HLTH LIT, SOC SUPPORT,& HLTH: SURVEY OF MEDICARE ENROLLE

HLTH LIT，SOC 支持，

• 批准号: 6473132
• 负责人: Shoou-Yih Daniel Lee
• 金额: $ 41.35万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2004-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6473132
• 关键词: Medicare /Medicaid; behavioral /social science research tag; choice; clinical research; comprehension; decision making; health behavior; health care service utilization; health education; health services research tag; health surveys; human old age (65+); human subject; medical records; questionnaires; social support network; socioenvironment

The purposes of this proposed research are (1) to examine the effects of health literacy on health and health service utilization, and (2) to investigate whether effects of health literacy are moderated by the support and networks of an individual's social environment. The target population is Medicare enrollees. Compared to their younger counterparts, older adults are likely to use more health services because of greater disease burden. With lower health literacy, they also are more likely to have problems following medical directions and suffer from adverse medical consequences. The past several years have witnessed a growing societal concern with low health literacy and its health toll. Research has shown that low health literacy may be associated with low health status and increased rates of hospitalization. However, it remains unclear how health literacy affects health and health service utilization. Furthermore, studies have shown significant individual variation in the adaptation to health literacy problems. In response to these problems, we plan to a conduct a face-to-face questionnaire survey and use information collected from computerized hospital records and medical charts to address the following research questions: (1) Does health literacy have direct or indirect effects on health status and health service utilization? If the effects are indirect, what are the casual mechanisms or intermediate steps that link low health literacy to poor health status and high utilization of hospital care? (2) Do social support and networks moderate the effects of health literacy on health and health service utilization? For example, does social support interact with health literacy in a way that the negative impact of low health literacy on health outcomes might be reduced by increased social support? Better knowledge of how health literacy are related to health and health service utilization will help policy-makers and health care providers identify and eliminate the missing links in the delivery of care for elderly patients with low health literacy. To the extent that there are moderating and protective effects of social supports and networks, available resources in the community could be employed to improve the quality of care for elderly patients. Furthermore, interventional efforts could be designed more efficiently and more effectively by focusing on those elderly patients who not only qualify as literacy incompetent but also lack the resources, support, tools, and skills to bridge the unmet literacy demand of their health conditions.

这项拟议的研究的目的是（1）研究健康素养对健康和健康服务利用的影响，以及（2）研究健康素养的影响是否受个人社会环境的支持和网络的调节。 目标人群是Medicare的参与者。 与年轻的同龄人相比，由于疾病负担更大，老年人可能会使用更多的健康服务。 有了较低的健康素养，他们也更有可能遵循医疗方向并遭受不良医疗后果的问题。在过去的几年中，人们对低健康素养及其健康损失的社会关注不断增长。 研究表明，低健康素养可能与健康状况低下和住院率提高有关。 但是，尚不清楚健康素养如何影响健康和健康服务的利用。 此外，研究表明，适应健康素养问题的个人差异很大。 为了应对这些问题，我们计划进行面对面的问卷调查，并使用从计算机医院记录和医疗图表中收集的信息来解决以下研究问题：（1）健康素养是否对健康状况和健康服务利用产生直接或间接影响？ 如果效果是间接的，那么将低健康素养与健康状况不佳和高利用医院护理联系起来的休闲机制或中间步骤是什么？ （2）社会支持和网络是否可以调节健康素养对健康和健康服务利用的影响？ 例如，社会支持是否会与健康素养对健康成果的负面影响可能会因社会支持的增加而降低？更好地了解健康素养与健康和卫生服务利用方式如何帮助决策者和卫生保健提供者识别并消除对低健康素养的老年患者提供护理中缺失的联系。在某种程度上，社会支持和网络有调节和保护作用，可以利用社区中的可用资源来提高老年患者的护理质量。 此外，通过专注于那些不仅具有识字能力的老年患者，而且缺乏弥合对健康状况未满足的识字需求的资源，支持，工具和技能，可以更有效，更有效地设计介入的努力。