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Does health literacy affect patients' receipt of preventative primary care? A multilevel analysis

Joshi, Chandni, Jayasinghe, Upali W., Parker, Sharon, Del Mar, Chris, Russell, Grant, Lloyd, Jane, Mazza, Danielle, Denney-Wilson, Elizabeth, van Driel, Mieke, Taylor, Richard, Harris, Mark F., Preventive Evidence into Practice (PEP) Partnership Group and Laws, Rachel 2014, Does health literacy affect patients' receipt of preventative primary care? A multilevel analysis, BMC family practice, vol. 15, pp. 1-10, doi: 10.1186/s12875-014-0171-z.

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Title Does health literacy affect patients' receipt of preventative primary care? A multilevel analysis
Author(s) Joshi, Chandni
Jayasinghe, Upali W.
Parker, Sharon
Del Mar, Chris
Russell, Grant
Lloyd, Jane
Mazza, Danielle
Denney-Wilson, Elizabeth
van Driel, Mieke
Taylor, Richard
Harris, Mark F.
Preventive Evidence into Practice (PEP) Partnership Group
Laws, RachelORCID iD for Laws, Rachel orcid.org/0000-0003-4328-1116
Journal name BMC family practice
Volume number 15
Article ID 171
Start page 1
End page 10
Total pages 10
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2014-10-25
ISSN 1471-2296
Keyword(s) Adult
Aged
Australia
Counseling
Exercise
Female
Health Literacy
Healthcare Disparities
Humans
Male
Middle Aged
Multilevel Analysis
Obesity
Overweight
Preventive Health Services
Primary Health Care
Primary Prevention
Referral and Consultation
Risk Reduction Behavior
Weight Reduction Programs
Preventive Evidence into Practice (PEP) Partnership Group
Summary BACKGROUND: People with limited health literacy are more likely to be socioeconomically disadvantaged and have risk factors for preventable chronic diseases. General practice is the ideal setting to address these inequalities however these patients engage less in preventive activities and experience difficulties navigating health services. This study aimed to compare primary care patients with and without sufficient health literacy in terms of their lifestyle risk factors, and explore factors associated with receiving advice and referral for these risk factors from their GPs. METHODS: A mailed survey of 739 patients from 30 general practices across four Australian states was conducted in 2012. Health literacy was measured using the Health Literacy Management Scale. Patients with a mean score of <4 within any domain were defined as having insufficient health literacy. Multilevel logistic regression was used to adjust for clustering of patients within practices. RESULTS: Patients with insufficient health literacy (n = 351; 48%) were more likely to report being overweight or obese, and less likely to exercise adequately. Having insufficient health literacy increased a patient's chance of receiving advice on diet, physical activity or weight management, and referral to and attendance at lifestyle modification programs. Not speaking English at home; being overweight or obese; and attending a small sized practice also increased patients' chances of receiving advice on these lifestyle risks. Few (5%, n = 37) of all patients reported being referred to lifestyle modification program and of those around three-quarters had insufficient health literacy. Overweight or obese patients were more likely to be referred to lifestyle modification programs and patients not in paid employment were more likely to be referred to and attend lifestyle programs. CONCLUSION: Patients with insufficient health literacy were more likely to report receiving advice and being referred by GPs to attend lifestyle modification. Although the number of patients referred from this sample was very low, these findings are positive in that they indicate that GPs are identifying patients with low health literacy and appropriately referring them for assistance with lifestyle modification. Future research should measure the effectiveness of these lifestyle programs for patients with low health literacy.
Language eng
DOI 10.1186/s12875-014-0171-z
Field of Research 111799 Public Health and Health Services not elsewhere classified
1117 Public Health And Health Services
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089702

Document type: Journal Article
Collections: School of Exercise and Nutrition Sciences
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.