动机和能力，以管理疾病。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To determine whether literacy mediates the association between education, hypertension knowledge and control.Methods: In-person interviews with a literacy assessment and chart review were conducted with 330 hypertensive patients from six primary care safety net clinics. Mediational analysis was used to test the role of literacy skills in explaining the relationship between education and hypertension knowledge and control.Results: In multivariate analyses that did not make an adjustment for the other variable, both lower educational attainment and more limited literacy were found to be significant independent predictors of poorer hypertension knowledge and control. When literacy was entered into models that included education only, the association between education and knowledge was fully attenuated and no longer significant (Grades 1-8: beta = -0.30, 95% Cl = -1.44-0.83), while the relationship between education and blood pressure control was only minimally reduced (AOR 2.46, 95% Cl 2.10-2.88). More limited literacy skills also was associated with hypertension control in the final model (AOR 2.68, 95% Cl 1.54-4.70).Conclusion: Patient literacy mediated the relationship between education and hypertension knowledge. Literacy was a significant independent predictor of blood pressure control, but only minimally explained the relationship between education and blood pressure.Practice implications: Health literacy is critical to the design of educational tools to improve knowledge acquisition. However, in order to impact health outcome, future health literacy studies should also address other psychosocial factors that impact motivation and capability to manage disease. (C) 2009 Elsevier Ireland Ltd. All rights reserved.