title: Health Literacy and Education as Mediators of Racial Disparities in Patient Activation Within an Elderly Patient Cohort.
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.
authors.forename: Nwamaka D
authors.initials: ND
authors.lastname: Eneanya
authors.forename: Michael
authors.initials: M
authors.lastname: Winter
authors.forename: Howard
authors.initials: H
authors.lastname: Cabral
authors.forename: Katherine
authors.initials: K
authors.lastname: Waite
authors.forename: Lori
authors.initials: L
authors.lastname: Henault
authors.forename: Timothy
authors.initials: T
authors.lastname: Bickmore
authors.forename: Amresh
authors.initials: A
authors.lastname: Hanchate
authors.forename: Michael
authors.initials: M
authors.lastname: Wolf
authors.forename: Michael K
authors.initials: MK
authors.lastname: Paasche-Orlow
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D057220:Health Literacy / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D010358:Patient Participation / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data