Despite the tremendous progress that has been made in improving cardiovascular health in the U.S. during the last decade, many ethnic minority populations still experience significant health disparity gaps that stem from both a paucity of valid research and a lack of culturally sensitive care. In particular, there has been growing concern about the high prevalence (44%) of hypertension (HTN) among Vietnamese Americans (VA). Compounding that concern is the problem of insufficient health literacy, an underlying issue and source of stress that many first generation VA immigrants suffer from. The high prevalence of HTN and limited health literacy are major public health threats for this underserved and understudied population - as low health literacy severely limits their ability to adequately manage their health. A major obstacle in planning and implementing culturally appropriate HTN intervention programs for this high risk group is the lack of systematic research. Among the gaps in the literature, the following are the most imperative: (1) a lack of culturally appropriate health literacy assessment tools for those with HTN and (2) a lack of systematic research on the impact of health literacy on the management of HTN. To fill those gaps, the purpose of this study is to development a HTN specific health literacy tool. To achieve that goal, the following specific aims are proposed:
Specific Aim 1 : Develop a culturally appropriate HTN health literacy assessment tool for Vietnamese Americans with limited English proficiency;
Specific Aim 2 : Pilot test and refine the HTN health literacy assessment tool;
Specific Aim 3 : Assess the reliability and validity of the HTN health literacy assessment tool. Accomplishing those aims will provide an important foundation toward the candidate's immediate and long term goals of assessing, developing, and testing culturally and linguistically appropriate HTN chronic care management programs for Vietnamese Americans. Moreover, the findings and methodological lessons learned from this study will be beneficial for other researchers working with ethnic minority populations that are largely isolated by insufficient health literacy.

Public Health Relevance

In accordance with the World Health Organization and the US Department of Health and Human Services, health literacy is a public concern due to its vital role in health promotion and disease prevention. This research will help support the need to improve health literacy as a way to promote health and improve the management of chronic diseases such as HTN.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Banks, David
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Johns Hopkins University
Schools of Nursing
United States
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Nguyen, Tam H; Park, Hyunjeong; Han, Hae-Ra et al. (2015) State of the science of health literacy measures: Validity implications for minority populations. Patient Educ Couns :