University of Arkansas for Medical Sciences, Center for Health Literacy, 4301 W. Markham Street, Slot 599A, Little Rock, AR, 72205-7199, USA.
Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06520-8056, USA.
J Urban Health. 2018 Aug;95(4):547-555. doi: 10.1007/s11524-018-0276-0.
Health literacy is increasingly understood to be a mediator of chronic disease self-management and health care utilization. However, there has been very little research examining health literacy among incarcerated persons. This study aimed to describe the health literacy and relevant patient characteristics in a recently incarcerated primary care patient population in 12 communities in 6 states and Puerto Rico. Baseline data were collected from 751 individuals through the national Transitions Clinic Network (TCN), a model which utilizes a community health worker (CHW) with a previous history of incarceration to engage previously incarcerated people with chronic medical diseases in medical care upon release. Participants in this study completed study measures during or shortly after their first medical visit in the TCN. Data included demographics, health-related survey responses, and a measure of health literacy, The Newest Vital Sign (NVS). Bivariate and linear regression models were fit to explore associations among health literacy and the time from release to first clinic appointment, number of emergency room visits before first clinic appointment and confidence in adhering to medication. Our study found that almost 60% of the sample had inadequate health literacy. Inadequate health literacy was associated with decreased confidence in taking medications following release and an increased likelihood of visiting the emergency department prior to primary care. Early engagement may improve health risks for this population of individuals that is at high risk of death, acute care utilization, and hospitalization following release.
健康素养越来越被认为是慢性病自我管理和医疗保健利用的中介。然而，很少有研究关注被监禁者的健康素养。本研究旨在描述 6 个州和波多黎各 12 个社区中最近被监禁的初级保健患者群体的健康素养和相关患者特征。通过全国过渡诊所网络（TCN）从 751 名个体中收集了基线数据，该模型利用了具有先前监禁史的社区卫生工作者（CHW），在释放后让患有慢性疾病的曾被监禁者参与医疗保健。本研究的参与者在 TCN 的第一次就诊期间或之后不久完成了研究措施。数据包括人口统计学、与健康相关的调查回复以及健康素养衡量标准——最新生命体征（NVS）。进行了双变量和线性回归模型拟合，以探讨健康素养与从释放到第一次就诊的时间、第一次就诊前急诊就诊次数以及对药物依从性的信心之间的关联。我们的研究发现，近 60%的样本存在健康素养不足的情况。健康素养不足与释放后对服用药物的信心降低以及在接受初级保健之前更有可能去急诊室就诊有关。早期参与可能会降低该人群的健康风险，该人群在释放后死亡、急性护理利用和住院的风险很高。
