Elsevier

Journal of Pediatric Nursing

Volume 36, September–October 2017, Pages 191-196
Journal of Pediatric Nursing

Health Literacy in Adolescents With Sickle Cell Disease

https://doi.org/10.1016/j.pedn.2017.05.012Get rights and content

Highlights

  • Patients with sickle cell disease (SCD) have poor health outcomes during transition.

  • Health literacy may facilitate more successful transitions in this population.

  • This study evaluated health literacy in 75 adolescents with SCD.

  • Health literacy was low and significantly correlated with age and grade level.

  • This study lays a solid foundation for future health literacy research in this population and others.

Abstract

Purpose

To evaluate health literacy in a cohort of 75 adolescents with sickle cell disease (SCD).

Design and Methods

This cross-sectional, descriptive correlational study included assessment of demographic measures and appraisal of data resulting from completion of the REALM-Teen and Newest Vital Sign (NVS) instruments by 75 Black, non-Hispanic adolescents with SCD. Convenience sampling was utilized. Inclusion criteria were a diagnosis of one of the four primary genotypes of SCD and age 10–19 years.

Results

Thirty-seven males and 38 females were recruited for the study. Their mean age was 14.7 years (SD = 2.2; range 8.1). Their grade level ranged from 4 to 12 (mean 8.7; SD = 2.2). Scores on the REALM-Teen ranged from 12 to 66 (mean 53.7; SD = 12.8). Scores on the NVS ranged from 0 to 6 (mean 2.37; SD = 1.33). These health literacy scores were lower using both the REALM-Teen and the NVS instruments when compared to scores in all healthy adolescents and adults. Current grade level and health literacy scores showed a moderately high positive correlation (r = 0.52, p < 0.01). Health literacy scores were also significantly positively correlated with age (r = 0.49, p < 0.01) and income (r = 0.37, p < 0.01).

Conclusions

Health literacy in adolescents with SCD is suboptimal. Future research should include identifying facilitators and barriers to health literacy levels in a larger cohort of adolescents with SCD.

Practice Implications

Health literacy is a potential facilitator of successful health outcomes for all adolescents. This study lays a solid foundation for future adolescent health literacy initiatives.

Section snippets

Purpose

Approximately five and a half million children in the U.S. are living with a chronic illness, including HIV, sickle cell disease, asthma and diabetes (Centers for Disease Control and Prevention, 2011, National Center for Healthcare Statistics, 2011). It is estimated that 90% of these children will now live until at least the age of 20; thus, most of these children will be transferred from the care of a pediatrician to an adult health provider sometime during their late adolescent years (Blum,

Design and Methods

This study used a descriptive, correlational cross-sectional design to explore the facilitators and barriers to health literacy levels in adolescents with sickle cell disease (SCD). A framework for studying adolescent health literacy was developed by Manganello and is named the Adolescent Health Literacy Model (Manganello, 2008). This model was used for this project to help conceptually and operationally define variables. Please see Fig. 1 for a graphic of the original model by Manganello (2008)

Results

Data were entered into IBM SPSS 22.0 Statistical Software for analysis. Descriptive statistical analysis was performed to examine the demographic characteristics of the sample. Pearson and Spearman correlations were performed to examine relationships among all study variables. Both multiple and simple regressions were also performed to identify predictor variables that contributed most to health literacy scores in this sample.

Because the validated health literacy instrument for adolescents is

Discussion

This study contributes several significant findings to the literature. First, this study revealed the previously unknown current state of health literacy in a sample of adolescents with SCD. The REALM-Teen health literacy instrument that was used for this study is designed to correlate raw scores with grade level literacy. With a mean score of 53.7, the average grade level literacy equivalent for this sample was 6th–7th grade despite the fact that the average grade level for this sample was 8th

Conclusions and Practice Implications

This study not only provided much needed insight into the health literacy levels of adolescents with SCD, but it also yielded meaningful implications for future clinical care and research in varying fields of study. Firstly, this study showed that evaluating health literacy scores in adolescents with SCD is feasible as all adolescents who agreed to participate were able to complete both scales and administration time was approximately two to five minutes for each instrument. Therefore, the

Acknowledgments

Thank you to Dr. George Buchanan for your guidance and mentorship on this project. I am forever grateful that you have always believed in me. Furthermore, thank you to the entire Hematology team at Children's Health Dallas for your unwavering support and help on this project. Thank you as well to those who helped to fund this study: Sigma Theta Tau (Epsilon Theta Chapter) Research Grant Award and the Rew Family Graduate Research Endowment in Nursing.

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