ESTABLISHING A LINK BETWEEN NUMERACY AND HEALTH

描述（由申请人提供）：在美国成年人中，社会经济地位和健康结果之间存在持久和普遍的联系。卫生知识普及是这一联系的潜在途径，并与发病率和死亡率的降低独立相关。读写能力很少被研究的一个方面是计算能力。算术能力被定义为能够熟练掌握基本的概率和数学概念。数值越高的患者主观健康风险感知越准确，对降低风险信息的理解也越好。风险沟通是重要卫生保健互动的重要组成部分，包括医患沟通、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，使他们积极参与医疗保健，并相信健康保护行为可以在他们的一生中带来个人利益。在本提案中，我们将探讨算术与采取健康保护行为之间的关系，包括宫颈癌、乳腺癌、结肠癌和前列腺癌筛查。该项目的具体目标是：

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.