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Factors Explaining Variability in Health Literacy Outcomes of Public Health Nursing Clients
Author(s) -
Monsen Karen A.,
Chatterjee Snigdhansu B.,
Timm Jill E.,
Kay Poulsen J.,
McNaughton Diane B.
Publication year - 2014
Publication title -
public health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 55
eISSN - 1525-1446
pISSN - 0737-1209
DOI - 10.1111/phn.12138
Subject(s) - health literacy , public health nursing , public health , nursing , literacy , medicine , psychology , health care , political science , pedagogy , law
Abstract Objectives To evaluate variability in health literacy outcomes due to home visiting ( HV ) program components including PHN , Intervention, and Client. Design and Sample A comparative, correlational study evaluated PHN home visiting program data that included PHN s ( N = 16); Interventions ( N = 21,634); and Clients ( N = 141). Client age ranged from 14 to 46 (median = 21, mean = 22.8, SD = 6.65). Clients were predominately White (75.9%), not married (84.4%), and female (99.3%). PHNS documented care using electronic health records ( EHR ) and the Omaha System. Measures The outcome of interest was health literacy benchmark attainment (adequate knowledge) operationalized by Omaha System Problem Rating Scale for Outcomes Knowledge scores averaged across problems. Intervention Program of individually tailored, evidence‐based HV interventions provided by PHN s. Results There were 233 different interventions for 22 problems. Knowledge benchmark was attained by 16.3% of clients. Four factors explained variance in reaching the knowledge benchmark: Client (51%), Problem (17%), Intervention (16%), and PHN (16%). Conclusions The PHN and intervention tailoring are actionable components of HV programs that explain variability in health literacy outcomes. Further research should examine effects of training on PHN relationship skills and intervention tailoring to optimize outcomes of evidence‐based PHN HV programs, and to evaluate whether improving health literacy may subsequently improve client problems.