Skip to main content
Sexually Transmitted Infections logoLink to Sexually Transmitted Infections
. 2001 Jun;77(3):206–211. doi: 10.1136/sti.77.3.206

Relation of health literacy to gonorrhoea related care

J Fortenberry 1, M McFarlane 1, M Hennessy 1, S Bull 1, D Grimley 1, L St 1, B Stoner 1, N VanDevanter 1
PMCID: PMC1744316  PMID: 11402232

Abstract

Objective: To assess the relation between health literacy and receipt of a screening test for gonorrhoea in the past year.

Methods: Study design was multisite, cross sectional survey of subjects enrolled from clinics, from community based organisations, and by street intercept. Data were obtained using face to face interview. The dependent variable was self reported receipt of a test for gonorrhoea in the past year. Health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine (REALM), recoded to represent 8th grade or lower reading or 9th grade and higher reading level. Statistical analyses were adjusted to account for selection bias in literacy assessment.

Results: 54% of the sample reported at least one gonorrhoea test in the previous year. 65% of the sample read at a 9th grade level or higher. REALM score was moderately correlated with the respondent's years of education. After adjustment for missing REALM data, past suspicion of gonorrhoea, self inspection for gonorrhoea, self efficacy for care seeking, REALM score of 9th grade reading level or higher, and younger age were independently associated with gonorrhoea testing in the previous year. For the average respondent, REALM reading grade level of 9th grade or higher is associated with a 10% increase in the probability of having a gonorrhoea test in the past year.

Conclusions: Low literacy appears to pose a barrier to care for sexually transmitted infections such as gonorrhoea.

