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

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

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

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

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Publication Type:: Journal Article
Citation:: Health and Quality of Life Outcomes, 2016, 14 (1)
Issue Date:: 2016-05-04

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Field	Value	Language
dc.contributor.author	Jayasinghe, UW	en_US
dc.contributor.author	Harris, MF	en_US
dc.contributor.author	Parker, SM	en_US
dc.contributor.author	Litt, J	en_US
dc.contributor.author	van Driel, M	en_US
dc.contributor.author	Mazza, D	en_US
dc.contributor.author	Del Mar, C	en_US
dc.contributor.author	Lloyd, J	en_US
dc.contributor.author	Smith, J	en_US
dc.contributor.author	Zwar, N	en_US
dc.contributor.author	Taylor, R	en_US
dc.contributor.author	Harris, M	en_US
dc.contributor.author	Russell, G	en_US
dc.contributor.author	Denney-Wilson, E https://orcid.org/0000-0001-9879-4969	en_US
dc.contributor.author	Laws, R	en_US
dc.contributor.author	Snowdon, T	en_US
dc.contributor.author	Bolger-Harris, H	en_US
dc.contributor.author	Groombridge, S	en_US
dc.contributor.author	Goldstein, S	en_US
dc.contributor.author	Howarth, T	en_US
dc.contributor.author	Huang, N	en_US
dc.contributor.author	Wilson, J	en_US
dc.date.available	2016-04-23	en_US
dc.date.issued	2016-05-04	en_US
dc.identifier.citation	Health and Quality of Life Outcomes, 2016, 14 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/117051
dc.description.abstract	© 2016 Jayasinghe et al. 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.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT568979
dc.relation.ispartof	Health and Quality of Life Outcomes	en_US
dc.relation.isbasedon	10.1186/s12955-016-0471-1	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Health Surveys	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Attitude to Health	en_US
dc.subject.mesh	Life Style	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Socioeconomic Factors	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Patients	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Health Literacy	en_US
dc.title	The impact of health literacy and life style risk factors on health-related quality of life of Australian patients	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	14	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	14	en_US

Abstract:

© 2016 Jayasinghe et al. 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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http://hdl.handle.net/10453/117051