Health literacy is the ability to understand, communicate, and use information in health care. Low health literacy (HL) affects use, quality, outcomes, and costs of medical care for 25-50 percent of US adults. Knowledge Gaps: Little is known about HL among youth. Health literacy may be particularly important for 17-25 year-olds who must assume responsibility for their own health care decisions in the transition from pediatric to adult health care. New information is needed about HL measurement as a precursor to future studies of HL and health care transition, yet few HL measures have been tested in this age group. Objectives: Objective 1: Evaluate strengths and limitations of five validated HL tools for use among 17-25 year-old transition-age youth, {and asses youth opinions about HL and the measurement tools. Objective 2: Measure basic health skills among youth, associations with HL scores, and assess youth opinions about health skills, health care challenges, and transition.} Objective 3: Conduct focus groups to more deeply explore youth perspectives and elicit youth suggestions and opinions about future interventions among adolescents and young adults. {Methods: Sample 280 17-25 year-olds from health care and education settings in Monroe County, New York.
Aim 1 a: Administer five HL tools that were validated in other age groups and determine the psychometric properties of each instrument.
Aim 1 b: obtain participant feedback about the tools and perspectives on HL.
Aim 1 c: identify strengths and limits of each tool based on: psychometric properties, validation against a standard for reading literacy, ease of use, administration time, and participant preferences.
Aim 2 a: Measure participant competence in performing basic health tasks (e.g. medication use) and correlate youth competence in health skills with youth HL scores.
Aim 2 b: Assess youth perceptions and opinions about health skills, health care, and transitions via semi-structured and open-ended questions.
Aim 3 : Conduct focus groups to explore in more depth the key constructs from Aims 1b and 2b, using HL results and health skills competence (along with age and gender) to help select and group participants for focus group discussions.} Project Team: Includes a new investigator and national leaders in health literacy and functional health skills measurement, psychometrics, adolescent health care transitions, and health services research. Significance: Identification of tools and methods that can effectively measure health literacy among 17-25 year-old youth is a necessary first step in further study of health literacy in this previously unexplored age group. Results will be used in subsequent studies to: 1) estimate the prevalence of health literacy problems among youth;2) examine associations between health literacy and youth health care skills, health care experiences, outcomes, and costs;and 3) develop interventions to improve those outcomes among transition- age youth and improve their ability to function effectively as adult consumers of health care. Public Health Relevance: It is important to identify low HL among 17-25 year-old transition-age youth in order to design and implement services to facilitate the transition from pediatric to adult care and improve health literacy among youth.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Small Research Grants (R03)
Project #
5R03HD056501-02
Application #
7616570
Study Section
Special Emphasis Panel (ZRG1-RPHB-B (50))
Program Officer
Haverkos, Lynne
Project Start
2008-05-01
Project End
2012-03-31
Budget Start
2009-04-01
Budget End
2012-03-31
Support Year
2
Fiscal Year
2009
Total Cost
$81,705
Indirect Cost
Name
University of Rochester
Department
Pediatrics
Type
Schools of Dentistry
DUNS #
041294109
City
Rochester
State
NY
Country
United States
Zip Code
14627
Shone, Laura P; King, Jennifer P; Doane, Cindy et al. (2011) Misunderstanding and potential unintended misuse of acetaminophen among adolescents and young adults. J Health Commun 16 Suppl 3:256-67