Association of Health Literacy with Complementary and Alternative Medicine Use: A Cross-Sectional Study in Adult Primary Care Patients
Association of Health Literacy with Complementary and Alternative Medicine Use: A Cross-Sectional Study in Adult Primary Care Patients
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DOI：
10.1186/1472-6882-11-138
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发表时间：
2011-12-30
影响因子：
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通讯作者：
Egede, Leonard E.
中科院分区：
文献类型：
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作者：
Bains, Sujeev S.;Egede, Leonard E.
背景：在美国，据估计 40% 的成年人采用补充和替代医学 (CAM) 疗法。最近，全国调查报告显示，超过 9000 万成年人的健康素养不足。迄今为止，尚无研究评估健康素养及其对 CAM 使用的影响。本研究的主要目的是评估健康素养和 CAM 使用之间的关系，与教育程度无关。第二个目标是评估不同种族健康素养对 CAM 使用的差异影响。方法：从初级保健门诊招募了 351 名患者。经过验证的调查评估了 CAM 使用 (I-CAM-Q)、健康素养 (REALM-R) 和人口统计信息。我们使用卡方统计数据比较了按健康素养（充足与不足）划分的人口统计数据以及按健康素养划分的总体和个人 CAM 类别。我们通过健康素养交互发现了种族，并运行了按种族分层的序贯逻辑回归模型，以测试健康素养与整体 CAM 使用（模型 1）、模型 1 + 教育（模型 2）和模型 2 + 其他人口特征（模型 3）之间的关联。我们分别报告了白人和非裔美国人健康素养对 CAM 使用的调整后影响。结果：75% 的参与者具有足够的素养，80% 使用 CAM。 CAM 的使用因 CAM 类别而异。在白人中，在未经调整的模型（模型 1，OR 7.68；p = 0.001）和针对教育调整的模型（模型 2，OR 7.70；p = 0.002）和其他社会人口统计学模型（模型 3，OR 9.42；p = 0.01）中，足够的健康素养与 CAM 使用的增加显着相关。在非裔美国人中，在任何模型中，足够的健康素养与 CAM 使用均无关。结论：我们发现种族与素养的相互作用表明，健康素养与 CAM 使用之间的关系因种族而存在显着差异。白人中足够的健康素养与 CAM 使用增加相关，但与非裔美国人中 CAM 使用无关。
Background: In the United States, it is estimated that 40% of adults utilize complementary and alternative medicine (CAM) therapies. Recently, national surveys report that over 90 million adults have inadequate health literacy. To date, no study has assessed health literacy and its effect on CAM use. The primary objective of this study was to assess the relationship between health literacy and CAM use independent of educational attainment. Second objective was to evaluate the differential effect of health literacy on CAM use by race.Methods: 351 patients were recruited from an outpatient primary care clinic. Validated surveys assessed CAM use (I-CAM-Q), health literacy (REALM-R), and demographic information. We compared demographics by health literacy (adequate vs. inadequate) and overall and individual CAM categories by health literacy using chi square statistics. We found a race by health literacy interaction and ran sequential logistic regression models stratified by race to test the association between health literacy and overall CAM use (Model 1), Model 1 + education (Model 2), and Model 2 + other demographic characteristics (Model 3). We reported the adjusted effect of health literacy on CAM use for both whites and African Americans separately.Results: 75% of the participants had adequate literacy and 80% used CAM. CAM use differed by CAM category. Among whites, adequate health literacy was significantly associated with increased CAM use in both unadjusted (Model 1, OR 7.68; p = 0.001) and models adjusted for education (Model 2, OR 7.70; p = 0.002) and other sociodemographics (Model 3, OR 9.42; p = 0.01). Among African Americans, adequate health literacy was not associated with CAM use in any of the models.Conclusions: We found a race by literacy interaction suggesting that the relationship between health literacy and CAM use differed significantly by race. Adequate health literacy among whites is associated with increased CAM use, but not associated with CAM use in African Americans.