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Association of Health Literacy and Numeracy with Interest in Research Participation

  • Sunil KripalaniEmail author
  • William J. Heerman
  • Niral J. Patel
  • Natalie Jackson
  • Kathryn Goggins
  • Russell L. Rothman
  • Vivian M. Yeh
  • Kenneth A. Wallston
  • Duane T. Smoot
  • Consuelo H. Wilkins
Original Research

Abstract

Background

There is much attention to recruitment of diverse populations in research, but little is known about the influence of health literacy and numeracy skills.

Objective

To determine if health literacy and numeracy affect individuals’ interest to participate in research studies.

Design

Cross-sectional survey data were pooled from 3 large studies conducted in the Mid-South Clinical Data Research Network.

Participants

Adult patients enrolled in 1 of 3 Mid-South Clinical Data Research Network studies.

Main Measures

The survey domains included demographic items, the 3-item Brief Health Literacy Screen (range 3–15), and the 3-item Subjective Numeracy Scale (range 3–18). The outcome was a sum index measure of a 7-item instrument (range 7–21) assessing individuals’ interest in participating in different types of research, including research that involves taking surveys, giving a blood sample, participating via phone or internet, taking an investigational medication, meeting at a local community center or school, including family, or staying overnight at a hospital.

Key Results

Respondents (N = 15,973) were predominately women (65.5%), White (81.4%), and middle aged (M = 52.8 years, SD = 16.5); 32.4% previously participated in research. Self-reported health literacy was relatively high (M = 13.5 out of 15, SD = 2.1), and subjective numeracy skills were somewhat lower (M = 14.3 out of 18, SD = 3.6). After adjustment for age, gender, race, income, education, and other characteristics, lower health literacy and numeracy skills were each independently associated with less interest in research participation (p < 0.001 for each). Prior research participation was associated with greater interest in future research participation (p < 0.001).

Conclusions

After adjustment for factors known to be predictive of interest, individuals with lower health literacy or numeracy scores were less interested in participating in research. Additional work is needed to elucidate reasons for this finding and to determine strategies to engage these populations.

KEY WORDS

health literacy health numeracy survey research 

Notes

Contributors

There are no additional contributors to this manuscript.

Funders

This work was supported by the Patient-Centered Outcomes Research Institute (R-1306-04869 and ME-1306-03342) and the National Institutes of Health (5UL1TR000445, 5U54MD007593, and 5U24TR001579).

Compliance with Ethical Standards

The Vanderbilt Institutional Review Board (IRB) approved each study. Participants provided electronic or written informed consent.

Prior Presentations

Patel, N.J., Jackson, N., Duke, L., Wilkins, C.H., Heerman, W.J., and Kripalani, S. The Effect of Health Literacy and Numeracy on Interest in Research Participation. Presented at the Advancing the Science of Community Engaged Research Conference in 2016.

Conflict of Interest

Sunil Kripalani, MD, MSc – Consultancies: SAI Interactive and Verustat/Stock ownership in Bioscape Digital.

Russell L. Rothman, MD, MPP – Consultancies: EdLogics, Inc. and Boehringer – Ingelheim.

Kenneth A. Wallston, PhD – Other – Member of the Advisory Board of EdLogics, Inc.

All other authors declare no conflicts of interest.

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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Sunil Kripalani
    • 1
    • 2
    • 3
    Email author
  • William J. Heerman
    • 2
    • 4
  • Niral J. Patel
    • 3
  • Natalie Jackson
    • 4
  • Kathryn Goggins
    • 2
    • 3
  • Russell L. Rothman
    • 1
    • 2
    • 3
  • Vivian M. Yeh
    • 3
  • Kenneth A. Wallston
    • 2
    • 5
  • Duane T. Smoot
    • 6
  • Consuelo H. Wilkins
    • 6
    • 7
    • 8
  1. 1.Division of General Internal Medicine and Public Health, Department of MedicineVanderbilt University Medical CenterNashvilleUSA
  2. 2.Center for Effective Health CommunicationVanderbilt University Medical CenterNashvilleUSA
  3. 3.Center for Clinical Quality and Implementation Research Vanderbilt University Medical CenterNashvilleUSA
  4. 4.Division of General PediatricsMonroe Carell Jr. Children’s Hospital at VanderbiltNashvilleUSA
  5. 5.School of NursingVanderbilt UniversityNashvilleUSA
  6. 6.Department of Internal MedicineMeharry Medical CollegeNashvilleUSA
  7. 7.Meharry-Vanderbilt AllianceVanderbilt University Medical CenterNashvilleUSA
  8. 8.Division of Geriatrics, Department of MedicineVanderbilt University Medical CenterNashvilleUSA

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