Culture and Health Literacy in a Dental Clinic

描述(由申请人提供)：这项研究旨在考察在复杂的医疗保健系统框架内，文化和教育或知识对患者牙科健康素养的影响。健康素养是社会审查中的四个信息领域之一，卫生保健提供者在对患者进行总体评估时应该进行这四个领域的评估。识字率低与健康状况较差、复杂用药方案遵从率低、住院率高、过度使用急救服务以及预防性保健服务使用不足有关。文化通过价值观和语言障碍与健康素养联系在一起，这些障碍塑造了人们对健康信息的感知和处理。教育系统的广义概念包括正在进行的成人教育和经验。卫生系统因素包括获得牙科保健的障碍以及保健就诊和服务的次数和类型。提出了三个具体目标：1)修订成人医学素养快速估计(REAL)，以纳入牙科术语(REAL-D)，并确定其与不同文化背景患者的知识、健康价值观和患者特征的关系；2)检查紧急/急诊就诊次数与预防性/全面就诊次数的差异；以及3)在控制文化背景(年龄、性别、种族/民族、首选语言)后，检查不同牙科健康素养水平的患者请求和接受健康促进教育服务范围的差异。这项可行性研究的目标是双管齐下的：修改和扩大牙齿健康素养的衡量标准，并开发一种程序，以前瞻性地利用电子患者记录(EPR)来跟踪患者与牙科保健系统的互动和口腔保健服务的获得。

DESCRIPTION (provided by applicant): This research is designed to examine the influence on a patient's dental health literacy of culture and education or knowledge within the framework of a complex health care system. Health literacy is one of four information domains in a social review that health care providers should conduct in their general assessment of a patient. Low literacy is associated with poorer health status, low rates of compliance with complicated medication regimens, high hospitalization rates, overuse of emergency services, and under-use of preventive health services. Culture is linked to health literacy by the values and language barriers that shape the perception and processing of health information. A broad conceptualization of the education system includes ongoing adult education and experiences. Health system factors include barriers to access dental care and number and type of health care visits and services. Three specific aims are proposed: 1) Revise the Rapid Estimate of Adult Literacy in Medicine (REALM) to incorporate dental terminology (REALM-D) and determine its association with knowledge, health values, and patient characteristics among culturally diverse patients; 2) Examine differences in numbers of urgent / emergency visits versus preventive/comprehensive visits by dental health literacy levels; and 3) Examine differences in the range of health promotion education services requested and received among patients with varied dental health literacy levels after controlling for cultural background (age, sex, race/ethnicity, preferred language). The goal of this feasibility study is two-pronged: to modify and expand a measure of dental health literacy, and to develop a process for prospectively utilizing an electronic patient record (EPR) to track patient interaction with the dental health care system and acquisition of oral health services.