Abstract
One third of Americans diagnosed with hypertension do not have their blood pressure managed to a therapeutic range as outlined by the current guidelines. Unmanaged hypertension leads to cardiovascular complications that include heart attacks and strokes. The financial burden of hypertension impacts the individuals, families, and the healthcare system as a whole. Patients with a low health literacy level have a higher prevalence of poorly managed hypertension. Primary health care providers need a better understanding of how to assess health literacy levels in patients with hypertension. The purpose of the proposed project is to increase the number of patients who receive personalized educational materials that are specific to their health literacy level. For this project, a tool kit was developed and implemented in a Midwest Metropolitan clinic that primarily serves an underserved population. The tool kit includes a hypertension health literacy assessment (HHLA) as well as educational hand-outs geared to a lower health literacy level addressing lifestyle modifications, diet, medications, and consequences of hypertension. The HHLA determines patients with low health literacy are likely to miss 8 or more questions on the survey with a P value of <0.05 for validity, and that patients that answer 19.3 questions correctly are considered to have adequate health literacy. Patients who score less than 20 on the HHLA will receive education in each category where a question on the survey was answered incorrectly. The nurse or provider will review the handout/s and missed questions with the patient. The tool kit provides individualized education to the patient to increase the health literacy level. Of the 29 participants, 58.6% had low health literacy. 100% of individuals with low health literacy missed questions in the consequences section and were given education material related to consequences. 47.1% of those with low health literacy missed questions related to lifestyle modification and were given education materials. 5.9% miss medication questions and were given education material. 88.2% missed questions related to diet and were given education materials. Patients with hypertension often have low health literacy. Using the HHLA allows providers to give education plans that are aimed at increasing the patient’s understanding of hypertension with the long-term goal of increasing the number of patients with managed hypertension.
Keywords: Hypertension, health literacy, education, management