Lindsay S. Mayberry|Jonathan S. Schildcrout|Kenneth A. Wallston|Kathryn Goggins|Amanda S. Mixon|Russell L. Rothman|Sunil Kripalani|Sunil Kripalani|Justin M. Bachmann|Susan P. Bell|Katharine M. Donato|Frank E. Harrell|Lindsay S. Mayberry|Amanda S. Mixon|Russell L. Rothman|Jonathan S. Schildcrout|John F. Schnelle|Eduard E. Vasilevskis|Kenneth A. Wallston|Courtney Cawthon|Kathryn Goggins|Samuel K. Nwosu
Health Literacy and 1-Year Mortality: Mechanisms of Association in Adults Hospitalized for Cardiovascular Disease
Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University|Vanderbilt University Medical Center|Vanderbilt University Medical Center|VA Tennessee Valley Healthcare System|Geriatric Research Education and Clinical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center
objective test theorized patientlevel mediators causal pathway health literacy hl 1year mortality adults cardiovascular disease cvd patients methods total 3000 adults treated vanderbilt university hospital october 11 2011 december 18 2015 acute coronary syndrome acute decompensated heart failure adhf participated vanderbilt inpatient cohort study participants completed bedsideadministered survey consented health record review longitudinal followup multivariable mediation models examined direct indirect effects hl latent variable 4 indicators 1year mortality discharge dichotomous hypothesized mediators included social support health competence health behavior comorbidity index type cvd diagnosis previousyear hospitalizations results 2977 patients discharged hospital 60 male mean age 61 years 83 nonhispanic white 37 admitted adhf 17 23 inadequate hl depending measure 10 n304 died within 1 year total effect lower hl 1year mortality adjusted odds ratio aor131 95 ci 101169 decomposed indirect effect aor150 95 ci 135167 via mediators nonsignificant direct effect aor087 95 ci 066114 sd decrease hl associated absolute 32 percentage point increase probability 1year mortality via mediators admitted adhf comorbidities health behavior health competence previousyear hospitalizations listed contribution indirect effect conclusion patientlevel factors link low hl mortality health competence health behavior modifiable mediators could targeted interventions post hospitalization cvd