Health literacy and education level correlates of participation and outcome in a remotely delivered epilepsy self-management program

Details

• Alternative Title:
  Epilepsy Behav
• Personal Author:
  Sudhakar, Shwetha ; Aebi, Michelle E. ; Burant, Christopher ; Wilson, Betsy ; Wenk, Jocasta ; Briggs, Farren B. S. ; Pyatka, Nataliya ; Blixen, Carol ; Sajatovic, Martha
• Description:
  Significance:
  
  Health literacy, the ability to understand necessary health information to make proper health decisions, has been linked to greater frequency of hospitalizations. However, there is limited literature on associations between health literacy and outcomes in epilepsy patients, and thus, this secondary analysis investigates associations between health literacy and outcomes in epilepsy patients enrolled in the self-management intervention “Self-management for people with epilepsy and a history of negative events” (SMART). We examined the associations between higher health literacy and higher education level and outcomes of the SMART trial.
  
  Methods:
  
  This is a secondary analysis of data from the SMART self-management intervention, where individuals were randomized to the SMART intervention or a 6-month waitlist control. Health literacy was assessed at baseline before randomization using the Rapid Estimate of Adult Literacy in Medicine (REALM-R). Education level was self-reported by participants at baseline. Pearson correlations between REALM-R scores and continuous demographic and clinical variables were conducted. Point bi-serial Pearson correlations were computed for REALM-R and dichotomous variables. The effect of education on change in negative health events (NHE) counts from baseline to six months was conducted using a linear regression. A logistic regression with health literacy and randomization arm as predictors and improvement in NHE (1=improvement, 0=no change or increased NHEs at 6 months) as the outcome was conducted.
  
  Results:
  
  Lower education and lower income were significantly correlated with lower health literacy (p<0.001 and p=0.03). Higher education level was associated with a greater improvement in 6 month seizure counts (rs(105)= 0.29, p= 0.002), and a greater improvement in total 6-month NHEs (rs(95)= 0.20, p= 0.045). Health literacy was not associated with change in NHEs or with study retention.
  
  Conclusions:
  
  The SMART intervention appears effective for individuals regardless of health literacy competency. Nevertheless, individuals with higher levels of education have fewer epilepsy complications, and thus, those with limited education may still require additional support while participating in epilepsy self-management programs.
  
  
• Subjects:
  Adult Article Education Educational Status Epilepsy Female Health Literacy Humans Income Male Middle Aged Patient Participation Prospective Studies Seizures Self-management Telemedicine Treatment Outcome Waiting Lists

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• Source:
  Epilepsy Behav. 107:107026
• Pubmed ID:
  32249034
• Pubmed Central ID:
  PMC7242156
• Document Type:
  Journal Article
• Funding:
  U48 DP005030/DP/NCCDPHP CDC HHS/United States ; U48DP005030/ACL/ACL HHS/United States ; UL1 TR000439/TR/NCATS NIH HHS/United States ; UL1 TR002548/TR/NCATS NIH HHS/United States
• Volume:
  107
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ba411259ef48f64f17c3764be96926f45a1a9aeb81cd2979d8d61b6c43a84939
• Download URL:
  https://stacks.cdc.gov/view/cdc/88286/cdc_88286_DS1.pdf
• File Type:
  [PDF - 83.83 KB ]