Department of Psychology, University of Houston, Houston, Texas, USA.
School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Psychol Health. 2021 Aug;36(8):985-1002. doi: 10.1080/08870446.2020.1817453. Epub 2020 Sep 8.
Determine the latent structure of health literacy in persons living with HIV (PLWH) and its association with health management and decision-making. Participants included 220 PLWH and 123 seronegative participants from Southern California and Alabama who completed a battery of well-validated health literacy measures, along with assessments of health management self-efficacy, health-related decision-making, depression, and basic clinical laboratory measures. Exploratory factor analysis in HIV - participants showed that the shared variance between a battery of health literacy measures, including health word reading, verbal comprehension, numeracy, and self-reported problems was best explained by a single factor. Similarly, a confirmatory factor analysis in PLWH also supported a single factor structure, but for a re-specified four-test solution based on the core performance-based measures of health literacy. In analyses adjusting for demographics, PLWH demonstrated significantly lower health literacy composite scores as compared to their HIV - counterparts. Among PLWH, lower health literacy was independently associated with lower self-efficacy for health management and poorer health-related decision-making. Findings suggest that numeracy, word recognition, and verbal comprehension and reasoning comprise a unitary construct of health literacy that is lower in PLWH as compared to seronegatives and is independently associated with important downstream aspects of health management and decision-making.
确定艾滋病毒感染者（PLWH）的健康素养的潜在结构及其与健康管理和决策的关系。参与者包括来自南加州和阿拉巴马州的 220 名 PLWH 和 123 名血清阴性参与者，他们完成了一系列经过充分验证的健康素养测量，以及健康管理自我效能、与健康相关的决策、抑郁和基本临床实验室测量的评估。在 HIV 参与者中的探索性因素分析表明，一系列健康素养测量（包括健康词汇阅读、语言理解、计算能力和自我报告的问题）之间的共享方差最好由单个因素来解释。同样，PLWH 的验证性因素分析也支持单因素结构，但基于健康素养的核心基于表现的测量重新指定了四个测试的解决方案。在调整人口统计学因素的分析中，与 HIV 阴性对照组相比，PLWH 的健康素养综合评分明显较低。在 PLWH 中，较低的健康素养与较低的健康管理自我效能和较差的与健康相关的决策独立相关。研究结果表明，计算能力、单词识别、语言理解和推理构成健康素养的单一结构，与血清阴性者相比，PLWH 的健康素养较低，并且与健康管理和决策的重要下游方面独立相关。
