TY - JOUR
T1 - Simple scoring algorithm to identify community-dwelling older adults with limited health literacy
T2 - A cross-sectional study in Taiwan
AU - Hou, Wen Hsuan
AU - Kuo, Ken N.
AU - Chen, Mu Jean
AU - Chang, Yao Mao
AU - Tsai, Han Wei
AU - Chan, Ding Cheng
AU - Su, Chien Tien
AU - Han, Der Sheng
AU - Shen, Hsiu Nien
AU - Li, Chung Yi
N1 - Funding Information:
Funding This research was supported by research grants from the Taiwan National Health Research Institutes (MOHW107-TDU-M-212-133001-107-FR-04), Chi Mei Medical Center (108CM-TMU-01), and Taipei Meidcal University Hospital (109TMUH-H-01).
Publisher Copyright:
© 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/11/25
Y1 - 2021/11/25
N2 - Objective Health literacy (HL) is the degree of individuals’ capacity to access, understand, appraise and apply health information and services required to make appropriate health decisions. This study aimed to establish a predictive algorithm for identifying community-dwelling older adults with a high risk of limited HL. Design A cross-sectional study. Setting Four communities in northern, central and southern Taiwan. Participants A total of 648 older adults were included. Moreover, 85% of the core data set was used to generate the prediction model for the scoring algorithm, and 15% was used to test the fitness of the model. Primary and secondary outcome measures Pearson’s χ2 test and multiple logistic regression were used to identify the significant factors associated with the HL level. An optimal cut-off point for the scoring algorithm was identified on the basis of the maximum sensitivity and specificity. Results A total of 350 (54.6%) patients were classified as having limited HL. We identified 24 variables that could significantly differentiate between sufficient and limited HL. Eight factors that could significantly predict limited HL were identified as follows: a socioenvironmental determinant (ie, dominant spoken dialect), a health service use factor (ie, having family doctors), a health cost factor (ie, self-paid vaccination), a heath behaviour factor (ie, searching online health information), two health outcomes (ie, difficulty in performing activities of daily living and requiring assistance while visiting doctors), a participation factor (ie, attending health classes) and an empowerment factor (ie, self-management during illness). The scoring algorithm yielded an area under the curve of 0.71, and an optimal cut-off value of 5 represented moderate sensitivity (62.0%) and satisfactory specificity (76.2%). Conclusion This simple scoring algorithm can efficiently and effectively identify community-dwelling older adults with a high risk of limited HL.
AB - Objective Health literacy (HL) is the degree of individuals’ capacity to access, understand, appraise and apply health information and services required to make appropriate health decisions. This study aimed to establish a predictive algorithm for identifying community-dwelling older adults with a high risk of limited HL. Design A cross-sectional study. Setting Four communities in northern, central and southern Taiwan. Participants A total of 648 older adults were included. Moreover, 85% of the core data set was used to generate the prediction model for the scoring algorithm, and 15% was used to test the fitness of the model. Primary and secondary outcome measures Pearson’s χ2 test and multiple logistic regression were used to identify the significant factors associated with the HL level. An optimal cut-off point for the scoring algorithm was identified on the basis of the maximum sensitivity and specificity. Results A total of 350 (54.6%) patients were classified as having limited HL. We identified 24 variables that could significantly differentiate between sufficient and limited HL. Eight factors that could significantly predict limited HL were identified as follows: a socioenvironmental determinant (ie, dominant spoken dialect), a health service use factor (ie, having family doctors), a health cost factor (ie, self-paid vaccination), a heath behaviour factor (ie, searching online health information), two health outcomes (ie, difficulty in performing activities of daily living and requiring assistance while visiting doctors), a participation factor (ie, attending health classes) and an empowerment factor (ie, self-management during illness). The scoring algorithm yielded an area under the curve of 0.71, and an optimal cut-off value of 5 represented moderate sensitivity (62.0%) and satisfactory specificity (76.2%). Conclusion This simple scoring algorithm can efficiently and effectively identify community-dwelling older adults with a high risk of limited HL.
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U2 - 10.1136/bmjopen-2020-045411
DO - 10.1136/bmjopen-2020-045411
M3 - Article
AN - SCOPUS:85121221300
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e045411
ER -
