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Relation of health literacy to gonorrhoea related care.
Sexually Transmitted Infections 2001;77(3):206-211.
Fortenberry JD, McFarlane MM, Hennessy M, Bull SS, Grimley DM, St. Lawrence
J, Stoner BP, VanDevanter N.
Abstract
OBJECTIVE: To assess the relation between health literacy and receipt
of a screening test for gonorrhoea in the past year. METHODS: Study design
was multisite, cross sectional survey of subjects enrolled from clinics,
from community based organisations, and by street intercept. Data were
obtained using face to face interview. The dependent variable was self
reported receipt of a test for gonorrhoea in the past year. Health literacy
was measured by the Rapid Estimate of Adult Literacy in Medicine (REALM),
recoded to represent 8th grade or lower reading or 9th grade and higher
reading level. Statistical analyses were adjusted to account for selection
bias in literacy assessment. RESULTS: 54% of the sample reported at least
one gonorrhoea test in the previous year. 65% of the sample read at a
9th grade level or higher. REALM score was moderately correlated with
the respondent's years of education. After adjustment for missing REALM
data, past suspicion of gonorrhoea, self inspection for gonorrhoea, self
efficacy for care seeking, REALM score of 9th grade reading level or
higher, and younger age were independently associated with gonorrhoea
testing in the previous year. For the average respondent, REALM reading
grade level of 9th grade or higher is associated with a 10% increase
in the probability of having a gonorrhoea test in the past year. CONCLUSIONS:
Low literacy appears to pose a barrier to care for sexually transmitted
infections such as gonorrhoea.