Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients

Abstract

Introduction Participation in the decision-making process and health literacy may both affect health outcomes; data on how these factors are related among diverse groups are limited. This study examined the relationship between health literacy and decision-making preferences in a medically underserved population. Methods We analyzed a sample of 576 primary care patients. Multivariable logistic regression was used to examine the independent association of health literacy (measured by the Rapid Estimate of Adult Literacy in Medicine-Revised) and patients’ decision-making preferences (physician-directed or patient-involved), controlling for age, race/ethnicity, and gender. We tested whether having a regular doctor modified this association. Results Adequate health literacy (OR=1.7; p=0.009) was significantly associated with preferring patient-involved decision-making, controlling for age, race/ethnicity, and gender. Having a regular doctor did not modify this relationship. Males were significantly less likely to prefer patient-involved decision-making (OR=0.65; p=0.024). Discussion Findings suggest health literacy affects decision-making preferences in medically underserved patients. More research is needed on how factors, such as patient knowledge or confidence, may influence decision-making preferences, particularly for those with limited health literacy.

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