Simple tool to measure health literacy in patients with HIV successfully predicts medication adherence
Research Activities, August 2010, No. 360
The ability to understand and act on medical information is at the crux of health literacy. However, current tools to measure health literacy may be off-putting because they require individuals to read lists of medical terms often unrelated to their health condition, while also assessing reading ability and not the ability to understand and act on health information. A new tool successfully overcomes that hurdle by asking patients with HIV about terms and practices they are familiar with. It also shows how well they stick to their medication regimen, a new study finds.
Researchers used the eight-item Brief Estimate of Health Knowledge and Action—HIV Version (BEHKA-HIV) to interview 204 patients with HIV in Chicago, Illinois, and Shreveport, Louisiana, in 2001. Three items test knowledge of HIV, asking patients to explain the terms "CD4 count" and "viral load" and to list their HIV medicines. The remaining five items query patients' actions regarding circumstances that affect their adherence to HIV medications. Also included in the study was a validated measure of HIV medication adherence. Results showed that patients who scored high on the BEHKA-HIV were adherent to their HIV medications. For example, 90.9 percent of patients who scored 6-8 on the BEHKA-HIV were classified as adherent, while just 51 percent of patients who scored 0-3 on the assessment were classified as adherent.
The authors suggest the BEHKA-HIV may better assess health literacy than other tools because it measures both knowledge of HIV and a patient's actions to overcome potential barriers to medication adherence. Further, it allows caregivers to identify gaps in a patient's understanding and what may be the cause of nonadherence to treatment, providing a teachable moment around administration of the test. This study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00078).
See "Health literacy in the context of HIV treatment: Introducing the brief estimate of health knowledge and action (BEHKA)—HIV version," by Chandra Y. Osborn, Ph.D., M.P.H., Terry C. Davis, Ph.D., Stacy Cooper Bailey, M.P.H., and Michael S. Wolf, Ph.D., M.P.H., in the February 2010 AIDS Behavior 14(1), pp. 181-188.