EXPANDING THE CONCEPTUAL FRAMEWORK OF HEALTH LITERACY TO IMPROVE LONG-TERM SERVICES AND SUPPORTS

dc.contributor.advisorSimon-Rusinowitz, Lorien_US
dc.contributor.authorRuben, Kathleen Annen_US
dc.contributor.departmentHealth Services Administrationen_US
dc.contributor.publisherDigital Repository at the University of Marylanden_US
dc.contributor.publisherUniversity of Maryland (College Park, Md.)en_US
dc.date.accessioned2014-02-06T06:30:32Z
dc.date.available2014-02-06T06:30:32Z
dc.date.issued2013en_US
dc.description.abstractLow health literacy is a significant and growing public health problem. It is estimated that 90 million individuals in the U.S. have low health literacy, which is associated with poor health outcomes. Individuals with low health literacy skills may not be able to obtain health information, communicate with health care providers, or make optimal health care decisions. People from all backgrounds can have low health literacy levels, however, the rates are higher in certain groups such as older adults, Medicaid beneficiaries, and minority populations. Due to our rapidly aging and increasingly diverse U.S. population, the problems associated with low health literacy may increase over the next few decades. Studies have examined the relationship between an individual's health literacy level and their own health outcomes. However, few have focused on how the health literacy level of others, such as caregivers and health care professionals, impacts the health outcomes of care recipients. It is important to understand this relationship in terms of elders who depend on others, such as caregivers and family members, for their care. This series of three studies addresses this critical gap in health literacy research. The first two studies examine the need for a health literacy component of a training program for care teams for individuals with dementia in participant-directed programs. The first is an ethnographic pilot study of caregivers in West Virginia's Personal Options Program, and the second is a mixed- methods study of "Decision-Making Partner" preparedness in Arkansas' IndependentChoices Program. The third study examines the effect of the emergency department referral process on repeated utilization of community health centers by low-income, uninsured adults and Medicaid Beneficiaries, as well as the role of Patient Navigators as mediators within the framework of health literacy. This research provides evidence that the health literacy level of others, including caregivers, decision-making partners, and health care providers significantly impacts the ability of older adults to access health services and supports, communicate with healthcare providers, navigate the healthcare system, and manage chronic diseases. Therefore, addressing health literacy is essential for increasing health-related knowledge, improving health outcomes, and decreasing health disparities in long-term care.en_US
dc.identifier.urihttp://hdl.handle.net/1903/14828
dc.language.isoenen_US
dc.subject.pqcontrolledHealth care managementen_US
dc.subject.pquncontrolledCash and Counselingen_US
dc.subject.pquncontrolledDementiaen_US
dc.subject.pquncontrolledHealth Literacyen_US
dc.subject.pquncontrolledParticipant-Directed Servicesen_US
dc.subject.pquncontrolledRepresentativesen_US
dc.subject.pquncontrolledTrainingen_US
dc.titleEXPANDING THE CONCEPTUAL FRAMEWORK OF HEALTH LITERACY TO IMPROVE LONG-TERM SERVICES AND SUPPORTSen_US
dc.typeDissertationen_US

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