Provider perceptions of limited health literacy in community health centers.
OBJECTIVE
To examine techniques used by community health center (HC) providers to care for patients with limited health literacy (LHL).


METHODS
Survey mailed to 803 HC providers in 10 Midwestern states. Response rate was 47.5%. Associations between variables were examined using generalized estimating equations (GEE) models to account for clustering of respondents within HCs.


RESULTS
The average provider estimates of LHL prevalence among English- and Spanish-speaking patients were 41+/-24% (mean+/-S.D.) and 48+/-30%, respectively. Those with training in health literacy were more likely to have patients repeat instructions back to check understanding (OR=2.05 and p=0.04) and were more likely to give out health education materials designed for patients with LHL (OR=2.80 and p=0.0002). Providers differed by type in encouraging patients to bring friends or family members to appointments (p=0.02).


CONCLUSIONS
Providers estimate LHL to be highly prevalent in their HCs, and use various techniques to assist patients.


CONCLUSIONS
Training in health literacy is associated with increased usage of evidence-based techniques to assist patients with LHL. Providers at all levels would likely benefit from LHL training. Most providers believe providing health education materials designed specifically for patients with LHL would be very helpful.
Schlichting
Jennifer A
JA
Department of Medicine , Diabetes Research and Training Center, The University of Chicago, IL, United States. jschlic@umich.edu
Quinn
Michael T
MT
Heuer
Loretta J
LJ
Schaefer
Cynthia T
CT
Drum
Melinda L
ML
Chin
Marshall H
MH
D000328:Adult; D001291:Attitude of Health Personnel; D003151:Community Health Centers / Q000458:organization & administration; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006379:Helping Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008503:Medical Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology; D008875:Middle Aged; D015146:Midwestern United States; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology; D010353:Patient Education as Topic / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D024382:Professional Role / Q000523:psychology*; D011795:Surveys and Questionnaires