The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients

Hahn, Elizabeth A.; Cella, David; Dobrez, Deborah G.; Weiss, Barry D.; Du, Hongwu; Lai, Jin Shei; Victorson, David; Garcia, Sofia F.

doi:10.1007/s11136-006-9128-6

Cited by 37 publications

(31 citation statements)

References 55 publications

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“…The quality of life instrument used for this study was designed to require relatively low literacy levels (i.e. it was written at approximately 7 th grade level) and previous research has indicated scores are not subject to systematic literacy bias (Hahn et al, 2007). However, Hahn et al, (2007) tested literacy bias among participants (high vs. low literacy) completing the FACT-G using a Talking Touchscreen.…”

Section: Discussionmentioning

confidence: 99%

“…it was written at approximately 7 th grade level) and previous research has indicated scores are not subject to systematic literacy bias (Hahn et al, 2007). However, Hahn et al, (2007) tested literacy bias among participants (high vs. low literacy) completing the FACT-G using a Talking Touchscreen. Still, the health literacy variable may affect responses to the HRQOL among those with very low levels of literacy.…”

Section: Discussionmentioning

confidence: 99%

“…A minimally important difference (MID) in the FACT-G scale is 5 points for the total score and 2 points for the subscales (Bruckner, Yose, Cashy, Webster, & Cella, 2005). The FACT-G is written at approximately a 7th grade level (per the Fleish-Kincaid readability grade level) and previous research indicates no systematic literacy bias in reporting HRQOL (Hahn et al, 2007). …”

Section: Methodsmentioning

confidence: 99%

“…One study found that literacy was not an independent risk factor for poorer HRQOL after controlling for measurement bias and other covariates (Hahn, Cella, Dobrez, Weiss, Du, Lai et al, 2007). However, another found that education, an important determinant of health literacy, predicted HRQOL among men with prostate cancer (Knight, Latini, Hart, Sadetsky, Kane, DuChane, & Carroll, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Health Literacy and Health-Related Quality of Life Among a Population-Based Sample of Cancer Patients

Halverson

Martínez-Donate

Palta

et al. 2015

Journal of Health Communication

118

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Health-related quality of life (HRQOL) is an important outcome in cancer care. Few studies indicate that that health literacy (HL) influences cancer patients’ HRQOL, but additional investigation is needed. We examined the relation between HL and HRQOL among cancer patients. A cross-sectional survey was conducted with cancer patients in Wisconsin during 2006–2007. Data on sociodemographics, clinical characteristics, HRQOL, and HL were obtained from the state’s cancer registry and a mailed questionnaire. Regression analyses were used to characterize the association between HRQOL and HL. The study sample included 1,841 adults, newly diagnosed with lung, breast, colorectal, or prostate cancer in 2004 (response rate=68%). HRQOL was measured with the Functional Assessment of Cancer Therapy-General (FACT-G). Adjusting for confounders, higher HL was associated with greater HRQOL (P <.0001). Controlling for covariates, we found significant differences between those in the highest and lowest health literacy categories (P <.0001) and in the physical (P <.0001), functional (P <.0001), emotional (P <.0001), and social (P =.0007) well-being subscales. These associations exceeded the minimally important difference threshold for overall HRQOL and functional well-being. HL is positively and independently associated with HRQOL among cancer patients. These findings support adoption of HL best practices by cancer care systems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health Literacy and Health-Related Quality of Life Among a Population-Based Sample of Cancer Patients

Halverson

Martínez-Donate

Palta

et al. 2015

Journal of Health Communication

118

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“…Although effects on patient-provider interaction of these TTS's have not been established yet, all findings so far indicate that they do increase the usability of questionnaires for low-literate patients [6][7][8][9][10][11][22][23][24]. However, the potential of such tools might be increased by systematically taking into account evidence-based knowledge on designing smart support for self-reliance of low-literate persons.…”

Section: Health Assessment Questionnairesmentioning

confidence: 99%

Deriving guidelines for designing interactive questionnaires for low-literate persons: development of a health assessment questionnaire

Cremers

Welbie

Kranenborg³

et al. 2015

Univ Access Inf Soc

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Large groups in society, in particular people with low literacy, lack the necessary proactivity and problem-solving skills to be self-reliant. One omnipresent problem area where these skills are relevant regards filling in forms and questionnaires. These problems could be potentially alleviated by taking advantage of the possibilities of information and communication technology (ICT), for example by offering alternatives to text, interactive self-explaining scales and easily accessible background information on the questionnaires' rationale. The goal of this paper was to present explorative design guidelines for developing interactive questionnaires for low-literate persons. The guidelines have been derived during a usercentered design process of the Dutch Talking Touch Screen Questionnaire (DTTSQ), an interactive health assessment questionnaire used in physical therapy. The DTTSQ was developed to support patients with low health literacy, meaning they have problems with seeking, understanding and using health information. A decent number of guidelines have been derived and presented according to an existing, comprehensive model. Also, lessons learned were derived from including low-literate persons in the usercentered design process. The guidelines should be made available to ICT developers and, when applied properly, will contribute to the advancement of (health) literacy and empower citizens to fully participate in society.

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Health literacy: Impact on quality of life in head and neck cancer survivors

et al. 2019

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Objectives Although inadequate health literacy has been shown to impact health outcomes in other cancers, little is known about its impact in head and neck cancer (HNC). This study aimed to determine the prevalence and predictors of inadequate health literacy and evaluate the association between health literacy and quality of life (QOL) in HNC survivors. Methods We conducted a retrospective analysis of HNC survivors evaluated in a multidisciplinary HNC survivorship clinic. Survivors had to be ≥1‐year postcompletion of treatment to be included in the analysis. Health literacy was assessed via self‐report with the Brief Health Literacy Screen (score <10 indicating inadequate health literacy), and QOL was measured using the University of Washington QOL questionnaire. Linear regression with robust standard errors was utilized to evaluate the association between health literacy and QOL. Results Of the 218 survivors evaluated, 13.8% (n = 30) demonstrated inadequate health literacy. After adjusting for age, marital status, site, stage, treatment modality, and years since treatment completion, social–emotional QOL scores for survivors with adequate health literacy were estimated to be 10.67 points higher than those with inadequate health literacy (P = .013). Health literacy was not significantly associated with physical QOL after adjusting for covariates (P = .130). Conclusion Inadequate health literacy is associated with a lower social QOL in HNC survivors, and among those with inadequate health literacy, interventions to ameliorate the impact on QOL are needed. Level of Evidence 4 Laryngoscope, 130:2354–2359, 2020

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The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients

Abstract: The TT is valid and useful for HRQL assessment in low literacy populations. There appears to be no systematic literacy bias in reporting HRQL, and low literacy is not an independent risk factor for poorer HRQL.

Cited by 37 publications

References 55 publications

Health Literacy and Health-Related Quality of Life Among a Population-Based Sample of Cancer Patients

Health Literacy and Health-Related Quality of Life Among a Population-Based Sample of Cancer Patients

Deriving guidelines for designing interactive questionnaires for low-literate persons: development of a health assessment questionnaire

Health literacy: Impact on quality of life in head and neck cancer survivors

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