A health care navigation tool assesses asthma self-management and health literacy

Luzmercy Perez, Knashawn H. Morales, Heather Klusaritz, Xiaoyan Han, Jingru Huang, Marisa Rogers, Ian M. Bennett, Cynthia S Rand, Grace Ndicu, Andrea J. Apter

Research output: Contribution to journalArticle

Abstract

Background Self-management of moderate-to-severe asthma depends on the patient's ability to (1) navigate (access health care to obtain diagnoses and treatment), (2) use inhaled corticosteroids (ICSs) properly, and (3) understand ICS function. Objective We sought to test whether navigation skills (medication recall, knowledge of copay requirements, and ability to provide information needed for a medical visit about a persistent cough unresponsive to medication) are related to other self-management skills and health literacy. Methods A 21-item Navigating Ability (NAV2) questionnaire was developed, validated, and then read to adults with moderate-to-severe asthma. ICS technique was evaluated by using scales derived from instructions in national guidelines; knowledge of ICS function was evaluated by using a validated 10-item questionnaire. Spearman correlation was computed between NAV2 score and these questionnaires and with numeracy (Asthma Numeracy Questionnaire) and print literacy (Short Test of Functional Health Literacy in Adults). Results Two hundred fifty adults participated: age, 51 ± 13 years; 72% female; 65% African American; 10% Latino; 50% with household income of less than $30,000/y; 47% with no more than a 12th-grade education; and 29% experienced hospitalizations for asthma in the prior year. A higher NAV2 score was associated with correct ICS technique (ρ = 0.24, P = .0002), knowledge of ICSs (ρ = 0.35, P < .001), better print literacy (ρ = 0.44, P < .001), and numeracy (ρ = 0.41, P < .001). Conclusions Patients with poor navigational ability are likely to have poor inhaler technique and limited understanding of ICS function, as well as limited numeracy and print literacy. Clinicians should consider these elements of self-management for their effect on asthma care and as a marker of more general health literacy deficits.

Original languageEnglish (US)
Pages (from-to)1593-1599.e3
JournalJournal of Allergy and Clinical Immunology
Volume138
Issue number6
DOIs
StatePublished - Dec 1 2016

Fingerprint

Health Literacy
Self Care
Adrenal Cortex Hormones
Asthma
Aptitude
Delivery of Health Care
Health Services Accessibility
Nebulizers and Vaporizers
Hispanic Americans
Cough
African Americans
Hospitalization
Guidelines
Education
Surveys and Questionnaires

Keywords

  • Adults
  • asthma
  • health disparities
  • health literacy
  • inhaled corticosteroids
  • minority groups
  • numeracy
  • print literacy
  • self-management

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Perez, L., Morales, K. H., Klusaritz, H., Han, X., Huang, J., Rogers, M., ... Apter, A. J. (2016). A health care navigation tool assesses asthma self-management and health literacy. Journal of Allergy and Clinical Immunology, 138(6), 1593-1599.e3. https://doi.org/10.1016/j.jaci.2016.08.043

A health care navigation tool assesses asthma self-management and health literacy. / Perez, Luzmercy; Morales, Knashawn H.; Klusaritz, Heather; Han, Xiaoyan; Huang, Jingru; Rogers, Marisa; Bennett, Ian M.; Rand, Cynthia S; Ndicu, Grace; Apter, Andrea J.

In: Journal of Allergy and Clinical Immunology, Vol. 138, No. 6, 01.12.2016, p. 1593-1599.e3.

