Functional, interactive and critical health literacy: Varying relationships with control over care and number of GP visits.

OBJECTIVE The aim of this study is to examine the extent to which functional, interactive and critical health literacy are associated with patients' perceived control over care and frequency of GP visits. METHODS Data from the Dutch 'National Panel of People with Chronic Illness or Disability' was used (N=2508). Health literacy was assessed by the Functional, Communicative and Critical Health Literacy measure. Perceived control over care was indicated by perceived ability to organize care, interact with providers and to perform self-care. By multivariate linear and logistic regression analyses, associations between health literacy and perceived control over care and subsequently frequency of GP visits were studied. RESULTS Mainly interactive health literacy was associated with patients' perceived ability to organize care, interact with healthcare providers and perform self-care, whereas only functional health literacy was associated with number of GP visits. CONCLUSION The results imply that some patients' may be less able to exert control over their care because of lower health literacy. Functional, interactive and critical health literacy vary in their relevance for patients' ability to exert control. PRACTICE IMPLICATIONS Initiatives for strengthening patients' role in healthcare may be improved by paying attention to patients' health literacy, specifically functional and interactive health literacy.

[1]  Ha T. Nguyen,et al.  Cognitive function is a risk for health literacy in older adults with diabetes. , 2013, Diabetes research and clinical practice.

[2]  D. Baker,et al.  Health literacy and performance on the Mini-Mental State Examination , 2002, Aging & mental health.

[3]  Stacey L. Sheridan,et al.  Low Health Literacy and Health Outcomes: An Updated Systematic Review , 2011, Annals of Internal Medicine.

[4]  Stephen R Cole,et al.  Use of multiple imputation in the epidemiologic literature. , 2008, American journal of epidemiology.

[5]  J. Wills,et al.  Understanding critical health literacy: a concept analysis , 2013, BMC Public Health.

[6]  M. P. Fransen,et al.  Applicability of Internationally Available Health Literacy Measures in the Netherlands , 2011, Journal of health communication.

[7]  J. Rademakers,et al.  Measuring patient activation in the Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13) , 2012, BMC Public Health.

[8]  M. Wolf,et al.  The Mini Mental Status Exam as a Surrogate Measure of Health Literacy , 2014, Journal of general internal medicine.

[9]  J. Corrigan,et al.  COMMITTEE ON IDENTIFYING PRIORITY AREAS FOR QUALITY IMPROVEMENT , 2003 .

[10]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[11]  Martin McKee,et al.  Managing chronic conditions: experience in eight countries. , 2008 .

[12]  J. Dekker,et al.  Comorbidity of chronic diseases: effects of disease pairs on physical and mental functioning. , 2005, Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation.

[13]  Michael K. Paasche-Orlow,et al.  The prevalence of limited health literacy , 2005, Journal of General Internal Medicine.

[14]  Developments in patient activation of people with chronic illness and the impact of changes in self-reported health: results of a nationwide longitudinal study in The Netherlands. , 2014, Patient education and counseling.

[15]  D. Chinn.  Critical health literacy: a review and critical analysis. , 2011, Social science & medicine.

[16]  G. Westert,et al.  The health status of the Dutch population as assessed by the EQ-6D , 2005, Quality of Life Research.

[17]  M. Kenward,et al.  Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls , 2009, BMJ : British Medical Journal.

[18]  Ina Wallace,et al.  Health literacy interventions and outcomes: an updated systematic review. , 2011, Evidence report/technology assessment.

[19]  S. Dulmen,et al.  Participation of chronic patients in medical consultations: patients' perceived efficacy, barriers and interest in support , 2015, Health expectations : an international journal of public participation in health care and health policy.

[20]  D. Nutbeam.  The evolving concept of health literacy. , 2008, Social science & medicine.

[21]  Michelle Hendriks,et al.  Patient Activation and Health Literacy as Predictors of Health Information Use in a General Sample of Dutch Health Care Consumers , 2014, Journal of health communication.

[22]  Jane Murray Cramm,et al.  Self-management abilities, physical health and depressive symptoms among patients with cardiovascular diseases, chronic obstructive pulmonary disease, and diabetes. , 2012, Patient education and counseling.

[23]  C. Drossaert,et al.  Validation of the Dutch functional, communicative and critical health literacy scales. , 2012, Patient education and counseling.

[24]  M. Heijmans,et al.  Minder zelfmanagementvaardigheden, dus meer zorggebruik? De relatie tussen patiënt activatie van mensen met diabetes en hun zorggebruik, zorgkosten, ervaringen met de zorg en diabetes-gerelateerde klachten. , 2013 .

[25]  Janet M. Corrigan,et al.  Priority Areas for National Action , 2003 .

[26]  Daniel T. Larose,et al.  Imputation of Missing Data , 2014 .

[27]  Gerardine Doyle,et al.  Health literacy and public health: A systematic review and integration of definitions and models , 2012, BMC Public Health.

[28]  C. von Wagner,et al.  Diabetes self-management in patients with low health literacy: ordering findings from literature in a health literacy framework. , 2012, Patient education and counseling.

[29]  G. Waverijn,et al.  Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management. , 2015, Patient education and counseling.

[30]  R. Rudd,et al.  Health literacy skills of U.S. adults. , 2007, American journal of health behavior.

[31]  B. Lo,et al.  Patient-centered communication , 2004, Journal of general internal medicine.

[32]  Y. Yamazaki,et al.  Patient health literacy and patient-physician information exchange during a visit. , 2009, Family practice.

[33]  I. Kai,et al.  Impact of communicative and critical health literacy on understanding of diabetes care and self-efficacy in diabetes management: a cross-sectional study of primary care in Japan , 2013, BMC Family Practice.

[34]  Stef van Buuren,et al.  Flexible Imputation of Missing Data , 2012 .

[35]  Andrew Steptoe,et al.  Health Literacy and Health Actions: A Review and a Framework From Health Psychology , 2009, Health education & behavior : the official publication of the Society for Public Health Education.

[36]  David A. Kindig,et al.  Health literacy : a prescription to end confusion , 2004 .

[37]  J. Dower,et al.  Hospital admissions, emergency department utilisation and patient activation for self-management among people with diabetes. , 2011, Diabetes research and clinical practice.

[38]  A. Coulter.  Patient Engagement—What Works? , 2012, The Journal of ambulatory care management.

[39]  J. Kawi.  Predictors of self-management for chronic low back pain. , 2014, Applied nursing research : ANR.

[40]  S. Bulstra,et al.  Pain, physical and social functioning, and quality of life in individuals with multiple hereditary exostoses in The Netherlands: a national cohort study. , 2012, The Journal of bone and joint surgery. American volume.