Educational Attainment but Not Literacy Is Associated with HIV Risk Behavior among Incarcerated Women

Clarke, Jennifer G.; Hebert, Megan R.; Ray, Moira K.; Stein, Michael D.

doi:10.1089/jwh.2005.14.852

Cited by 25 publications

(17 citation statements)

References 33 publications

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“…In this group, race was significantly associated with smoking practice, African American women being significantly less likely to smoke and being significantly more likely to have lower health literacy. In a study of 423 female prison inmates, many of whom had dropped out of school, HIV risk behaviour was associated with educational attainment but not with health literacy [31]. One of the studies [31] compared 3 and the other [30], 4 health literacy levels across the REALM score.…”

Section: Resultsmentioning

confidence: 99%

Health in the 'hidden population' of people with low literacy. A systematic review of the literature

2010

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BackgroundMuch of the evidence of an association between low functional or health literacy and poor health comes from studies that include people who have various cognitive difficulties or who do not speak the dominant language of their society. Low functional or health literacy among these people is likely to be evident in spoken conversation. However, many other people can talk readily about health and other issues but have problems using written information. Consequently, their difficulties may be far less evident to healthcare professionals, creating a 'hidden population' whose functional or health literacy problems have different implications because they are less likely to be recognised and addressed.We aimed to review published research to investigate relationships between low functional or health literacy and health in working age adults who can converse in the dominant language but have difficulty with written language.MethodsWe searched reviews and electronic databases for studies that examined health-related outcomes among the population of interest. We systematically extracted data relating to relationships between low functional or health literacy and both health status and various possible mediators or moderators of the implications of literacy for health. We developed a narrative review.ResultsTwenty-four studies met our inclusion criteria. Lower functional or health literacy in this population was found to be associated with worse health status. This may be mediated by difficulties accessing healthcare, and poorer self-management of health problems. It is currently unclear whether, how or to what extent these difficulties are mediated by poorer knowledge stemming from low functional or health literacy. The variation in functional or health literacy measures and comparisons make it difficult to compare study findings and to establish the implications of different literacy issues for health outcomes.ConclusionsThere is evidence in the literature that low functional or health literacy is associated with poor health in the 'hidden population' of adults whose literacy difficulties may not be evident to health care providers. Further research is needed to help understand the particular disadvantages faced by this population and to establish appropriate responses.

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Section: Resultsmentioning

confidence: 99%

Health in the 'hidden population' of people with low literacy. A systematic review of the literature

2010

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“…In this regard, future research should more squarely focus on the issue of literacy and health literacy, which have been shown to mediate the relationship between educational attainment and health knowledge and behavior, 4243 although not always. 4445 Indeed, some of our study participants may not have had the requisite literacy to adequately distinguish didactic and testimonial textual forms, which could help explain why no difference was found within the less-educated population.…”

Section: Discussionmentioning

confidence: 96%

Can pictorial warning labels on cigarette packages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content

Thrasher

Arillo-Santillán

Villalobos

et al. 2012

Cancer Causes Control

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Objective This study aimed to determine the most effective content of pictorial health warning labels (HWLs) and whether educational attainment moderates these effects. Methods Field experiments were conducted with 529 adult smokers and 530 young adults (258 nonsmokers; 271 smokers), wherein participants reported responses to different HWLs printed on cigarette packages. One experiment involved manipulating textual form (testimonial narrative vs didactic) and the other involved manipulating imagery type (diseased organs vs human suffering). Results Tests of mean ratings and rankings indicated that HWLs with didactic textual forms had equivalent or significantly higher credibility, relevance, and impact than HWLs with testimonial forms. Results from mixed-effects models confirmed these results. However, responses differed by participant educational attainment: didactic forms were consistently rated higher than testimonials among participants with higher education, whereas the difference between didactic and testimonial narrative forms was weaker or not statistically significant among participants with lower education. In the second experiment, with textual content held constant, greater credibility, relevance and impact was found for graphic imagery of diseased organs than imagery of human suffering. Conclusions Pictorial HWLs with didactic textual forms appear to work better than with testimonial narratives. Future research should determine which pictorial HWL content has the greatest real-world impact among consumers from disadvantaged groups, including assessment of how HWL content should change to maintain its impact as tobacco control environments strengthen and consumer awareness of smoking-related risks increases.

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“…This rate is approximately fi ve times that identifi ed in a national sample of community-dwelling women (Kessler et al, 2005). Estimates of women under the infl uence of alcohol at the time of arrest suggest even higher rates (El-Bassel et al, 1995;Greenfeld and Snell, 1999;Paasche-Orlow et al, 2005).…”

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confidence: 89%

Relationship of Alcohol Use and Sexual Risk Taking Among Hazardously Drinking Incarcerated Women: An Event-Level Analysis

Stein¹,

Anderson²,

Caviness³

et al. 2009

J. Stud. Alcohol Drugs

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ABSTRACT. Objective:To understand the association of alcohol use with sex and unprotected sex among hazardously drinking incarcerated women, we examined the relationship of these behaviors on any given day. Method: Participants endorsed unprotected sex and hazardous alcohol consumption (four or more drinks at a time on at least 3 separate days in the previous 3 months or a score of 8 or above on the Alcohol Use Disorders Identifi cation Test). Participants recalled behaviors in the 90 days before incarceration using the Timeline Followback method. Generalized estimating equation models estimated the effect of daily alcohol use and selected covariates on the odds of sexual-risk behavior. Results: The 245 participants averaged 34 years of age and were 71.4% white; 67.8% used cocaine. On most (84.7%) drinking days, women consumed four or more drinks. One hundred forty-one participants (57.6%) reported sex with only main partners, 10.6% with only casual partners, and 30.6% with both casual and main partners. The likelihood of having any sex (odds ratio = 1.78, p < .01) and unprotected sex (odds ratio = 1.95, p < .01) was higher on days when participants consumed alcohol compared with nondrinking days. However, when the analysis was restricted to days on which participants reported having sex, the odds of having unprotected sex was not signifi cantly associated with drinking. Conclusions: Among incarcerated women who reported hazardous drinking, alcohol use was associated with an increased likelihood of sexual activity and a concomitant increase in unprotected sex. However, use of alcohol was not signifi cantly associated with condom use on days when participants were sexually active. (J. Stud. Alcohol Drugs 70: [508][509][510][511][512][513][514][515] 2009)

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Educational Attainment but Not Literacy Is Associated with HIV Risk Behavior among Incarcerated Women

Abstract: Correctional education programs to reduce HIV risk behavior should focus on those with low educational attainment irrespective of literacy skills.

Cited by 25 publications

References 33 publications

Health in the 'hidden population' of people with low literacy. A systematic review of the literature

Health in the 'hidden population' of people with low literacy. A systematic review of the literature

Can pictorial warning labels on cigarette packages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content

Relationship of Alcohol Use and Sexual Risk Taking Among Hazardously Drinking Incarcerated Women: An Event-Level Analysis

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