Examining the Impact of Health Literacy on Communication: A Quantitative and Qualitative Analysis of a Previously Under-Studied Patient Population

Abstract

Low health literacy is highly prevalent in the United States and can significantly impact health outcomes for patients. Prior research has shown that communication is a major mediator between health literacy and health outcomes. However, there has been limited investigation into the quality of communication of patients who attend clinics staffed by medical residents. The patient population attending the resident clinic at Temple University Hospital is made up mostly of African Americans from lower-income neighborhoods of North Philadelphia. This investigation aims to gather data regarding the relationship between health literacy and communication in this previously under-studied patient population. Using a rapidly self-administered health literacy screening tool, the quantitative data reveals a high prevalence of low health literacy in this patient population. Additionally, using a semi-structured interview with a two-staged coding process, the qualitative data describes several ways in which limited health literacy can diminish optimal patient-provider communication. The patients in this study population express a high desire for information about their health status, as incomplete communication was a potential source of anxiety. Suggestions from patients in this population focus on increasing active participation in clinic visits. Study subjects agreed that interventions targeted towards medical residents would help to improve communication with low health literacy patients. Novel approaches to educating medical trainees about health literacy should be investigated in the future.