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Patient Safety and Quality Improvement

Exploring Predictors of Health Literacy in an Academic Otolaryngology Clinic

Monday, October 2, 2023
4:03 PM - 4:09 PM East Coast USA Time
Location: 202A

    Presenting Author(s)

  • Madison N. Hearn, BS

    MD candidate
    Penn State College of Medicine
    Alexandria, PA, United States

    • Senior Author(s)

  • Neerav Goyal, MD MPH FACS

    Associate Professor; Division Chief Head and Neck Surgery; Vice Chair Patient Safety and Quality
    Penn State Milton S. Hershey Medical Center
    Hershey, PA, United States

    • Co-Author(s)

  • TK

    Tonya King, PhD

    Penn State University Department of Public Health Sciences, USA

Disclosure(s):
Madison N. Hearn, BS: No relevant relationships to disclose.
Neerav Goyal, MD MPH FACS: No relevant relationships to disclose.
Introduction: Health literacy impacts patients’ ability to participate in their healthcare and has been connected to health outcomes. The goal of this study is to describe health literacy among patients presenting to an academic Otolaryngology clinic and assess predictors of inadequate health literacy.

Methods: Patients aged 18 years or older completed the study questionnaire at an academic Otolaryngology clinic from March to June 2022. The questionnaire included the Brief Health Literacy Screen, a validated survey used to calculate a health literacy score, with 15 being the highest possible score. Demographic data extracted from the electronic medical record was linked to the survey responses and deidentified for analysis. Logistic regression analyses assessed the association between inadequate health literacy and patient factors. Inadequate health literacy was defined as a score ≤ 9. Analyses were conducted using SAS statistical software version 9.4.

Results: The study included 374 patients, with a mean age of 54.8 years (SD=17.8). Most patients were white (79%), native English speakers (95%), and from urban counties (95%). Median health literacy was 14.5 (Q1-Q3: 12.0-15.0) and 43 participants (12%) had inadequate health literacy. In bivariate analysis, odds of inadequate health literacy were 2.5 times greater with public vs. private insurance (95%CI 1.24-5.20, p=0.011). Upon multivariable analysis, only gender (p < 0.001) and race (p=0.005) remained significant predictors. Odds of inadequate health literacy were 3.7 times greater for males vs. females (95%CI 1.79-7.81). Asian race was associated with odds of inadequate health literacy 19.1 times greater than White participants (95%CI 3.99-91.70). There were no significant associations between inadequate health literacy and age nor rurality.

Conclusions: Inadequate health literacy was connected to factors including gender, insurance status, and race, but not to age or rurality. 12% of patients had inadequate health literacy, which may perpetuate disparities in care and necessitate interventions to help boost patient understanding.