Evaluating the brief health literacy screen--the authors' reply.
Evaluating the brief health literacy screen--the authors' reply.
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评估简短的健康素养筛查——作者的答复。
DOI：
10.1007/s11606-013-2654-3
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发表时间：
2014
影响因子：
5.7
通讯作者：
Kripalani,Sunil
中科院分区：
文献类型：
--
作者：
Wallston,KennethA;Goggins,KathrynM;Kripalani,Sunil
作者回复：我们感谢Louis等人的来信，感谢他们对我们关于在临床实践中使用简短健康素养筛查（BHLS）的文章的推荐。他们表示，在他们的机构中，他们没有发现BHLS和成人功能健康素养短测试（S-TOFHLA）之间的同等程度的关系，并假设这可能是由于两种患者群体的差异。他们推测，他们的结果可能不如我们的结果有希望，因为“这些工具可能在健康素养高的人群中表现更好。”我们同意两种患者群体存在差异，但我们不同意我们得出结果的原因是由于两个机构之间的种族或教育差异。首先，我们文章中提出的多元回归分析调整了种族和教育（以及性别和年龄），仍然发现BHLS和S-TOFHLA之间存在显著关系。其次，在他们来信的刺激下，我们检查了种族或教育水平是否在我们的住院病人样本中缓和了我们的发现，其中34%的病人（n= 163）是非裔美国人，12%（n= 58）只有高中或更低的教育水平。种族和教育水平对我们的研究结果都没有影响；在我们的样本中，黑人的BHLS和S-TOFHLA之间的关系和白人一样强，受教育程度较低的人和至少上过一些大学的人一样强。在纳什维尔，即使不是在芝加哥，BHLS似乎也能有效地评估健康素养，即使是在具有较低健康素养特征的患者亚组中。尽管如此，我们支持Louis等人的呼吁“进一步评估BHLS在不同患者群体中的效用”，特别是那些可能被怀疑难以理解与其人口统计学特征无关的医疗信息的患者。
The Authors Reply—We thank Louis et al. for their letter commending our article regarding the Brief Health Literacy Screen (BHLS) as used in clinical practice. They state that at their institution they did not find the same magnitude of relationship between the BHLS and the short Test of Functional Health Literacy in Adults (S-TOFHLA) that we found at our institution, and hypothesized that this may have been due to differences in the two patient populations. They speculated that their results might have been less promising than ours because “the tools may perform better in populations with high health literacy.” We agree that there are differences in the two patient populations, but we disagree that the reason we obtained the results we did was due to either racial or educational differences between the two institutions. For one thing, the multiple regression analyses presented in our article adjusted for race and education (along with sex and age) and still found a significant relationship between the BHLS and the S-TOFHLA. Secondly, stimulated by their letter, we examined whether race or educational level moderated our finding in our inpatient sample, where 34% of the patients (n= 163) were African American and 12%(n= 58) had a high school education level or less. Neither race nor educational level made a difference in our findings; the relationship between the BHLS and S-TOFHLA is as strong for Blacks in our sample as it is for Whites, and for those with less education as for those with at least some college. In Nashville, if not in Chicago, the BHLS appears to validly assess health literacy even among subgroups of patients who have characteristics consistent with lower health literacy. Despite that, we endorse Louis et al.’s call “to further evaluate the utility of the BHLS in diverse patient populations,” particularly those which might be suspected of having difficulty understanding medical information unrelated to their demographic characteristics.