Health literacy and long-term health outcomes following myocardial infarction: protocol for a multicentre, prospective cohort study (ENHEARTEN study)

Abstract

IntroductionLow health literacy is common in people with cardiovascular disease and may be one factor that affects an individual’s ability to maintain secondary prevention health behaviours following myocardial infarction (MI). However, little is known about the association between health literacy and longer-term health outcomes in people with MI. The ENhancing HEAlth literacy in secondary pRevenTion of cardiac evENts (ENHEARTEN) study aims to examine the relationship between health literacy and a number of health outcomes (including healthcare costs) in a cohort of patients following their first MI. Findings may provide evidence for the significance of health literacy as a predictor of long-term cardiac outcomes.Methods and analysisENHEARTEN is a multicentre, prospective observational study in a convenience sample of adults (aged >18 years) with their first MI. A total of 450 patients will be recruited over 2 years across two metropolitan health services and one rural/regional health service in Victoria, Australia. The primary outcome of this study will be all-cause, unplanned hospital admissions within 6 months of index admission. Secondary outcomes include cardiac-related hospital admissions up to 24 months post-MI, emergency department presentations, health-related quality of life, mortality, cardiac rehabilitation attendance and healthcare costs. Health literacy will be observed as a predictor variable and will be determined using the 12-item version of the European Health Literacy Survey (HLS-Q12).Ethics and disseminationEthics approval for this study has been received from the relevant human research ethics committee (HREC) at each of the participating health services (lead site Monash Health HREC; approval number: RES-21-0000-242A) and Services Australia HREC (reference number: RMS1672). Informed written consent will be sought from all participants. Study results will be published in peer-reviewed journals and collated in reports for participating health services and participants.Trial registration numberACTRN12621001224819.

Use of co‐design methodology in the development of cardiovascular disease secondary prevention interventions: A scoping review

“…Evidence also shows that these populations receive suboptimal healthcare access compared to other population groups 64 . Healthcare services have an important role to play in addressing this social gradient, 65 by ensuring that the care they provide is accessible for all, including culturally and linguistically diverse communities, minority groups and those with lower socioeconomic status 66 . Use of the co‐design approach can take context‐specific challenges of ‘underserved’ population groups into consideration to provide a culturally appropriate and logistically sound CVD intervention that is feasible and acceptable.…”

Depression mediates the association between health literacy and health-related quality of life after myocardial infarction

“…For instance, the Health Literacy Questionnaire (HLQ) covers nine different domains of health literacy and therefore provides a comprehensive description of health literacy ( 14 ). So far there are only a few studies which applied a selection of two ( 15 ) or four domains ( 16 , 17 ) of the HLQ, and only two studies used all nine domains ( 18 , 19 ).…”

Developing and Implementing a Hospital‑based Family-centered Health Approach for Patients Undergoing Percutaneous Coronary Intervention: A Randomized Controlled Trial

“…Longitudinal studies found that hospital readmissions within a month of PCI are 75% higher amongst patients with limited H.L. [42,43]. Numerous studies suggest that hospitalbased and pre-discharge educational strategies improve treatment outcomes and reduce atherosclerosis recurrence, resulting in CHD [44][45][46].…”