Influence of Health Literacy and Cancer among Rural Patients in Rehabilitation

描述(由申请者提供)：健康素养已成为一个重要的概念，因为它的四个组成部分：文化和概念知识，听和说(口语素养)，写和读(印刷素养)，和算术影响个人的健康结果。由于个人并不生活在真空中，重要的是要了解健康素养在从个人到家庭、卫生保健系统和社区的多个互动层面上的复杂互动。对于来自阿巴拉契亚农村社区的癌症和其他慢性病患者，描述这些多个观点是如何相互联系和影响的，这是本研究未予探索的重点。目前的研究是制定研究计划的第一步，旨在解决这些复杂的相互作用和文献中的空白。通过深入访谈和焦点小组，本研究的目的是从个人、家庭、卫生保健机构和患者所在的农村家庭社区的角度来探讨健康素养的影响。我们建议达致三个具体目标：1.描述这一人群的健康素养水平。2.)确定住院康复设施在促进健康交流和解决潜在的健康素养问题方面的支持和障碍。3.)解决卫生知识普及对从康复机构向一个人的农村家庭社区过渡的影响。这项描述性的先导研究是朝着我们为这一人群开发和经验性评估健康素养干预措施的最终目标迈出的关键的第一步。稍后的调查将包括审查康复环境中目前的进程，以及这些进程如何积极或消极地支持健康传播，特别是在农村人口的健康知识普及方面。长期目标是制定干预措施，减少障碍并加强健康沟通方面的支持，以减少不良的健康结果，减少康复方面的健康差距，并对癌症患者和其他慢性病患者的环境过渡产生积极影响。公共卫生相关性：低健康素养有可能对处于康复环境中的癌症和其他慢性病患者的健康和福祉产生负面影响。低健康素养可能会对癌症和其他慢性病的自我管理以及服药依从性等问题产生负面影响。如果个人来自农村社区，移植到大都市住院康复机构，然后送回农村社区，这个问题可能会变得更加复杂。重要的是要了解低健康素养如何在复杂的社会环境中与个人相互作用，包括家庭、保健环境和家庭社区，目的是减少这些人口中潜在的健康差距。

DESCRIPTION (provided by applicant): Health literacy has emerged as an important construct because it's four components: cultural and conceptual knowledge, listening and speaking (oral literacy), writing and reading (print literacy), and numeracy affect the health outcomes of individuals. As individuals don't live in a vacuum, it is important to understand the complex interaction of health literacy at multiple levels of interaction from the individual to the family, health care system and community. Describing how these multiple points of view connect and influence each other for individuals with cancer and other chronic illnesses, from rural Appalachian communities who are in a rehabilitation setting is the under explored focus of this study. The current study is the first step in developing a program of research designed to address these complex interactions and gaps in the literature. Through in-depth interviews and focus groups, the goal of the present study is to explore the influence of health literacy from the individual, family, health care facility and the patient's rural home community point of view. We propose to achieve three specific aims: 1.) Describe the health literacy level of this population. 2.) Determine the supports and barriers found in an inpatient rehabilitation facility in terms of facilitating health communication and addressing potential health literacy issues. 3.) Address the impact of health literacy on the transition from a rehabilitation facility back to a person's rural home community. This descriptive pilot study is a critical first step toward our ultimate goal of developing and empirically assessing health literacy interventions for this population. Later inquiries will include an examination of current processes in a rehabilitation setting and how they positively or negatively support health communication particularly in terms of health literacy in rural populations. The long-term goal is to develop interventions that will decrease the barriers and enhance the supports in health communication to decrease poor health outcomes, decrease health disparities in rehabilitation and positively influence transitions between settings for individuals with cancer and other chronic disease. PUBLIC HEALTH RELEVANCE: Low health literacy has the potential to negatively impact individuals with cancer and other chronic illness who are in a rehabilitation setting in terms of health and well-being. Low health literacy can negatively impact issues such as self-management of cancer and other chronic illness and medication adherence. This problem is possibly compounded if the individual is from a rural community, transplanted to a metropolitan inpatient rehabilitation setting and then sent back to their rural community. It is important to understand how low health literacy interacts with the individual in their complex social setting, including family, health care setting and home community with the goal of reducing potential health disparities among this population.