Examining health literacy among urban African-American adolescents with asthma

Abstract

Objective: This exploratory study assessed health literacy among urban African-American high school students to improve understanding of the association between adolescent health literacy and asthma. Methods: We conducted a secondary data analysis of the control group (n = 181) of the Puff City randomized controlled trial (2006–2010), a web-based intervention to promote asthma management among students, grades 9 through 12. A validated self-report 3-item health literacy screening instrument was completed at final online follow-up survey. Logistic regression was used to explore the association between health literacy, demographic characteristics, quality of life, asthma management, and health care utilization. Results: Multivariate analysis revealed that an overall inadequate health literacy score was associated with students who were more likely to be younger (OR 0.61; 95% CI 0.44–0.84), not on Medicaid (OR 0.36; 95% CI 0.17–0.76), have at least one hospitalization (OR 1.29; 95% CI 1.07–1.56); and a lower overall quality of life (OR 0.75; 95% CI 0.59–0.95). Those lacking confidence in filling out medical forms, needing help reading hospital materials, and having difficulty understanding written information were more likely to not have a rescue inhaler (OR 0.49; 95% CI 0.25–0.94), have one or more emergency visits (OR 1.21 95% CI 1.02–1.43), and one or more hospitalizations (OR 1.19; 95% CI 1.01–1.41), respectively. Conclusions: The findings indicate a significant association between inadequate health literary and suboptimal asthma management. It is important to advance understanding of adolescent health literacy, especially those at-risk, as they assume asthma self-management tasks and move toward independent adult self-care.

Keywords:

• Education
• management/control
• prevention
• quality of life

Acknowledgements

The authors appreciate and acknowledge the collaboration of the Detroit Public School System and the principals of the following Detroit Public high schools: Cody, Henry Ford, Mackenzie, Mumford, Northwestern, and Redford. These principals exhibit a deep concern for the health and welfare of their students. We also acknowledge Ms. Anntinette McCain of the Office of Health, Physical Education & Safety and Ms. Sybil St. Clair of the Office of Research, Evaluation, and Assessment for their guidance and advice.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This research was supported by the National Institutes of Health, National Heart, Lung, and Blood Institute (grant R01 HL068971-05).