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    Skill set or mind set? Associations between health literacy, patient activation and health. 
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    • Skill set or mind set? Associations between health literacy, patient activation and health.
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    • Centre for Cancer Prevention
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    Skill set or mind set? Associations between health literacy, patient activation and health.

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    Published version (159.3Kb)
    Volume
    8
    Pagination
    e74373 - ?
    DOI
    10.1371/journal.pone.0074373
    Journal
    PLoS One
    Issue
    9
    Metadata
    Show full item record
    Abstract
    OBJECTIVE: There is ongoing debate on whether health literacy represents a skill-based construct for health self-management, or if it also more broadly captures personal 'activation' or motivation to manage health. This research examines 1) the association between patient activation and health literacy as they are most commonly measured and 2) the independent and combined associations of patient activation and health literacy skills with physical and mental health. METHODS: A secondary analysis of baseline cross-sectional data from the LitCog cohort of older adults was used. Participants (n = 697) were recruited from multiple US-based health centers. During structured face-to-face interviews, participants completed the Test of Functional Health Literacy in Adults (TOFHLA), the Patient Activation Measure (PAM), the SF-36 physical health summary subscale, and Patient Reported Outcomes Measurement Information Service (PROMIS) short form subscales for depression and anxiety. RESULTS: The relationship between health literacy and patient activation was weak, but significant (r = 0.11, p<0.01). In models adjusted for participant characteristics, lower health literacy was associated with worse physical health (β = 0.13, p<0.001) and depression (β = -0.16, p<0.001). Lower patient activation was associated with worse physical health (β = 0.19, p<0.001), depression (β = -0.27, p<0.001) and anxiety (β-0.24, p<0.001). CONCLUSIONS: The most common measures of health literacy and patient activation are weakly correlated with each other, but also independently correlated with health outcomes. This suggests health literacy represents a distinct skill-based construct, supporting the Institute of Medicine's definition. Deficits in either construct could be useful targets for behavioral intervention.
    Authors
    Smith, SG; Curtis, LM; Wardle, J; von Wagner, C; Wolf, MS
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/13012
    Collections
    • Centre for Cancer Prevention [936]
    Language
    eng
    Licence information
    CC-BY
    Copyright statements
    © 2013 Smith et al.
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