title: The meaning of numbers in health: exploring health numeracy in a Mexican-American population.
abstract: BACKGROUND
  Health numeracy can be defined as the ability to use numeric information in the context of health. The interpretation and application of numbers in health may vary across cultural groups.
  
  
  OBJECTIVE
  To explore the construct of health numeracy among persons who identify as Mexican American.
  
  
  METHODS
  Qualitative focus group study. Groups were stratified by preferred language and level of education. Audio-recordings were transcribed and Spanish groups (n = 3) translated to English. An analysis was conducted using principles of grounded theory.
  
  
  METHODS
  A purposeful sample of participants from clinical and community sites in the Milwaukee and Chicago metropolitan areas.
  
  
  METHODS
  A theoretical framework of health numeracy was developed based upon categories and major themes that emerged from the analysis.
  
  
  RESULTS
  Six focus groups were conducted with 50 participants. Initial agreement in coding was 59-67% with 100% reached after reconciliation by the coding team. Three major themes emerged: 1) numeracy skills are applied to a broad range of communication and decision making tasks in health, 2) affective and cognitive responses to numeric information influence use of numbers in the health setting, and 3) there exists a strong desire to understand the meaning behind numbers used in health. The findings informed a theoretical framework of health numeracy.
  
  
  CONCLUSIONS
  Numbers are important across a range of skills and applications in health in a sample of an urban Mexican-American population. This study expands previous work that strives to understand the application of numeric skills to medical decision making and health behaviors.
authors.affiliation: The Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 63226-0509, USA. mschap@mcw.edu
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Schapira
authors.forename: Kathlyn E
authors.initials: KE
authors.lastname: Fletcher
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Ganschow
authors.forename: Cindy M
authors.initials: CM
authors.lastname: Walker
authors.forename: Bruce
authors.initials: B
authors.lastname: Tyler
authors.forename: Sam
authors.initials: S
authors.lastname: Del Pozo
authors.forename: Carrie
authors.initials: C
authors.lastname: Schauer
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002641:Chicago; D032882:Comprehension; D003431:Cross-Cultural Comparison; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006266:Health Education / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008433:Mathematics; D017058:Mexican Americans / Q000523:psychology*; D008875:Middle Aged; D014922:Wisconsin; D055815:Young Adult