The impact of health literacy and life style risk factors on health-related quality of life of Australian patients

Upali W. Jayasinghe, Mark Fort Harris, Sharon M. Parker, John Litt, Mieke van Driel, Danielle Mazza, Chris Del Mar, Jane Lloyd, Jane Smith, Nicholas Zwar, Richard Taylor, Mark Harris, Grant Russell, Elizabeth Denney-Wilson, Rachel Laws, Teri Snowdon, Helen Bolger-Harris, Stephan Groombridge, Stan Goldstein, Teresa Howarth & 3 others Nancy Huang, Jinty Wilson, Preventive Evidence into Practice (PEP) Partnership Group

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Abstract

Background: Limited evidence exists regarding the relationship between health literacy and health-related quality of life (HRQoL) in Australian patients from primary care. The objective of this study was to investigate the impact of health literacy on HRQoL in a large sample of patients without known vascular disease or diabetes and to examine whether the difference in HRQoL between low and high health literacy groups was clinically significant. Methods: This was a cross-sectional study of baseline data from a cluster randomised trial. The study included 739 patients from 30 general practices across four Australian states conducted in 2012 and 2013 using the standard Short Form Health Survey (SF-12) version 2. SF-12 physical component score (PCS-12) and mental component score (MCS-12) are derived using the standard US algorithm. Health literacy was measured using the Health Literacy Management Scale (HeLMS). Multilevel regression analysis (patients at level 1 and general practices at level 2) was applied to relate PCS-12 and MCS-12 to patient reported life style risk behaviours including health literacy and demographic factors. Results: Low health literacy patients were more likely to be smokers (12 % vs 6 %, P = 0.005), do insufficient physical activity (63 % vs 47 %, P < 0.001), be overweight (68 % vs 52 %, P < 0.001), and have lower physical health and lower mental health with large clinically significant effect sizes of 0.56 (B (regression coefficient) = -5.4, P < 0.001) and 0.78(B = -6.4, P < 0.001) respectively after adjustment for confounding factors. Patients with insufficient physical activity were likely to have a lower physical health score (effect size = 0.42, B = -3.1, P < 0.001) and lower mental health (effect size = 0.37, B = -2.6, P < 0.001). Being overweight tended to be related to a lower PCS-12 (effect size = 0.41, B = -1.8, P < 0.05). Less well-educated, unemployed and smoking patients with low health literacy reported worse physical health. Health literacy accounted for 45 and 70 % of the total between patient variance explained in PCS-12 and MCS-12 respectively. Conclusions: Addressing health literacy related barriers to preventive care may help reduce some of the disparities in HRQoL. Recognising and tailoring health related communication to those with low health literacy may improve health outcomes including HRQoL in general practice.

Original languageEnglish
Article number68
JournalHealth and Quality of Life Outcomes
Volume14
Issue number1
DOIs
Publication statusPublished - 4 May 2016

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Health Literacy
Life Style
Quality of Life
General Practice
Health
Mental Health
Exercise
Health Communication
Multilevel Analysis
Preventive Medicine
Risk-Taking
Health Surveys
Vascular Diseases
Primary Health Care
Patient Care
Cross-Sectional Studies
Smoking
Regression Analysis
Demography

