Paper Presentation: Supporting Patient Well-Being and Quality of Life—The Influence of Health Seeking Behavior on the Health Literacy of Adolescents with Sickle Cell Disease (214-2)

12:35 – 12:55 pm Thursday, September 3

Between 94% and 98% of children with sickle cell disease (SCD) are living to age 18 years and beyond. However, patients with SCD experience significant morbidity and mortality after they transfer from pediatric care to adult care. One hypothesis is that health literacy plays a role in the transition of children with SCD from pediatric care to adult care.

Due to a paucity of literature on health literacy in adolescents with SCD, more exploratory data must be gathered in order to determine significant influencing factors of health literacy in adolescents with SCD. Based on the framework for studying adolescent health literacy (Manganello, 2008), it is postulated that health-seeking behavior may play an influencing role in the health literacy levels of adolescents with SCD.

The purpose of this study is twofold: a) to evaluate types of health-seeking behaviors in adolescents with SCD and b) to determine if there is a statistically significant difference in health literacy levels in adolescents with SCD based upon differing health-seeking behaviors.

This was a cross-sectional, descriptive study evaluating the influence of health-seeking behaviors on health literacy levels in 134 black, non-Hispanic adolescents with SCD at a large tertiary care center in Dallas, Texas. This study included an assessment of demographic measures and appraisal of data resulting from the completion of the Newest Vital Sign (NVS) health literacy instrument. Convenience sampling was utilized for patient recruitment. Inclusion criteria were a diagnosis of one of the four primary genotypes of SCD and age 10-19 years. Institutional Review Boards approved the study. Data were entered into SPSS 23.0 Statistical Software for analysis. The level of statistical significance set for this study was p < .05. Descriptive statistics were calculated for all variables. Frequencies and percentages were calculated for all categorical and ordinal variables, including health-seeking behavior. Independent Samples t-tests were conducted to test for differences in adolescent health literacy scores based upon differing health-seeking behaviors.

The mean age of this study sample was 14.8 years (SD=2.2) with a range from 10.3 to 18.4 years of age. The sample was comprised of a relatively equal number of males and females, with 71 males (53.4%) and 62 females (46.6%). The participants had a mean grade level of 8.5 (SD=2.3). Mean NVS health literacy score was 2.7 (SD=1.6). When asked “Where do you go first for health information?” 110 participants responded. The two most common responses were the Internet (29.6%; n=40) and health care providers (27.4%; n=37). Remaining respondents answered as follows: a) 10.4% friends and family (n=14); b) 6.7% SCDAA (n=9); c) 3% books (n=4); d) 2.2% other (n=3). For the two most common responses, mean NVS scores for adolescents using the Internet first for health information were 2.48 (SE=.28) compared to 2.92 (SE=.22) for adolescents using healthcare providers as their first source of health information. There was no statistical difference (t (75)=-.12; p=.22) in NVS scores between adolescents using the Internet versus healthcare providers as their first source of health information.

Elizabeth Perry Caldwell, PhD RN
Libby Rosonet, MSN RN CPHON®
CNE Hours: