TY - JOUR
T1 - The process-knowledge model of health literacy
T2 - Evidence from a componential analysis of two commonly used measures
AU - Chin, Jessie
AU - Morrow, Daniel G.
AU - Stine-Morrow, Elizabeth A L
AU - Conner-Garcia, Thembi
AU - Graumlich, James F.
AU - Murray, Michael D.
N1 - Funding Information:
We thank Brennan Payne, Laura D’Andrea, Maryrose Buttice and research coordinators in OSF Saint Francis Medical Center for their assistance on research. This material is based on work supported by the National Institute of Aging (Grant R01 AG31718). Any opinions, findings, and conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the NIH.
PY - 2011
Y1 - 2011
N2 - We investigated the effects of domain-general processing capacity (fluid ability such as working memory), domain-general knowledge (crystallized ability such as vocabulary), and domain-specific health knowledge for two of the most commonly used measures of health literacy (S-TOFHLA and REALM). One hundred forty six community-dwelling older adults participated; 103 had been diagnosed with hypertension. The results showed that older adults who had higher levels of processing capacity or knowledge (domain-general or health) performed better on both of the health literacy measures. Processing capacity interacted with knowledge: Processing capacity had a lower level of association with health literacy for participants with more knowledge than for those with lower levels of knowledge, suggesting that knowledge may offset the effects of processing capacity limitations on health literacy. Furthermore, performance on the two health literacy measures appeared to reflect a different weighting for the three types of abilities. S-TOFHLA performance reflected processing capacity as well as general knowledge, whereas performance on the REALM depended more on general and health knowledge than on processing capacity. The findings support a process-knowledge model of health literacy among older adults, and have implications for selecting health literacy measures in various health care contexts.
AB - We investigated the effects of domain-general processing capacity (fluid ability such as working memory), domain-general knowledge (crystallized ability such as vocabulary), and domain-specific health knowledge for two of the most commonly used measures of health literacy (S-TOFHLA and REALM). One hundred forty six community-dwelling older adults participated; 103 had been diagnosed with hypertension. The results showed that older adults who had higher levels of processing capacity or knowledge (domain-general or health) performed better on both of the health literacy measures. Processing capacity interacted with knowledge: Processing capacity had a lower level of association with health literacy for participants with more knowledge than for those with lower levels of knowledge, suggesting that knowledge may offset the effects of processing capacity limitations on health literacy. Furthermore, performance on the two health literacy measures appeared to reflect a different weighting for the three types of abilities. S-TOFHLA performance reflected processing capacity as well as general knowledge, whereas performance on the REALM depended more on general and health knowledge than on processing capacity. The findings support a process-knowledge model of health literacy among older adults, and have implications for selecting health literacy measures in various health care contexts.
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U2 - 10.1080/10810730.2011.604702
DO - 10.1080/10810730.2011.604702
M3 - Article
C2 - 21951254
AN - SCOPUS:80053556697
SN - 1081-0730
VL - 16
SP - 222
EP - 241
JO - Journal of Health Communication
JF - Journal of Health Communication
IS - SUPPL. 3
ER -