title: Health Literacy Rates in a Population of Patients with Rheumatoid Arthritis in Southwestern Ontario.
abstract: OBJECTIVE
  To determine the rate of low health literacy in the rheumatoid arthritis (RA) population in southwestern Ontario.
  
  
  METHODS
  For the study, 432 patients with RA were contacted, and 311 completed the assessment. The health literacy levels of the participants were estimated using 4 assessment tools administered in the following order: the Single Item Literacy Screener (SILS), the Medical Term Recognition Test (METER), the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Shortened Test of Functional Health Literacy in Adults (STOFHLA).
  
  
  RESULTS
  The rates of low literacy as estimated by STOFHLA, REALM, METER, and SILS were 14.5%, 14.8%, 14.1%, and 18.6%, respectively. All 4 assessment tools were statistically significantly correlated. STOFHLA, REALM, and METER were strongly correlated with each other (r = 0.59-0.79), while SILS only demonstrated moderate correlations with the other assessment tools (r = 0.33-0.45). Multiple linear regression and binary logistic regression analyses revealed that low levels of education and a lack of daily reading activity were common predictors of low health literacy. Using a non-English primary language at home was found to be a strong predictor of low health literacy in STOFHLA, REALM, and METER. Male sex was found to be a significant predictor of poor performance in REALM and METER, but not STOFHLA.
  
  
  CONCLUSIONS
  Low health literacy is an important issue in the southwestern Ontario RA population. About 1 in 7 patients with RA may not have the necessary skills to become involved in making decisions regarding their personal health. Rheumatologists should be aware of the low health literacy levels of patients with RA and should consider identifying patients at risk of low health literacy.
authors.affiliation: From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care.
authors.forename: Zhaowei
authors.initials: Z
authors.lastname: Gong
authors.affiliation: From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Haig
authors.affiliation: From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Pope
authors.affiliation: From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care.
authors.forename: Sherry
authors.initials: S
authors.lastname: Rohekar
authors.affiliation: From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care.
authors.forename: Gina
authors.initials: G
authors.lastname: Rohekar
authors.affiliation: From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care.
authors.forename: Nicole G H
authors.initials: NG
authors.lastname: LeRiche
authors.affiliation: From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care. andy.thompson@rogers.com.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Thompson
mesh_terms: D000367:Age Factors; D000368:Aged; D001172:Arthritis, Rheumatoid; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010817:Physician-Patient Relations; D012737:Sex Factors; D011795:Surveys and Questionnaires
keywords: HEALTH LITERACY; ONTARIO; RHEUMATOID ARTHRITIS