ESTABLISHING A LINK BETWEEN NUMERACY AND HEALTH

描述（由申请人提供）：美国成年人的社会经济地位和健康结果之间存在持久和普遍的联系。卫生知识普及是实现这一联系的一个潜在途径，并与发病率和死亡率的下降独立相关。识字的一个方面很少被研究，那就是算术。 计算能力被定义为具有基本概率和数学概念的能力。计算能力越强的患者，主观健康风险认知越准确，对风险降低信息的理解也越好。风险沟通是重要的医疗保健互动的重要组成部分，包括提供者-患者沟通，知情同意和共同决策。计算能力可以提高患者处理风险信息的能力，积极参与他们的医疗保健，并相信健康保护行为可以在他们的生命过程中带来个人利益。在这个提案中，我们将探讨计算能力和健康保护行为（包括宫颈癌、乳腺癌、结肠癌和前列腺癌筛查）之间的关系。 该项目的具体目标是： 1.增加我们对计算能力与认知，心理和决策结构之间联系的理解，这些结构与采取健康保护行为有关。评估的认知过程将包括对筛查行为的风险和益处的了解。评估的心理特征包括掌握、一般自我效能、控制点、乐观和信任。评估的决策结构将包括信息寻求和参与医疗决策的愿望。 2.测试计算能力和癌症筛查行为（包括宫颈癌、乳腺癌、结直肠癌和前列腺癌筛查）之间的关联，同时控制社会经济特征。这种关联将在教育水平、种族和民族、收入和年龄不同的初级保健患者人群中进行评价。 我们的方法将被设计为评估的影响，算术作为一个独立的结构，从正规教育和一般识字。虽然一般的识字能力与算术能力有关，但它肯定不完全是预测性的。识字的人可能算术不好，而识字的人可能识字不好。这些发现将对数学在教育中的作用以及干预措施在提高成年人算术能力方面的潜在作用产生影响。

DESCRIPTION (provided by applicant): A persistent and pervasive link has been present between socioeconomic status and health outcomes among adults in the United States. Health literacy is a potential pathway for this link and has been independently associated with decreases in morbidity and mortality. One aspect of literacy that has been little studied is numeracy. Numeracy is defined as having facility with basic probability and mathematical concepts. More numerate patients are more accurate in subjective health risk perceptions and have a better comprehension of risk reduction information. Risk communication is an essential component to important health care interactions including provider- patient communication, informed consent, and shared decision-making. Numeracy may improve the capacity of patients to process risk information, to be active participants in their healthcare, and to believe that health protective behaviors can result in personal benefit over the course of their lives. In this proposal we will explore the relationship between numeracy and the adoption of health protective behaviors including cervical, breast, colon, and prostate cancer screening. The specific aims of this project are: 1. To increase our understanding of the link between numeracy and cognitive, psychological, and decision-making constructs that are relevant to the adoption of health protective behaviors. Cognitive processes evaluted will include knowledge of the risks and benefits of screening behaviors. Psychological traits evaluated will include mastery, general self-efficacy, locus of control, optimism, and trust. Decision-making constructs evaluated will include information seeking and the desire to participate in medical decision-making. 2. To test the association between numeracy and the adoption of cancer screening behaviors, including cervical, breast, colorectal, and prostate cancer screening, while controlling for socioeconomic characteristics. This association will be evaluated in a population of primary care patients that is diverse in educational level, race and ethnicity, income, and age. Our methods will be designed to evaluate the influence of numeracy as a separate construct from formal education and general literacy. While general literacy is related to numeracy, it is certainly not entirely predictive. Literate individuals may have poor numeracy, and numate persons may have poor literacy. The findings will have implications for the role of mathematics in education and the potential role of interventions to improve numeracy among adults.