Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Suite 525, 1590 North High Street, Columbus, OH 43201, USA.
J Community Health. 2013 Aug;38(4):753-8. doi: 10.1007/s10900-013-9675-z.
The Amish have cultural practices that include formal education through the 8th grade. This study's purpose was to compare the health literacy among Amish to non-Amish adults living in Ohio Appalachia to understand its potential contribution to poorer health behaviors (e.g. lower cancer screening rates). Amish (n = 143) and non-Amish (n = 154) adults completed interviews as part of a lifestyle study. The rapid estimate of adult literacy in medicine (REALM) instrument (score range 0-66) was used and mean REALM scores were compared (t test) and correct pronunciation of each word was compared (Chi square test). Significance was considered at p < 0.001 because of multiple comparisons. Mean REALM scores among Amish males (53.3 ± 13.1) and females (56.2 ± 8.6) were significantly (p < 0.001) lower compared to non-Amish males (61.2 ± 9.8) and females (63.0 ± 6.2). Twelve percent of Amish participants read at or lower than a 6th grade level compared to 2.6 % of non-Amish participants. This study provides a glimpse into how culture may influence health literacy. Many Amish participants had limited or marginal health literacy. Innovative strategies that address inadequate health literacy and specific cultural characteristics are needed to improve health-related behaviors and outcomes among the Amish.
阿米什人有文化习俗，包括 8 年级的正规教育。本研究的目的是比较俄亥俄州阿巴拉契亚地区阿米什人和非阿米什成年人的健康素养，以了解其对较差健康行为（例如，较低的癌症筛查率）的潜在贡献。阿米什人（n=143）和非阿米什人（n=154）成年人完成了生活方式研究的访谈。使用了成人医学简易评估量表（REALM）（得分范围 0-66），比较了平均 REALM 得分（t 检验）和每个单词的正确发音（卡方检验）。由于进行了多次比较，因此认为 p<0.001 具有统计学意义。与非阿米什男性（61.2±9.8）和女性（63.0±6.2）相比，阿米什男性（53.3±13.1）和女性（56.2±8.6）的平均 REALM 得分明显较低（p<0.001）。与非阿米什参与者 2.6%相比，有 12%的阿米什参与者的阅读水平低于或等于 6 年级。本研究提供了一个了解文化如何影响健康素养的视角。许多阿米什参与者的健康素养有限或边缘。需要针对不足的健康素养和特定的文化特征制定创新策略，以改善阿米什人群的与健康相关的行为和结果。
