Health literacy - An overlooked factor in understanding HIV health disparities
Health literacy - An overlooked factor in understanding HIV health disparities
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DOI：
10.1016/j.amepre.2007.07.022
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发表时间：
2007-11-01
影响因子：
5.5
通讯作者：
Wolf, Michael S.
中科院分区：
文献类型：
--
作者：
Osborn, Chandra Y.;Paasche-Orlow, Michael K.;Wolf, Michael S.
背景：有限的健康素养可能是造成医疗保健种族差异的一个因素。本研究探讨了有限的健康素养在种族与HIV-药物依从性之间的中介作用。方法：2001年从两个诊所招募了204名HIV感染者。进行了结构化的面对面访谈，以获得有关患者人口统计学、用药依从性和健康素养的信息。2006年，在调整了相关协变量后，运用多元回归模型检验了种族、文化程度和艾滋病药物依从性之间的关系。结果：在排除文化因素的调整分析中，非洲裔美国人不遵守艾滋病药物治疗方案的可能性是白人的2.40倍(95%可信区间[CI]=1.14-5.08)。当识字能力被包括在最终模型中时，对种族的影响估计减少了25%，变得没有意义。文化程度仍然是不依从性的显著独立预测因素(调整后的优势比[AOR]=2.12，95%CI=1.932.32)。结论：在本研究中，有限的健康素养中介了种族和HIV药物依从性之间的关系。调查人员需要考虑应对卫生保健中的识字和沟通障碍的潜在效用，作为减少种族差异的干预措施的一部分。
Background: Limited health literacy may be a contributing factor to racial disparities in health care. This study examined the mediating effect of limited health literacy on the relationship between race and HIV-medication adherence.Methods: A total of 204 patients infected with HIV were recruited from two clinics in 2001. Structured in-person inter-views were conducted to obtain information on patient demographics, medication adherence, and health literacy. Multivariate regression models were run in 2006 to examine the associations among race, literacy, and HIV-medication adherence after adjusting for relevant covariates.Results: In an adjusted analysis that excluded literacy, African Americans were 2.40 times more likely to be nonadherent to their HIV-medication regimen than whites (95% confidence interval [CI]=1.14-5.08). When literacy was included in the final model, the effect estimates of race diminished 25% to nonsignificance. Literacy remained a significant independent predictor of nonadherence (adjusted odds ratio [AOR] =2.12,95% CI=1.932.32).Conclusions: In this study, limited health literacy mediated the relationship between race and HIV-medication adherence. Investigators need to consider the potential utility of responding to literacy and communication barriers in health care as part of interventions to reduce racial disparities.