title: The association of health literacy with illness and medication beliefs among older adults with asthma.
abstract: OBJECTIVE
  Suboptimal health literacy (HL) and asthma beliefs are associated with poor asthma self-management and outcomes. We tested the hypothesis that low HL is associated with inaccurate beliefs.
  
  
  METHODS
  Asthmatics ≥60 were recruited from hospital and community practices in New York, NY and Chicago, IL (n=420). HL was measured with the Short Test of Functional Health Literacy in Adults; validated instruments derived from the self regulation model were used to assess beliefs. The association of beliefs with HL was evaluated with multivariate models.
  
  
  RESULTS
  Thirty-six percent of patients had low HL; 54% believed they only have asthma when symptoms are present, 29% believed they will not always have asthma and 20% believed that their doctor can cure asthma. HL was associated with beliefs of not having asthma all the time and that asthma can be cured (OR: 1.84, 95% CI: 1.2-2.82; OR: 2.22, 95% CI: 1.29-3.82, respectively). Patients with low HL were also more likely to be concerned about medication use (β=0.92, p=.05), despite recognizing their necessity (β=-1.36, p=.01).
  
  
  CONCLUSIONS
  Older asthmatics with low HL endorse erroneous asthma beliefs.
  
  
  CONCLUSIONS
  Health communications for improving self-management behaviors in asthma should employ both health literacy-appropriate strategies and messages to counter illness-related misconceptions.
authors.affiliation: Division of General Internal Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. alex.federman@mssm.edu
authors.forename: Alex D
authors.initials: AD
authors.lastname: Federman
authors.forename: Michael
authors.initials: M
authors.lastname: Wolf
authors.forename: Anastasia
authors.initials: A
authors.lastname: Sofianou
authors.forename: Elizabeth A H
authors.initials: EA
authors.lastname: Wilson
authors.forename: Melissa
authors.initials: M
authors.lastname: Martynenko
authors.forename: Ethan A
authors.initials: EA
authors.lastname: Halm
authors.forename: Howard
authors.initials: H
authors.lastname: Leventhal
authors.forename: Juan P
authors.initials: JP
authors.lastname: Wisnivesky
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology*; D002641:Chicago; D003469:Culture; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D009518:New York; D009519:New York City; D012648:Self Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Asthma; Asthmatics; Elderly; Health literacy; Illness beliefs; Medication beliefs; Older; Self-management