University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, New South Wales, Australia; University of Sydney, Faculty of Medicine and Health, School of Public Health, Wiser Healthcare, New South Wales, Australia.
University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, New South Wales, Australia; University of Sydney, Faculty of Medicine and Health, School of Public Health, New South Wales, Australia.
Prev Med. 2022 Mar;156:106980. doi: 10.1016/j.ypmed.2022.106980. Epub 2022 Feb 3.
This study aimed to explore the impact of health literacy on psychosocial and behavioural outcomes for people who were not at high risk of cardiovascular disease receiving a hypothetical blood pressure reading of 135/85 mmHg. We performed a secondary analysis of data from a national sample of Australians aged 40 to 50 years (n = 1318) recruited online. Health literacy was measured using the validated Newest Vital Sign (inadequate: 0-3; adequate: 4-6). Analysed outcomes included: willingness to increase exercise and accept medication; perceived severity; positive and negative affect; illness perceptions and impacts on life and motivation. Participants with inadequate levels of health literacy perceived a blood pressure reading of 135/85 mmHg to be less serious compared to individuals with adequate health literacy (Mean Difference [MD]:0.21; 95%CI 0.03-0.39; p = .024; d = 0.13), and reported less motivation to eat well (MD:0.44; 95%CI 0.31-0.58; p < .001; d = 0.38) and exercise (MD:0.43; 95%CI 0.31-0.58; p < .001; d = 0.36). However, they were more willing to accept medication (MD:0.20; 95%CI 0.07-0.34; p = .004; d = 0.17). Participants with inadequate health literacy also perceived the condition to have fewer negative impacts on aspects of life and work than individuals with adequate health literacy, but reported greater negative emotion and more negative illness perceptions (all p < .001). Tailored communication and behaviour change support may be needed when communicating blood pressure information to people with lower health literacy and not at high risk of cardiovascular disease given the differential impacts on medication (increased willingness) and healthy exercise and diet behaviours (decreased willingness) observed in this study.
本研究旨在探讨健康素养对心血管疾病低危人群接受血压值为 135/85mmHg 假设读数后的心理社会和行为结果的影响。我们对在线招募的 40 至 50 岁澳大利亚全国样本（n=1318）的数据分析进行了二次分析。健康素养使用经过验证的最新生命体征（不足：0-3；充足：4-6）进行测量。分析的结果包括：增加锻炼和接受药物治疗的意愿；感知严重程度；积极和消极影响；疾病认知和对生活的影响以及动机。与具有充足健康素养的个体相比，健康素养水平不足的个体认为血压值 135/85mmHg 的严重程度较低（平均差异[MD]：0.21；95%置信区间 0.03-0.39；p=0.024；d=0.13），并且报告的改善饮食和锻炼的动机较小（MD：0.44；95%置信区间 0.31-0.58；p<0.001；d=0.38）。然而，他们更愿意接受药物治疗（MD：0.20；95%置信区间 0.07-0.34；p=0.004；d=0.17）。健康素养不足的参与者还认为该疾病对生活和工作方面的负面影响较少，而健康素养充足的参与者则认为该疾病对生活和工作方面的负面影响较多，但报告的负面情绪更多，疾病认知更消极（均 p<0.001）。鉴于本研究中观察到药物治疗（增加意愿）和健康锻炼和饮食行为（降低意愿）的差异影响，在向健康素养较低且心血管疾病低危人群传达血压信息时，可能需要有针对性的沟通和行为改变支持。