Key Words: literacy; care seeking behaviour; gonorrhoea

Full Text

The Full Text of this article is available as a PDF (112.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baker D. W., Parker R. M., Williams M. V., Clark W. S. Health literacy and the risk of hospital admission. J Gen Intern Med. 1998 Dec;13(12):791–798. doi: 10.1046/j.1525-1497.1998.00242.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baker D. W., Parker R. M., Williams M. V., Pitkin K., Parikh N. S., Coates W., Imara M. The health care experience of patients with low literacy. Arch Fam Med. 1996 Jun;5(6):329–334. doi: 10.1001/archfami.5.6.329. [DOI] [PubMed] [Google Scholar]
  3. Davis T. C., Jackson R. H., George R. B., Long S. W., Talley D., Murphy P. W., Mayeaux E. J., Truong T. Reading ability in patients in substance misuse treatment centers. Int J Addict. 1993 May;28(6):571–582. doi: 10.3109/10826089309039648. [DOI] [PubMed] [Google Scholar]
  4. Davis T. C., Long S. W., Jackson R. H., Mayeaux E. J., George R. B., Murphy P. W., Crouch M. A. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993 Jun;25(6):391–395. [PubMed] [Google Scholar]
  5. Doak C. C., Doak L. G., Friedell G. H., Meade C. D. Improving comprehension for cancer patients with low literacy skills: strategies for clinicians. CA Cancer J Clin. 1998 May-Jun;48(3):151–162. doi: 10.3322/canjclin.48.3.151. [DOI] [PubMed] [Google Scholar]
  6. Estey A., Musseau A., Keehn L. Patient's understanding of health information: a multihospital comparison. Patient Educ Couns. 1994 Aug;24(1):73–78. doi: 10.1016/0738-3991(94)90027-2. [DOI] [PubMed] [Google Scholar]
  7. Fortenberry J. D. Health care seeking behaviors related to sexually transmitted diseases among adolescents. Am J Public Health. 1997 Mar;87(3):417–420. doi: 10.2105/ajph.87.3.417. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gazmararian J. A., Parker R. M., Baker D. W. Reading skills and family planning knowledge and practices in a low-income managed-care population. Obstet Gynecol. 1999 Feb;93(2):239–244. doi: 10.1016/s0029-7844(98)00431-1. [DOI] [PubMed] [Google Scholar]
  9. Hearth-Holmes M., Murphy P. W., Davis T. C., Nandy I., Elder C. G., Broadwell L. H., Wolf R. E. Literacy in patients with a chronic disease: systemic lupus erythematosus and the reading level of patient education materials. J Rheumatol. 1997 Dec;24(12):2335–2339. [PubMed] [Google Scholar]
  10. Howard-Pitney B., Winkleby M. A., Albright C. L., Bruce B., Fortmann S. P. The Stanford Nutrition Action Program: a dietary fat intervention for low-literacy adults. Am J Public Health. 1997 Dec;87(12):1971–1976. doi: 10.2105/ajph.87.12.1971. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Jolly B. T., Scott J. L., Feied C. F., Sanford S. M. Functional illiteracy among emergency department patients: a preliminary study. Ann Emerg Med. 1993 Mar;22(3):573–578. doi: 10.1016/s0196-0644(05)81944-4. [DOI] [PubMed] [Google Scholar]
  12. Kefalides P. T. Illiteracy: the silent barrier to health care. Ann Intern Med. 1999 Feb 16;130(4 Pt 1):333–336. doi: 10.7326/0003-4819-130-4-199902161-00001. [DOI] [PubMed] [Google Scholar]
  13. Meade C. D., Byrd J. C., Lee M. Improving patient comprehension of literature on smoking. Am J Public Health. 1989 Oct;79(10):1411–1412. doi: 10.2105/ajph.79.10.1411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Murphy J., Gamble G., Sharpe N. Readability of subject information leaflets for medical research. N Z Med J. 1994 Dec 14;107(991):509–510. [PubMed] [Google Scholar]
  15. Parikh N. S., Parker R. M., Nurss J. R., Baker D. W., Williams M. V. Shame and health literacy: the unspoken connection. Patient Educ Couns. 1996 Jan;27(1):33–39. doi: 10.1016/0738-3991(95)00787-3. [DOI] [PubMed] [Google Scholar]
  16. Parker R. M., Williams M. V., Baker D. W., Nurss J. R. Literacy and contraception: exploring the link. Obstet Gynecol. 1996 Sep;88(3 Suppl):72S–77S. doi: 10.1016/0029-7844(96)00250-5. [DOI] [PubMed] [Google Scholar]
  17. Plimpton S., Root J. Materials and strategies that work in low literacy health communication. Public Health Rep. 1994 Jan-Feb;109(1):86–92. [PMC free article] [PubMed] [Google Scholar]
  18. Weiss B. D., Coyne C. Communicating with patients who cannot read. N Engl J Med. 1997 Jul 24;337(4):272–274. doi: 10.1056/NEJM199707243370411. [DOI] [PubMed] [Google Scholar]
  19. Weissman A. "Race-ethnicity": a dubious scientific concept. Public Health Rep. 1990 Jan-Feb;105(1):102–103. [PMC free article] [PubMed] [Google Scholar]
  20. Wells J. A. Readability of HIV/AIDS educational materials: the role of the medium of communication, target audience, and producer characteristics. Patient Educ Couns. 1994 Dec;24(3):249–259. doi: 10.1016/0738-3991(94)90068-x. [DOI] [PubMed] [Google Scholar]
  21. Wells J. A., Ruscavage D., Parker B., McArthur L. Literacy of women attending family planning clinics in Virginia and reading levels of brochures on HIV prevention. Fam Plann Perspect. 1994 May-Jun;26(3):113-5, 131. [PubMed] [Google Scholar]
  22. Williams M. V., Baker D. W., Parker R. M., Nurss J. R. Relationship of functional health literacy to patients' knowledge of their chronic disease. A study of patients with hypertension and diabetes. Arch Intern Med. 1998 Jan 26;158(2):166–172. doi: 10.1001/archinte.158.2.166. [DOI] [PubMed] [Google Scholar]
  23. Williams M. V., Parker R. M., Baker D. W., Parikh N. S., Pitkin K., Coates W. C., Nurss J. R. Inadequate functional health literacy among patients at two public hospitals. JAMA. 1995 Dec 6;274(21):1677–1682. [PubMed] [Google Scholar]

Articles from Sexually Transmitted Infections are provided here courtesy of BMJ Publishing Group

RESOURCES