Is health literacy related to health behaviors and cell phone usage patterns among the text4baby target population?
Is health literacy related to health behaviors and cell phone usage patterns among the text4baby target population?
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DOI：
10.1186/2049-3258-72-13
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Parker R
中科院分区：
文献类型：
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作者：
Poorman E;Gazmararian J;Elon L;Parker R
Text4baby为孕妇和产后妇女提供教育短信，目标是服务不足的妇女。本研究的主要目的是检查text4baby目标人群的健康行为和手机使用模式及其与健康素养的关系。研究人员从亚特兰大的两家妇女、婴儿和儿童诊所招募孕妇和产后妇女。这些妇女被问及她们的人口统计数据、选择的怀孕或产后健康行为以及手机使用模式。健康素养技能是用英文版的最新生命体征来衡量的。采用多变量逻辑回归，通过健康素养分类检查健康行为和手机使用模式，控制普遍接受的混杂因素。共招募了468名女性，其中445人完成了最新生命体征测试。其中，22%的人卫生知识不足，50%的人卫生知识中等，28%的人有足够的卫生知识技能。与足够的健康素养相比，有限的文化素养与怀孕期间不服用每日维生素（OR 3.6, 95% CI: 1.6, 8.5）和从不给婴儿母乳喂养（OR 1.4, 95% CI: 1.1, 1.8）独立相关。大多数（69.4%）受访者在入组前每天收到9条或更多短信，四分之一（24.6%）的受访者在过去六个月内更换过手机号码，7.0%的受访者共用一部手机。控制潜在的混杂因素，健康素养有限的人比健康素养充足的人更有可能共用一部手机（OR 2.57, 95% CI: 1.79, 3.69）。Text4baby信息应该适用于健康素养水平较低的人群，特别是因为这一人群可能有更高的针对性不健康行为患病率。Text4baby和其他针对低健康素养人群的移动医疗项目也应该意识到这些人群使用手机的不同方式，包括：共享手机，这可能意味着参与者不会收到信息或有特殊的隐私问题；频繁更换手机号码可能导致更高的流失率；以及短信在每天接收大量短信的人群中的渗透率。
Text4baby provides educational text messages to pregnant and postpartum women and targets underserved women. The primary purpose of this study is to examine the health behaviors and cell phone usage patterns of a text4baby target population and the associations with health literacy. Pregnant and postpartum women were recruited from two Women, Infant and Children clinics in Atlanta. Women were asked about their demographics, selected pregnancy or postpartum health behaviors, and cell phone usage patterns. Health literacy skills were measured with the English version of the Newest Vital Sign. Multivariable logistic regression was used to examine health behaviors and cell usage patterns by health literacy classification, controlling for commonly accepted confounders. Four hundred sixty-eight women were recruited, and 445 completed the Newest Vital Sign. Of these, 22% had inadequate health literacy, 50% had intermediate health literacy, and 28% had adequate health literacy skills. Compared to adequate health literacy, limited literacy was independently associated with not taking a daily vitamin during pregnancy (OR 3.6, 95% CI: 1.6, 8.5) and never breastfeeding their infant (OR 1.4, 95% CI: 1.1, 1.8). The majority (69.4%) of respondents received nine or more text messages a day prior to enrollment, one in four participants (24.6%) had changed their number within the last six months, and 7.0% of study participants shared a cell phone. Controlling for potentially confounding factors, those with limited health literacy were more likely to share a cell phone than those with adequate health literacy (OR 2.57, 95% CI: 1.79, 3.69). Text4baby messages should be appropriate for low health literacy levels, especially as this population may have higher prevalence of targeted unhealthy behaviors. Text4baby and other mhealth programs targetting low health literacy populations should also be aware of the different ways that these populations use their cell phones, including: sharing cell phones, which may mean participants will not receive messages or have special privacy concerns; frequently changing cell phone numbers which could lead to higher drop-off rates; and the penetrance of text messages in a population that receives many messages daily.