Cite this

Jayasinghe, U. W., Harris, M. F., Parker, S. M., Litt, J., van Driel, M., Mazza, D., ... Preventive Evidence into Practice (PEP) Partnership Group (2016). The impact of health literacy and life style risk factors on health-related quality of life of Australian patients. Health and Quality of Life Outcomes, 14(1), [68]. https://doi.org/10.1186/s12955-016-0471-1
Jayasinghe, Upali W. ; Harris, Mark Fort ; Parker, Sharon M. ; Litt, John ; van Driel, Mieke ; Mazza, Danielle ; Del Mar, Chris ; Lloyd, Jane ; Smith, Jane ; Zwar, Nicholas ; Taylor, Richard ; Harris, Mark ; Russell, Grant ; Denney-Wilson, Elizabeth ; Laws, Rachel ; Snowdon, Teri ; Bolger-Harris, Helen ; Groombridge, Stephan ; Goldstein, Stan ; Howarth, Teresa ; Huang, Nancy ; Wilson, Jinty ; Preventive Evidence into Practice (PEP) Partnership Group. / The impact of health literacy and life style risk factors on health-related quality of life of Australian patients. In: Health and Quality of Life Outcomes. 2016 ; Vol. 14, No. 1.
@article{091e00b91e914927b93f1f22b82ac657,
title = "The impact of health literacy and life style risk factors on health-related quality of life of Australian patients",
abstract = "Background: Limited evidence exists regarding the relationship between health literacy and health-related quality of life (HRQoL) in Australian patients from primary care. The objective of this study was to investigate the impact of health literacy on HRQoL in a large sample of patients without known vascular disease or diabetes and to examine whether the difference in HRQoL between low and high health literacy groups was clinically significant. Methods: This was a cross-sectional study of baseline data from a cluster randomised trial. The study included 739 patients from 30 general practices across four Australian states conducted in 2012 and 2013 using the standard Short Form Health Survey (SF-12) version 2. SF-12 physical component score (PCS-12) and mental component score (MCS-12) are derived using the standard US algorithm. Health literacy was measured using the Health Literacy Management Scale (HeLMS). Multilevel regression analysis (patients at level 1 and general practices at level 2) was applied to relate PCS-12 and MCS-12 to patient reported life style risk behaviours including health literacy and demographic factors. Results: Low health literacy patients were more likely to be smokers (12 {\%} vs 6 {\%}, P = 0.005), do insufficient physical activity (63 {\%} vs 47 {\%}, P < 0.001), be overweight (68 {\%} vs 52 {\%}, P < 0.001), and have lower physical health and lower mental health with large clinically significant effect sizes of 0.56 (B (regression coefficient) = -5.4, P < 0.001) and 0.78(B = -6.4, P < 0.001) respectively after adjustment for confounding factors. Patients with insufficient physical activity were likely to have a lower physical health score (effect size = 0.42, B = -3.1, P < 0.001) and lower mental health (effect size = 0.37, B = -2.6, P < 0.001). Being overweight tended to be related to a lower PCS-12 (effect size = 0.41, B = -1.8, P < 0.05). Less well-educated, unemployed and smoking patients with low health literacy reported worse physical health. Health literacy accounted for 45 and 70 {\%} of the total between patient variance explained in PCS-12 and MCS-12 respectively. Conclusions: Addressing health literacy related barriers to preventive care may help reduce some of the disparities in HRQoL. Recognising and tailoring health related communication to those with low health literacy may improve health outcomes including HRQoL in general practice.",
author = "Jayasinghe, {Upali W.} and Harris, {Mark Fort} and Parker, {Sharon M.} and John Litt and {van Driel}, Mieke and Danielle Mazza and {Del Mar}, Chris and Jane Lloyd and Jane Smith and Nicholas Zwar and Richard Taylor and Mark Harris and Grant Russell and Elizabeth Denney-Wilson and Rachel Laws and Teri Snowdon and Helen Bolger-Harris and Stephan Groombridge and Stan Goldstein and Teresa Howarth and Nancy Huang and Jinty Wilson and {Preventive Evidence into Practice (PEP) Partnership Group}",
year = "2016",
month = "5",
day = "4",
doi = "10.1186/s12955-016-0471-1",
language = "English",
volume = "14",
journal = "Health and Quality of Life Outcomes",
issn = "1477-7525",
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Jayasinghe, UW, Harris, MF, Parker, SM, Litt, J, van Driel, M, Mazza, D, Del Mar, C, Lloyd, J, Smith, J, Zwar, N, Taylor, R, Harris, M, Russell, G, Denney-Wilson, E, Laws, R, Snowdon, T, Bolger-Harris, H, Groombridge, S, Goldstein, S, Howarth, T, Huang, N, Wilson, J & Preventive Evidence into Practice (PEP) Partnership Group 2016, 'The impact of health literacy and life style risk factors on health-related quality of life of Australian patients' Health and Quality of Life Outcomes, vol. 14, no. 1, 68. https://doi.org/10.1186/s12955-016-0471-1

The impact of health literacy and life style risk factors on health-related quality of life of Australian patients. / Jayasinghe, Upali W.; Harris, Mark Fort; Parker, Sharon M.; Litt, John; van Driel, Mieke; Mazza, Danielle; Del Mar, Chris; Lloyd, Jane; Smith, Jane; Zwar, Nicholas; Taylor, Richard; Harris, Mark; Russell, Grant; Denney-Wilson, Elizabeth; Laws, Rachel; Snowdon, Teri; Bolger-Harris, Helen; Groombridge, Stephan; Goldstein, Stan; Howarth, Teresa; Huang, Nancy; Wilson, Jinty; Preventive Evidence into Practice (PEP) Partnership Group.

In: Health and Quality of Life Outcomes, Vol. 14, No. 1, 68, 04.05.2016.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The impact of health literacy and life style risk factors on health-related quality of life of Australian patients

AU - Jayasinghe, Upali W.

AU - Harris, Mark Fort

AU - Parker, Sharon M.

