Health Literacy and Enduring and Severe Psychotic Disorders: The Development, Implementation, and Evaluation of Cardiometabolic Health Literacy Interventions in Outpatients, Inpatients, and Primary Health Care Settings

Abstract

Background

Premature mortality rates from natural causes are considerably higher in people with an enduring and severe psychotic disorder (ESPD) than those found in the general population. Low individual Health Literacy (HL) must be considered when addressing the physical health concerns and premature mortality rates in this population. HL focuses on the necessary individual skills required to obtain, process, and understand health information (Sorensen et al. 2012). Improving individual HL knowledge and skills in this population may empower the patient to self-manage their cardiometabolic comorbidities, and subsequently, help to reduce premature mortality rates.

Aim

The purpose of this thesis is to enhance the understanding of HL and HL interventions in people with an ESPD. The HL interventions in this thesis were feasibility studies designed to test, whether the HL interventions can be implemented in this population group to improve individual HL knowledge and skills.

Methods

Three studies were completed to evaluate the thesis objectives. The studies used a pre-post test study design. Two multi-component HL interventions were developed and were called: (1) Health Education Literacy Program (HELP); and (2) Wallet Prompt Card (WPC). The first two studies piloted the HELP to examine its feasibility in inpatients and outpatients with an ESPD. The third study piloted the WPC to examine its feasibility in outpatients with an ESPD. The Health Literacy Questionnaire (HLQ) was used to evaluate the participants individual HL at baseline and six weeks.

Results

The HL interventions were effective in improving individual HL knowledge and skills. The HELP showed significant (P <0.05) improvements in mean scores for two HLQ domains, and the WPC showed improvements across three domains.

Conclusion

HL interventions are feasible and have the potential to improve individual HL, and thereby, improve health outcomes and reduce premature mortality in this population.