Research output: Contribution to journalArticle

Perez, L, Morales, KH, Klusaritz, H, Han, X, Huang, J, Rogers, M, Bennett, IM, Rand, CS, Ndicu, G & Apter, AJ 2016, 'A health care navigation tool assesses asthma self-management and health literacy', Journal of Allergy and Clinical Immunology, vol. 138, no. 6, pp. 1593-1599.e3. https://doi.org/10.1016/j.jaci.2016.08.043
Perez, Luzmercy ; Morales, Knashawn H. ; Klusaritz, Heather ; Han, Xiaoyan ; Huang, Jingru ; Rogers, Marisa ; Bennett, Ian M. ; Rand, Cynthia S ; Ndicu, Grace ; Apter, Andrea J. / A health care navigation tool assesses asthma self-management and health literacy. In: Journal of Allergy and Clinical Immunology. 2016 ; Vol. 138, No. 6. pp. 1593-1599.e3.
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abstract = "Background Self-management of moderate-to-severe asthma depends on the patient's ability to (1) navigate (access health care to obtain diagnoses and treatment), (2) use inhaled corticosteroids (ICSs) properly, and (3) understand ICS function. Objective We sought to test whether navigation skills (medication recall, knowledge of copay requirements, and ability to provide information needed for a medical visit about a persistent cough unresponsive to medication) are related to other self-management skills and health literacy. Methods A 21-item Navigating Ability (NAV2) questionnaire was developed, validated, and then read to adults with moderate-to-severe asthma. ICS technique was evaluated by using scales derived from instructions in national guidelines; knowledge of ICS function was evaluated by using a validated 10-item questionnaire. Spearman correlation was computed between NAV2 score and these questionnaires and with numeracy (Asthma Numeracy Questionnaire) and print literacy (Short Test of Functional Health Literacy in Adults). Results Two hundred fifty adults participated: age, 51 ± 13 years; 72{\%} female; 65{\%} African American; 10{\%} Latino; 50{\%} with household income of less than $30,000/y; 47{\%} with no more than a 12th-grade education; and 29{\%} experienced hospitalizations for asthma in the prior year. A higher NAV2 score was associated with correct ICS technique (ρ = 0.24, P = .0002), knowledge of ICSs (ρ = 0.35, P < .001), better print literacy (ρ = 0.44, P < .001), and numeracy (ρ = 0.41, P < .001). Conclusions Patients with poor navigational ability are likely to have poor inhaler technique and limited understanding of ICS function, as well as limited numeracy and print literacy. Clinicians should consider these elements of self-management for their effect on asthma care and as a marker of more general health literacy deficits.",
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AU - Rogers, Marisa

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N2 - Background Self-management of moderate-to-severe asthma depends on the patient's ability to (1) navigate (access health care to obtain diagnoses and treatment), (2) use inhaled corticosteroids (ICSs) properly, and (3) understand ICS function. Objective We sought to test whether navigation skills (medication recall, knowledge of copay requirements, and ability to provide information needed for a medical visit about a persistent cough unresponsive to medication) are related to other self-management skills and health literacy. Methods A 21-item Navigating Ability (NAV2) questionnaire was developed, validated, and then read to adults with moderate-to-severe asthma. ICS technique was evaluated by using scales derived from instructions in national guidelines; knowledge of ICS function was evaluated by using a validated 10-item questionnaire. Spearman correlation was computed between NAV2 score and these questionnaires and with numeracy (Asthma Numeracy Questionnaire) and print literacy (Short Test of Functional Health Literacy in Adults). Results Two hundred fifty adults participated: age, 51 ± 13 years; 72% female; 65% African American; 10% Latino; 50% with household income of less than $30,000/y; 47% with no more than a 12th-grade education; and 29% experienced hospitalizations for asthma in the prior year. A higher NAV2 score was associated with correct ICS technique (ρ = 0.24, P = .0002), knowledge of ICSs (ρ = 0.35, P < .001), better print literacy (ρ = 0.44, P < .001), and numeracy (ρ = 0.41, P < .001). Conclusions Patients with poor navigational ability are likely to have poor inhaler technique and limited understanding of ICS function, as well as limited numeracy and print literacy. Clinicians should consider these elements of self-management for their effect on asthma care and as a marker of more general health literacy deficits.

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