AU - Litt, John

AU - van Driel, Mieke

AU - Mazza, Danielle

AU - Del Mar, Chris

AU - Lloyd, Jane

AU - Smith, Jane

AU - Zwar, Nicholas

AU - Taylor, Richard

AU - Harris, Mark

AU - Russell, Grant

AU - Denney-Wilson, Elizabeth

AU - Laws, Rachel

AU - Snowdon, Teri

AU - Bolger-Harris, Helen

AU - Groombridge, Stephan

AU - Goldstein, Stan

AU - Howarth, Teresa

AU - Huang, Nancy

AU - Wilson, Jinty

AU - Preventive Evidence into Practice (PEP) Partnership Group

PY - 2016/5/4

Y1 - 2016/5/4

N2 - Background: Limited evidence exists regarding the relationship between health literacy and health-related quality of life (HRQoL) in Australian patients from primary care. The objective of this study was to investigate the impact of health literacy on HRQoL in a large sample of patients without known vascular disease or diabetes and to examine whether the difference in HRQoL between low and high health literacy groups was clinically significant. Methods: This was a cross-sectional study of baseline data from a cluster randomised trial. The study included 739 patients from 30 general practices across four Australian states conducted in 2012 and 2013 using the standard Short Form Health Survey (SF-12) version 2. SF-12 physical component score (PCS-12) and mental component score (MCS-12) are derived using the standard US algorithm. Health literacy was measured using the Health Literacy Management Scale (HeLMS). Multilevel regression analysis (patients at level 1 and general practices at level 2) was applied to relate PCS-12 and MCS-12 to patient reported life style risk behaviours including health literacy and demographic factors. Results: Low health literacy patients were more likely to be smokers (12 % vs 6 %, P = 0.005), do insufficient physical activity (63 % vs 47 %, P < 0.001), be overweight (68 % vs 52 %, P < 0.001), and have lower physical health and lower mental health with large clinically significant effect sizes of 0.56 (B (regression coefficient) = -5.4, P < 0.001) and 0.78(B = -6.4, P < 0.001) respectively after adjustment for confounding factors. Patients with insufficient physical activity were likely to have a lower physical health score (effect size = 0.42, B = -3.1, P < 0.001) and lower mental health (effect size = 0.37, B = -2.6, P < 0.001). Being overweight tended to be related to a lower PCS-12 (effect size = 0.41, B = -1.8, P < 0.05). Less well-educated, unemployed and smoking patients with low health literacy reported worse physical health. Health literacy accounted for 45 and 70 % of the total between patient variance explained in PCS-12 and MCS-12 respectively. Conclusions: Addressing health literacy related barriers to preventive care may help reduce some of the disparities in HRQoL. Recognising and tailoring health related communication to those with low health literacy may improve health outcomes including HRQoL in general practice.

AB - Background: Limited evidence exists regarding the relationship between health literacy and health-related quality of life (HRQoL) in Australian patients from primary care. The objective of this study was to investigate the impact of health literacy on HRQoL in a large sample of patients without known vascular disease or diabetes and to examine whether the difference in HRQoL between low and high health literacy groups was clinically significant. Methods: This was a cross-sectional study of baseline data from a cluster randomised trial. The study included 739 patients from 30 general practices across four Australian states conducted in 2012 and 2013 using the standard Short Form Health Survey (SF-12) version 2. SF-12 physical component score (PCS-12) and mental component score (MCS-12) are derived using the standard US algorithm. Health literacy was measured using the Health Literacy Management Scale (HeLMS). Multilevel regression analysis (patients at level 1 and general practices at level 2) was applied to relate PCS-12 and MCS-12 to patient reported life style risk behaviours including health literacy and demographic factors. Results: Low health literacy patients were more likely to be smokers (12 % vs 6 %, P = 0.005), do insufficient physical activity (63 % vs 47 %, P < 0.001), be overweight (68 % vs 52 %, P < 0.001), and have lower physical health and lower mental health with large clinically significant effect sizes of 0.56 (B (regression coefficient) = -5.4, P < 0.001) and 0.78(B = -6.4, P < 0.001) respectively after adjustment for confounding factors. Patients with insufficient physical activity were likely to have a lower physical health score (effect size = 0.42, B = -3.1, P < 0.001) and lower mental health (effect size = 0.37, B = -2.6, P < 0.001). Being overweight tended to be related to a lower PCS-12 (effect size = 0.41, B = -1.8, P < 0.05). Less well-educated, unemployed and smoking patients with low health literacy reported worse physical health. Health literacy accounted for 45 and 70 % of the total between patient variance explained in PCS-12 and MCS-12 respectively. Conclusions: Addressing health literacy related barriers to preventive care may help reduce some of the disparities in HRQoL. Recognising and tailoring health related communication to those with low health literacy may improve health outcomes including HRQoL in general practice.

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U2 - 10.1186/s12955-016-0471-1

DO - 10.1186/s12955-016-0471-1

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VL - 14

JO - Health and Quality of Life Outcomes

JF - Health and Quality of Life Outcomes

SN - 1477-7525

IS - 1

M1 - 68

ER -