The overall objective of this study is to investigate longitudinal associations between cognition, health literacy(HL), and self-care in patients with chronic obstructive pulmonary disease (COPD), and determine whethersocial support from informal caregivers mitigates these associations. Cognitive function, a major component ofHL, declines progressively in many COPD patients. HL might change over time as well, progressively alteringCOPD patients' ability to understand and use health information. However, longitudinal data on HL are notavailable. It is also unknown whether acute COPD exacerbations temporarily worsen cognition and HL, asmight be expected owing to hypoxemia. Informal caregivers frequently help COPD patients manage theirhealth at home, but little is known about the extent to which social support compensates for the HL andcognitive limitations of these patients, and whether caregivers' own problems of HL limit their ability to helpothers manage their chronic disease. Elucidating these issues could provide important data for developinginterventions aimed at both patients and caregivers to overcome HL and cognition barriers to successful COPDmanagement, and perhaps to other chronic diseases as well. Accordingly, the Specific Aims of this study areto (1) Examine longitudinally the trajectory of HL among patients with COPD, both as the disease progressesover time and following acute exacerbations; (2) Assess the association between HL, and it subcomponents,and specific self-management behaviors in patients with COPD, such as medication adherence and inhalertechnique; (3) Evaluate the mitigating role of support from informal caregivers and caregivers' HL on therelationship between patients' HL and COPD self-management. We will address these aims by conducting astudy of 400 English and Spanish-speaking adults with COPD from two socioeconomically and racially diverseinner-city primary care practices in New York City, NY and Chicago, IL. Patients will be followed for 2 years tocollect data on HL, cognitive function, COPD symptoms and self-management behaviors. These data will alsobe assessed at the time of a hospital discharge for COPD exacerbation and one week later. Additionally, 100informal caregivers of a subset of patients with COPD will be interviewed to determine their HL. This study isinnovative in its longitudinal examination of the effects of HL and cognitive function and the potential mitigatingrole of caregiver support and caregiver HL. It will expand our understanding of the mechanisms through whichHL and cognition influence COPD self-management, offering us an opportunity to design interventions toimprove outcomes in a highly vulnerable population.
The objective of this study is to understand how health literacy and cognitive function change over time in patients with chronic obstructive pulmonary disease (COPD) and affect self-management of this condition, and how social support from informal caregivers may mitigate their effects. The study will be conducted in New York City and Chicago, IL, and will involve interviews of 400 patients, with multiple observations over 2 years, and 100 caregivers. By describing the vicissitudes of health literacy, the study will identify the contexts in which intensive interventions are needed to adequately support self-care for COPD.
| Badr, Hoda; Federman, Alex D; Wolf, Michael et al. (2017) Depression in individuals with chronic obstructive pulmonary disease and their informal caregivers. Aging Ment Health 21:975-982 |
| Federman, Alex D; Wolf, Michael S; Sheng, Tiffany et al. (2016) Diminished Cognitive Function Among Chronic Obstructive Pulmonary Disease Patients During Periods of Acute Illness Exacerbation. J Gerontol A Biol Sci Med Sci 71:279-80 |
| Kale, Minal S; Federman, Alex D; Krauskopf, Katherine et al. (2015) The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease. PLoS One 10:e0123937 |
| Krauskopf, Katherine; Federman, Alex D; Kale, Minal S et al. (2015) Chronic Obstructive Pulmonary Disease Illness and Medication Beliefs are Associated with Medication Adherence. COPD 12:151-64 |
