Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id f0MHnI916100; Mon, 22 Jan 2001 12:49:18 -0500 (EST) Date: Mon, 22 Jan 2001 12:49:18 -0500 (EST) Message-Id: <NDBBKNOLGLDNLBPDOLFCOEAGCPAA.sandras@u.washington.edu> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: "Sandra Smith" <sandras@u.washington.edu> To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:2804] Low literacy and HIV X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas X-Mailer: Microsoft Outlook IMO, Build 9.0.2416 (9.0.2911.0) Content-Type: multipart/mixed; Status: O Content-Length: 8638 Lines: 143 This is a multi-part message in MIME format. ------=_NextPart_000_0012_01C08458.20D6A420 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit Low literacy in the news toady: Low Health Literacy Portends Low CD4+ Counts, High Viral Loads WESTPORT, CT (Reuters Health) Jan 15 - Among patients infected with HIV, inability to read and comprehend basic healthcare information is associated with significantly worse health outcomes, report Dr. Seth C. Kalichman and Dr. David Rompa, of the Medical College of Wisconsin in Milwaukee. "Because AIDS affects populations of young people with disadvantaged educations and people living in the developing world, we thought it important to test whether reading ability interferes with consistently taking medications for HIV infection," Dr. Kalichman told Reuters Health. A total of 339 HIV-infected subjects participated in the study; medical records were available for 167. The investigators assessed health literacy using the reading comprehension scale of the Test of Functional Health Literacy in Adults. The 25% of subjects who scored below 80% correct were classified as having lower health literacy. "This study is the first to demonstrate that people with HIV who have low reading ability have far more difficulty adhering to their medications and have more serious immune system damage related to poor medication adherence," Dr. Kalichman stated. The findings are described in the December issue of the Journal of Acquired Immune Deficiency Syndromes. The researchers measured significantly lower viral loads, higher CD4+ cell counts, and an increased likelihood of receiving antiretroviral medications in subjects with higher health literacy compared with those of lower health literacy. Those with lower health literacy perceived their health as poorer, which in turn was associated with progression to AIDS and greater number of hospitalizations. Lower health literacy translated to difficulty in accessing care because of subjects' beliefs that "treatment could not help them" and "they mistrusted healthcare providers." It is difficult to identify people with low literacy because many are ashamed to talk about their reading problems, Dr. Kalichman said. He added, "The best way to screen patients for reading ability is to ask them to read something, like a health information brochure, and then ask simple questions to test whether the patient comprehended a key concept. This can detect a reading problem without embarrassing the patient." For patients with poor literacy skills, Dr. Kalichman and Dr. Rompa recommend such measures as simplified instructions, nonverbal forms of communication such as color-coded medicine containers and blister pack medication doses, and use of pictographs for medical instructions. Use of such measures could achieve significant health savings, they speculate. "The payoff is improved health and therefore less use of hospital care and other expensive services," Dr. Kalichman pointed out. In addition, "when treatments fail, the costs can even be higher because of issues of medication resistance. So interventions to improve medication adherence for low-literacy populations will ultimately save healthcare costs." J Acquir Immune Defic Syndr 2000;25:337-344. Sandra Smith, MPH, CHES Health Education Specialist University of Washington Center for Health Education & Research Clinical Instructor, Health Services Dept Editor, Beginnings: A Practical Guide through Pregnancy Editor, http://www.PrenatalEd.com Mailing Address: 2821 2nd Ave #1601 Seattle WA 98121 206-441-7046 sandras@u.washington.edu ------=_NextPart_000_0012_01C08458.20D6A420 Content-Type: application/ms-tnef; name="winmail.dat" Content-Transfer-Encoding: base64 Content-Disposition: attachment; filename="winmail.dat" eJ8+IgARAQaQCAAEAAAAAAABAAEAAQeQBgAIAAAA5AQAAAAAAADoAAEIgAcAGAAAAElQTS5NaWNy b3NvZnQgTWFpbC5Ob3RlADEIAQ2ABAACAAAAAgACAAEGgAMADgAAANEHAQAWAAkALQAAAAEAJgEB A5AGAEQNAAAiAAAACwACAAEAAAALACMAAAAAAAMAJgAAAAAACwApAAAAAAADADYAAAAAAB4AcAAB AAAAFQAAAExvdyBsaXRlcmFjeSBhbmQgSElWAAAAAAIBcQABAAAAFgAAAAHAhJssKeghYJPwSBHU rewAUNrYt6kAAAIBHQwBAAAAHgAAAFNNVFA6U0FORFJBU0BVLldBU0hJTkdUT04uRURVAAAACwAB DgAAAABAAAYOALaoCpuEwAECAQoOAQAAABgAAAAAAAAAa21rK1z70xGt6wBQ2ti3qcKAAAALAB8O 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