Health numeracy in Japan: measures of basic numeracy account for framing bias in a highly numerate population
Health numeracy in Japan: measures of basic numeracy account for framing bias in a highly numerate population
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DOI：
10.1186/1472-6947-12-104
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发表时间：
2012-09-11
影响因子：
3.5
通讯作者：
Kawamoto, Keiko
中科院分区：
文献类型：
--
作者：
Okamoto, Masako;Kyutoku, Yasushi;Kawamoto, Keiko
背景：健康计算能力是人们根据医疗风险信息做出决策的重要因素。然而，在许多国家，包括日本，计算能力的研究一直limited.Methods：为了填补这一空白，我们评估了健康的计算水平在日本成年人的样本翻译两个著名的尺度，客观地衡量数学和概率的基本理解：由Schwartz和他的同事开发的3项计算能力量表（Schwartz量表）及其扩展版本，Lipkus及其同事开发的11项计算能力量表（Lipkus量表）。参与者（n = 300）在量表上的表现远远高于在美国进行的原始研究（Schwartz-J的平均项目正确回答率为80%，Lipkus-J为87%）。这种高性能导致了两个分数分布的天花板效应，这使得很难应用参数统计分析，并限制了统计结果的解释。然而，数据提供了一些证据，这些量表的可靠性和有效性：可靠性的日本版本（Schwartz-J和Lipkus-J）的内部一致性（Cronbach的α = 0.53 Schwartz-J和0.72 Lipkus-J）与原来的。收敛效度与现有的日本健康素养措施（由高桥和同事开发的解释医疗信息的能力测试），其中包含一些项目的算术呈正相关。此外，如之前的研究所示，健康计算能力仍然与框架偏差相关，Lipkus-J表现低于中位数的个体在评估手术风险时受到概率框架的显著影响。一个显着的关联也被发现使用Schwartz-J，其中包括只有三个items.Conclusions：尽管相对较高的健康水平的算术根据这些尺度，算术措施仍然是重要的决定因素潜在的易感性框架偏见。这表明，在日本，识别计算能力低的人，以使他们能够正确理解风险信息是非常重要的，需要进一步研究在日本进行这种干预的有效计算措施。
Background: Health numeracy is an important factor in how well people make decisions based on medical risk information. However, in many countries, including Japan, numeracy studies have been limited.Methods: To fill this gap, we evaluated health numeracy levels in a sample of Japanese adults by translating two well-known scales that objectively measure basic understanding of math and probability: the 3-item numeracy scale developed by Schwartz and colleagues (the Schwartz scale) and its expanded version, the 11-item numeracy scale developed by Lipkus and colleagues (the Lipkus scale).Results: Participants' performances (n = 300) on the scales were much higher than in original studies conducted in the United States (80% average item-wise correct response rate for Schwartz-J, and 87% for Lipkus-J). This high performance resulted in a ceiling effect on the distributions of both scores, which made it difficult to apply parametric statistical analysis, and limited the interpretation of statistical results. Nevertheless, the data provided some evidence for the reliability and validity of these scales: The reliability of the Japanese versions (Schwartz-J and Lipkus-J) was comparable to the original in terms of their internal consistency (Cronbach's alpha = 0.53 for Schwartz-J and 0.72 for Lipkus-J). Convergent validity was suggested by positive correlations with an existing Japanese health literacy measure (the Test for Ability to Interpret Medical Information developed by Takahashi and colleagues) that contains some items relevant to numeracy. Furthermore, as shown in the previous studies, health numeracy was still associated with framing bias with individuals whose Lipkus-J performance was below the median being significantly influenced by how probability was framed when they rated surgical risks. A significant association was also found using Schwartz-J, which consisted of only three items.Conclusions: Despite relatively high levels of health numeracy according to these scales, numeracy measures are still important determinants underlying susceptibility to framing bias. This suggests that it is important in Japan to identify individuals with low numeracy skills so that risk information can be presented in a way that enables them to correctly understand it. Further investigation is required on effective numeracy measures for such an intervention in Japan.