Health literacy and education as mediators of racial disparities in patient activation within an elderly patient cohort

Nwamaka D. Eneanya*, Michael Winter, Howard Cabral, Katherine Waite, Lori Henault, Timothy Bickmore, Amresh Hanchate, Michael Wolf, Michael K. Paasche-Orlow

*Corresponding author for this work

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

The Patient Activation Measure (PAM) assesses facets of patient engagement to identify proactive health behaviors and is an important predictor of health outcomes. Health literacy and education are also important for patient participation and successful navigation of the health care system. Because health literacy, education, and patient activation are associated with racial disparities, we sought to investigate whether health literacy and education would mediate racial differences in patient activation. Participants were 265 older adults who participated in a computer- based exercise interventional study. Health literacy was assessed using the Test of Functional Health Literacy in Adults (TOFHLA). Of 210 eligible participants, 72% self- identified as Black and 28% as White. In adjusted analyses, education and health literacy each significantly reduced racial differences in patient activation. These findings are especially important when considering emerging data on the significance of patient activation and new strategies to increase patient engagement.

Original languageEnglish (US)
Pages (from-to)1427-1440
Number of pages14
JournalJournal of health care for the poor and underserved
Volume27
Issue number3
DOIs
StatePublished - Aug 1 2016

Keywords

  • Education
  • Health literacy
  • Patient activation
  • Racial disparities

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Eneanya, N. D., Winter, M., Cabral, H., Waite, K., Henault, L., Bickmore, T., Hanchate, A., Wolf, M., & Paasche-Orlow, M. K. (2016). Health literacy and education as mediators of racial disparities in patient activation within an elderly patient cohort. Journal of health care for the poor and underserved, 27(3), 1427-1440. https://doi.org/10.1353/HPU.2016.0133