| Individuals with limited health literacy have poorer health outcomes, under-utilize preventive services, and encounter challenges in understanding health information. The overall aim of this study was to investigate the experiences of, and preferences, for receiving health information from individuals with varying health literacy and numeracy abilities who are at risk for CVD. Patient-level quantitative and qualitative data were collected from adults, age 40 years and older, who received care at either Kaiser Permanente Colorado (KPCO) or Denver Health and Hospital Authority (DHHA), and had two or more risk factors for cardiovascular disease. At KPCO a list of 32,041 members meeting the study criteria was generated from the electronic medical records system. A randomly selected sample (N=493) from the patient list were invited by letter to participate in the study. Seventy-five members completed the study survey. At DHHA a two-tiered recruitment strategy was used consisting of a recruitment letter mailed to 173 individuals followed by in-clinic recruitment. Seventy-five patients from DHHA completed the, study survey. All 150 participants provided data on health literacy ability, numeracy ability, sociodemographics, health status, patient activation, illness perception, and information related to their experiences with accessing, using, and understanding health information. We conducted in-depth interviews with 28 participants to further explore experiences and preferences for health information. In-depth interviews were also conducted with 9 health educators to understand how health information is currently shared with patients/members. The majority of participants had adequate functional health literacy, while 65% had low numeracy skills. Regardless of health literacy or numeracy ability, participants preferred to receive health information during a face-to-face conversation with their physician, primarily to receive immediate answers to their health questions. Individuals with limited health literacy did not prefer to receive information via written or impersonal modalities such as pamphlets and the internet. Numeracy abilities appear to be of equal or greater importance than health literacy abilities for comprehension of health information. While patients overwhelmingly prefer to receive health information during face-to-face encounters with their health care providers, having multiple modalities available in plain, clear language is key to patients' understanding and applying information to health behavior. |
