Health literacy and aging: A process-knowledge approach

健康素养和老龄化：过程知识方法

• 批准号: 7575725
• 负责人: Daniel G Morrow
• 金额: $ 27.45万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-01 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7575725
• 关键词: Aging; Behavior; Blood Vessels; Characteristics; Chronic Disease; Cognition; Cognitive; Cognitive aging; Comprehension; Disease; Elderly; Foundations; Goals; Guidelines; Health; Health Status; Health behavior outcomes; Healthcare; Healthy People 2010; Heart Diseases; Heart failure; Hospitals; Hypertension; Individual; Individual Differences; Information Resources; Information Services; Instruction; Intervention; Knowledge; Language; Learning; Link; Liquid substance; Measures; Medication Errors; Memory; Mind; Modeling; Outcome; Patients; Performance; Pharmaceutical Preparations; Pharmacy facility; Problem Solving; Process; Psyche structure; Reading; Regression Analysis; Reporting; Research; Resources; Risk Factors; Role; Self Care; Self Care outcome; Self Management; Short-Term Memory; Sorting - Cell Movement; Source; Speed; Staging; Stroke; Structure; Surface; Text; Time; Translating; Variant; Vascular Diseases; age related; base; design; health literacy; improved; language processing; literacy; neglect; patient safety; processing speed; public health relevance; skills; standard measure; theories; young adult

DESCRIPTION (provided by applicant): The broad goals of this project are to improve self-care (e.g., medication use) and health outcomes among older adults with inadequate health literacy. Elders with chronic illness such as hypertension have less effective health literacy skills compared to younger adults, which predicts poor self-care and outcomes. While the association of health literacy and health is often presumed to reflect poor comprehension of health information, there is little direct evidence for these relationships, in part because health literacy models are not integrated with language comprehension theory. Health literacy in the present project is conceptualized in terms of a cognitive model of language processing that identifies the multiple levels of representing information conveyed by text. Specific aims are: (1) To model components of health literacy by examining the extent to which individual differences in standard measures of health literacy are explained by general measures of cognitive ability (i.e., working memory) and health-related knowledge. (2) Based on this model, to investigate relationships between components underlying health literacy and processes involved in understanding medication and discharge instructions related to hypertension. This involves a) Exploring the text demands involved in constructing multileveled representations of these texts; b) Assessing how individual differences in health literacy (and its cognitive underpinnings) impact different levels of these representations, so as to contribute to variation in comprehension, memory, and problem-solving from health texts; (3) To investigate the impact of critical text characteristics (e.g., pictorials) on literacy differences in performance. The first stage of the research will use a broad battery of measures of fluid mental abilities and health knowledge to model health literacy as a combination of patient abilities critical to comprehension. Studies in the second stage build on this ability-based model of health literacy to investigate differences in comprehension and memory for health texts. Regression analyses will investigate how these differences in performance reflect cognitive ability and health knowledge. The final studies investigate how to design texts to mitigate the comprehension difficulties associated with cognitive and knowledge limits. The project will produce guidelines for constructing health texts for older adults with different profiles of cognitive resources and knowledge, mitigating effects of inadequate health literacy on health outcomes. Public Health Relevance: Findings from this project will integrate health literacy models with theories of language comprehension and cognitive aging to help explain the impact of health literacy on patients' ability to understand, remember, and use health information. This knowledge in turn will guide design of health care texts such as medication and hospital discharge instructions, so that these texts better guide self-care behaviors, thereby mitigating the impact of inadequate health literacy on health behaviors and outcomes.

描述（由申请人提供）：该项目的广泛目标是改善健康素养不足的老年人的自我保健（例如，用药）和健康成果。与年轻人相比，患有慢性疾病的长者（例如高血压）的健康素养技巧较低，这预测了自我保健和结果不佳。尽管健康素养与健康的关联通常是为了反映对健康信息的理解不良，但这些关系的直接证据很少，部分原因是健康素养模型与语言理解理论没有融合在一起。本项目中的健康素养是根据语言处理的认知模型概念化的，该模型标识了代表文本传达的信息的多个级别。具体目的是：（1）通过检查健康素养量度的个体差异在多大程度上通过认知能力（即工作记忆）和与健康相关的知识来解释的程度来对健康素养的组成部分进行建模。 （2）基于该模型，以研究健康素养基础的组成部分与了解与高血压有关的药物和排出指令所涉及的过程之间的关系。这涉及a）探索在构建这些文本的多级表示中所涉及的文本要求； b）评估健康素养（及其认知基础）的个体差异如何影响这些表示形式的不同级别，从而有助于从健康文本中的理解，记忆和解决问题的差异； （3）研究关键文本特征（例如图片）对性能识字差异的影响。研究的第一阶段将使用大量的流体心理能力和健康知识衡量，以对健康素养进行建模，以此作为对理解至关重要的患者能力的结合。第二阶段的研究基于这种基于能力的健康素养模型，以研究健康文本的理解和记忆差异。回归分析将研究这些绩效的差异如何反映认知能力和健康知识。最终研究研究了如何设计文本以减轻与认知和知识限制相关的理解困难。该项目将制定针对具有不同认知资源和知识概况的老年人构建健康文本的准则，从而减轻健康素养对健康结果的影响不足。公共卫生相关性：该项目的发现将将健康素养模型与语言理解和认知衰老理论相结合，以帮助解释健康素养对患者理解，记住和使用健康信息的能力的影响。这些知识又将指导医疗保健文本（例如药物和医院出院说明）的设计，以便这些文本更好地指导自我保健行为，从而减轻健康素养对健康行为和结果的影响不足。