Rescue Mission Roatan: Assessment of Health Literacy using the SAHL Questionnaire
Ryan J. Hendrix, MD1 , Alyssa Stetson, BS1, Erek Arsiniega, BS2, Rose L. Schack, DO2, John F. Kelly, MD1, Chandra .S. Joshi, MD2 , Peter J. Foley, MD2 , Demetrius E. Litwin, MD1, Ulises Torres, MD1 ; 1University of Massachusetts Medical School, Surgery, Worcester, MA, USA; 2University of Massachusetts Medical School, Anesthesiology, Worcester, MA, USA
Background:
Health literacy is a key determinant of health, and is considered a stronger predictor of an individual’s health status than income, employment status, education level, or racial/ethnic group. The current study aims to demonstrate the ease of administration of the validated Short Assessment of Health Literacy (SAHL) questionnaire and potential to enhance a global surgery mission.
Methods:
Patients from a public medical center in Roatan, Honduras were queried to participate in a cross-sectional, qualitative, anonymous, self-reported survey. A score ≤14 on the 18-question SAHL signified poor health literacy.
Results:
27 patients were enrolled in the study. Median age was 33 years (IQR: 27-49. Mean score on the SAHL questionnaire was 12.6 (SD: 4.3); individual scores ranged from 3-18. Overall, 59% of patients (n=16) were found to have low healthy literacy. On univariate analysis, highest education level completed suggested a potentially significant association with low health literacy (OR 11.56, 95% CI 1.86-71.8; p=0.01). On multivariable analysis controlling for both clinically relevant and statistically significant covariates, the adjusted odds ratio (aOR) of having low health literacy was 16.27 (95% CI 1.36 – 194.4; p=0.03) when an individual failed to progress beyond 7th grade (Table 1).
Conclusion:
Screening with the SAHL questionnaire is an effective mechanism to identify patients with low health literacy. Identifying these patients is critical to improve communication and understanding between patient and provider.
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