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dc.contributor.authorSmith, SGen_US
dc.contributor.authorCurtis, LMen_US
dc.contributor.authorWardle, Jen_US
dc.contributor.authorvon Wagner, Cen_US
dc.contributor.authorWolf, MSen_US
dc.date.accessioned2016-06-21T14:20:20Z
dc.date.available2013-07-31en_US
dc.date.issued2013en_US
dc.date.submitted2016-06-21T13:16:18.263Z
dc.identifier.urihttp://qmro.qmul.ac.uk/xmlui/handle/123456789/13012
dc.description.abstractOBJECTIVE: 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.en_US
dc.format.extente74373 - ?en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofPLoS Oneen_US
dc.rightsCC-BY
dc.subjectAgeden_US
dc.subjectAnxietyen_US
dc.subjectDepressionen_US
dc.subjectFemaleen_US
dc.subjectHealth Literacyen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMental Healthen_US
dc.subjectMiddle Ageden_US
dc.subjectMotivationen_US
dc.subjectPatientsen_US
dc.titleSkill set or mind set? Associations between health literacy, patient activation and health.en_US
dc.typeArticle
dc.rights.holder© 2013 Smith et al.
dc.identifier.doi10.1371/journal.pone.0074373en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/24023942en_US
pubs.issue9en_US
pubs.notesNot knownen_US
pubs.publication-statusPublished onlineen_US
pubs.volume8en_US
dcterms.dateAccepted2013-07-31en_US


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