Sarah Nouri|Deborah E. Barnes|Aiesha Volow|Ryan Mcmahan|Margot Kushel|Chengshi Jin|John Boscardin|Rebecca L. Sudore
Health Literacy Matters More Than Experience for Advance Care Planning Knowledge Among Older Adults
University of California, San Francisco|University of California, San Francisco|San Francisco VA Medical Center|San Francisco VA Medical Center|University of California, San Francisco|University of California, San Francisco|San Francisco General Hospital|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|San Francisco VA Medical Center|University of California, San Francisco|San Francisco General Hospital
advance care planning acp engagement low among vulnerable populations including limited health literacy lhl limited knowledge acp may modifiable mediator relationship lhl acp goal determine whether health literacy associated acp knowledgecrosssectional designa public health delivery system veterans affairs medical center san francisco caenglish spanishspeaking patients n 1400acp knowledge assessed seven validated multiplechoice questions health literacy measured using validated scale sociodemographic measures included age sex language education race health status social support prior acp experience defined documented legal forms andor goalsofcare discussions medical record used kruskalwallis tests linear regression examine associations acp knowledge lhl prior acp experience sociodemographic factorsmean age participants 65 10 years 48 women 34 lhl 32 spanish speaking 47 high school education less 70 nonwhite mean 7point knowledge scores lower limited vs adequate health literacy 38 sd 19 vs 55 sd 17 p 001 multivariable analysis acp knowledge scores 10 point lower among lhl 06 points lower among spanish speakers high school education less 05 points lower among individuals nonwhite race p 001 knowledge scores 002 points lower per year older age p 007 001 points higher per point greater social support p 005 prior acp experience associated knowledge adjustment p 7health literacy sociodemographics stronger predictors prior acp experience acp knowledge study suggests providing easytounderstand acp materials paramount offered even patients previous experience acp process j geriatr soc 6721512156 2019