Using Health Literacy and Learning Style Preferences to Optimize the Delivery of Health Information

Abstract

Limited patient understanding of hypertension contributes to poor health outcomes. In 2 sequential randomized studies, the authors determined the impact of administering information tailored to health literacy level alone or in combination with preferred learning style on patients' understanding of hypertension. Patients with high blood pressure were recruited in an academic emergency department. In Experiment 1 (N = 85), the control group received only the routine discharge instructions; the intervention group received discharge instructions combined with information consistent with their health literacy level as determined by the Short Test of Functional Health Literacy. In Experiment 2 (N = 87), the information provided to the intervention group was tailored to both health literacy and learning style, as indicated by the VARK™ Questionnaire. To measure learning, the authors compared scores on a hypertension assessment administered during the emergency department visit and 2 weeks after discharge. Participants who received materials tailored to both health literacy level and learning style preference showed greater gains in knowledge than did those receiving information customized for health literacy level only. This study demonstrates that personalizing health information to learning style preferences and literacy level improves patient understanding of hypertension.

[Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Health Communication for the following free supplemental resources: Appendix A: High Blood Pressure Questionnaire; and Appendix B: Multivariate linear regression of adjusted association between intervention and knowledge retention (with item 17 included). Appendix A is the hypertension knowledge test developed and previously described (Koonce, Giuse, Alexander, & Storrow, 2011). Appendix B provides the results of the multivariate linear regression analysis of the data set with the inclusion of all 17 quiz items.]

Acknowledgments

This study was funded by a grant from the Institute of Museum and Library Services (IMLS LG-06-10-0186-10). The authors acknowledge Karen Miller, Sandra Martin, Dan McCollum, and Marcia Epelbaum for their assistance in the emergency department and Songphan Choemprayong for assistance during the manuscript preparation process.

Notes

Note. Percentages may not equal 100% because of rounding. S-TOFHLA = Short Test of Functional Health Literacy.

^a Household income was not collected in the health literacy study.

^b Health literacy level was measured using the S-TOFHLA in Experiment 1 and the Chew et al. questions in Experiment 2.

^a The personalized materials given to patients in both studies did not contain all the information needed to correctly answer this question.

^a Interviewer #3 in Experiment 1 is the same as Interviewer #1 in Experiment 2.

*p<.05 (two-tailed). **p<.001 (two-tailed).