Assessing health literacy levels of Spanish-speaking Hispanic patients in Spanish at federally qualified health centers (FQHCs) in the Midwest

Alba, Armando De; Britigan, Denise H.; Lyden, Elizabeth; Johansson, Patrik

doi:10.1353/hpu.2016.0158

Cited by 16 publications

(7 citation statements)

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“…Based on the results from the National Assessment of Adult Literacy, Hispanics have the lowest average health literacy level compared to all racial/ethnic group (Kutner et al, 2006). Results from a study conducted in rural and urban Hispanic populations in the Midwest were also consistent with the national statistics in terms of low health literacy levels (De Alba et al, 2016).…”

supporting

confidence: 74%

Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites

Alba

Schober

Johansson

2020

Health Promotion Practice

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Background Nationally, Hispanics experience health disparities manifested as a higher prevalence of chronic diseases in comparison to non-Hispanic Whites. Factors that influence health disparities in this population include inadequate dissemination of culturally and linguistically appropriate health information. Method Our qualitative analysis is based on data obtained from three focus groups with Spanish-speaking Hispanic adults conducted at a clinic in Nebraska. Participants were asked about their perceptions of health information in the form of videos, brochures, and websites. We followed the consolidated criteria for reporting qualitative research and used the theoretical framework of content analysis. Results For videos, attributes associated with higher levels of trust included a friendly health professional, the logo or name of a health care institute, and a reference specifying “se habla Español.” For brochures, attributes associated with trust included use of visual aids, use of numerous colors and big font sizes, the year of printing, and a health care agency logo. For websites, characteristics associated with trust were inclusion of plain language, use of pictures and videos, and date of last update. In all focus groups, participants perceived the use of mixed English/Spanish language in health information from pamphlets and websites as unprofessional. The use of unknown governmental logos in health promotional videos and websites was perceived as untrustworthy information. Conclusions Spanish-speaking Hispanics prefer health information supported by a health care agency or delivered by a health care professional. Health communication strategies should avoid the use of mixed English/Spanish language in sensitive information especially when combined with governmental logos.

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confidence: 74%

Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites

Alba

Schober

Johansson

2020

Health Promotion Practice

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“…In the United States, Andrulis and Brach (2007) calculated that approximately 40% of adults have limited health literacy, and that over one-half of them are nonwhite and/or Hispanic. Brice et al (2008) found low health literacy levels in Spanish-speaking patients in an emergency department, and Alba, Britigan, Lyden, and Johansson (2016) demonstrated similar results in Spanish-speaking patients in federally qualified health centers across the Midwestern U.S. Functional health literacy has been described as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Kindig, Panzer, & Nielsen-Bohlman, 2004). This definition is undergoing continual revision as research in the field advances and as researchers move away from a “deficit model” toward a realization that health literacy is a social construct that is variable and interdependent on social, economic, demographic, and other unknown factors (Pleasant, 2014).…”

mentioning

confidence: 99%

Health Literacy Estimation of English and Spanish Language Caregivers

Cooper¹,

Blucker²,

Thompson³

et al. 2018

HLRP: Health Literacy Research and Practice

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Background: Provider ability to estimate caregiver health literacy (HL) in English-speaking caregivers has been shown to be poor, but estimation of HL in Spanish-speaking caregivers by physicians and staff has yet to be studied. Linguistic differences can further hinder communication in medical care. Objective: This study evaluated how well pediatric providers and staff predict caregiver HL as measured by two HL tools in a bilingual (English/Spanish) population. Method: For this study, we obtained a convenience sample of caregivers, evaluating one group with the Newest Vital Sign (NVS) and the second group with the Short Assessment of Health Literacy (SAHL). Physicians/nurse practitioners (NPs), and medical assistants (MAs) estimated caregiver scores for each tool. We dichotomized estimated and actual scores for each tool using published standards. We used McNemar's test and Cohen's Kappa to evaluate agreement between dichotomized predicted and actual scores. We used log binomial regression to examine how caregiver's language affected agreement between dichotomized caregiver scores and provider estimates. All physicians/NPs were native English speakers only and all MAs were native bilingual English/Spanish speakers. Physicians/NPs used interpretation services when appropriate. Key Results: Fifty caregivers were evaluated using the NVS and 50 using the SAHL. There was no overall association between dichotomized physician/NP or MA estimation and caregiver score for either tool. However, providers' estimates were less likely to match caregiver scores when the caregiver's language was Spanish (NVS: relative risk [RR] = 0.57 [95% CI 0.37, 0.87], SAHL: RR = 0.37 [95% CI 0.23,0.6]). Conclusion: Physician/NP and MA ability to estimate caregiver HL in English proficient and limited English proficiency caregivers is poor. The physician/NP group was less likely to estimate HL correctly if the caregivers spoke Spanish. Providers must use additional caution when providing cross-language care. [ HLRP: Health Literacy Research and Practice . 2018;2(2):e107–e114.] Plain Language Summary: This study examined estimation of health literacy of English- and Spanish-speaking caregivers by pediatric providers and medical assistants. We found that both providers and staff estimate caregiver health literacy poorly, and that primary language discordance may be a factor. The results support the institution of universal health literacy precautions for all caregivers of pediatric patients.

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“…Further, despite research that shows minority populations have inequitable educational attainment, particularly in older populations [ 25 ], past research has found that minority populations do not reap the same health benefit from educational attainment as their white counterparts; given the same education, disadvantaged and marginalized groups are at an increased risk for unhealthy behaviors and health outcomes when compared to whites [ 26 ]. Previous research has found that lower educational attainment was associated with lower health literacy levels, especially among minority populations [ 27 ], further demonstrating the importance of identifying those with low levels of education and it connection with one’s health literacy and health outcomes. These health inequities may be due to underlying social determinants that are exacerbated among minority populations, such as racial discrimination and lack of access to other social resources.…”

Section: Discussionmentioning

confidence: 99%

Social Risk of Pregnant Women at a Community Health Center: An Application of the PRAPARE Assessment Tool

Luzius

Merriweather

Busch

et al. 2023

J Immigrant Minority Health

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Community health centers (CHCs) screen patients for social determinants of health (SDoH). The study’s purpose was to assess the relationship between demographic factors and unmet social needs (SDoH risk) among pregnant mothers. Patient data from 345 pregnant women between January 2019-December 2020 assessed SDoH risk, using the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) tool. Chi-square analyses explored relationships between social needs and demographic factors, and a multivariate logistic regression examined associations between these variables controlling for covariates. Hispanic patients and those who preferred to speak Spanish had 2.35 and 5.39 times the odds, respectively as non-Hispanic Whites and English speakers of having moderate/high/urgent SDoH risks. Mothers who had not completed high school had increased odds (aOR = 7.38) of SDoH risk. By identifying indicators that increase social risk level, CHCs can connect patients to essential social services, improving the downstream health of mothers and children.

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Assessing health literacy levels of Spanish-speaking Hispanic patients in Spanish at federally qualified health centers (FQHCs) in the Midwest

Abstract: Low levels of health literacy reported in this study are consistent with previous assessments. We observed statistically significant differences in LHLL based on gender, education level, and country of origin.

Cited by 16 publications

References 10 publications

Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites

Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites

Health Literacy Estimation of English and Spanish Language Caregivers

Social Risk of Pregnant Women at a Community Health Center: An Application of the PRAPARE Assessment Tool

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