Effect of Health Literacy on Research Follow-Up

Abstract

Previous research has not examined the effect of health literacy on research subjects' completion of scheduled research follow-up. This article evaluates patient factors associated with incomplete research follow-up at three time points after enrollment in a large, hospital-based prospective cohort study. Predictor variables included health literacy, age, race, gender, education, employment status, difficulty paying bills, hospital diagnosis, length of stay, self-reported global health status, depression, perceived health competence, medication adherence, and health care system distrust. In a sample of 2,042 patients, multivariable models demonstrated that lower health literacy and younger age were significantly associated with a lower likelihood of completing research follow-up interviews at 2–3 days, 30 days, and 90 days after hospital discharge. In addition, patients who had less education, were currently employed, and had moderate financial stress were less likely to complete 90-day follow-up. This study is the first to demonstrate that lower health literacy is a significant predictor of incomplete research follow-up.

Acknowledgments

We acknowledge the following additional members of the Vanderbilt Inpatient Cohort Study research team who contributed to the study design or conduct: Courtney Cawthon, MPH; Catherine Couey; Olivia Dozier; Catherine Evans; Vanessa Fuentes; Frank E. Harrell, PhD; Blake Hendrickson; Daniel Lewis; Abby G. Meyers, MD; Heidi Poppendeck; Monika Rizk; Hannah Rosenberg; Russell L. Rothman, MD, MPP; Amanda H. Salanitro, MD, MS, MSPH; Eduard E. Vasilevskis, MD, MPH; Ken Wallston, PhD; and Kelly H. S. Wright, MA.