Association of Health Literacy and Numeracy with Interest in Research Participation
There is much attention to recruitment of diverse populations in research, but little is known about the influence of health literacy and numeracy skills.
To determine if health literacy and numeracy affect individuals’ interest to participate in research studies.
Cross-sectional survey data were pooled from 3 large studies conducted in the Mid-South Clinical Data Research Network.
Adult patients enrolled in 1 of 3 Mid-South Clinical Data Research Network studies.
The survey domains included demographic items, the 3-item Brief Health Literacy Screen (range 3–15), and the 3-item Subjective Numeracy Scale (range 3–18). The outcome was a sum index measure of a 7-item instrument (range 7–21) assessing individuals’ interest in participating in different types of research, including research that involves taking surveys, giving a blood sample, participating via phone or internet, taking an investigational medication, meeting at a local community center or school, including family, or staying overnight at a hospital.
Respondents (N = 15,973) were predominately women (65.5%), White (81.4%), and middle aged (M = 52.8 years, SD = 16.5); 32.4% previously participated in research. Self-reported health literacy was relatively high (M = 13.5 out of 15, SD = 2.1), and subjective numeracy skills were somewhat lower (M = 14.3 out of 18, SD = 3.6). After adjustment for age, gender, race, income, education, and other characteristics, lower health literacy and numeracy skills were each independently associated with less interest in research participation (p < 0.001 for each). Prior research participation was associated with greater interest in future research participation (p < 0.001).
After adjustment for factors known to be predictive of interest, individuals with lower health literacy or numeracy scores were less interested in participating in research. Additional work is needed to elucidate reasons for this finding and to determine strategies to engage these populations.
KEY WORDShealth literacy health numeracy survey research
There are no additional contributors to this manuscript.
This work was supported by the Patient-Centered Outcomes Research Institute (R-1306-04869 and ME-1306-03342) and the National Institutes of Health (5UL1TR000445, 5U54MD007593, and 5U24TR001579).
Compliance with Ethical Standards
The Vanderbilt Institutional Review Board (IRB) approved each study. Participants provided electronic or written informed consent.
Patel, N.J., Jackson, N., Duke, L., Wilkins, C.H., Heerman, W.J., and Kripalani, S. The Effect of Health Literacy and Numeracy on Interest in Research Participation. Presented at the Advancing the Science of Community Engaged Research Conference in 2016.
Conflict of Interest
Sunil Kripalani, MD, MSc – Consultancies: SAI Interactive and Verustat/Stock ownership in Bioscape Digital.
Russell L. Rothman, MD, MPP – Consultancies: EdLogics, Inc. and Boehringer – Ingelheim.
Kenneth A. Wallston, PhD – Other – Member of the Advisory Board of EdLogics, Inc.
All other authors declare no conflicts of interest.
- 9.Kutner MA, Greenberg E, Baer J. National Assessment of Adult Literacy (NAAL): A first look at the literacy of America’s adults in the 21st century. US Department of Education. Washington, DC: National Center for Education Statistics; 2005.Google Scholar
- 10.Institute of Medicine Committee on Health Literacy. Health Literacy: A Prescription to End Confusion. Washington (DC): National Academies Press; 2004.Google Scholar
- 11.Ratzan SC, Parker, RM, Selden CR, Zorn, CR. National library of medicine current bibliographies in medicine: Health Lliteracy. Bethesda (MD): U.S. Department of Health and Human Services, National Institues of Health; 2000.Google Scholar
- 15.Kripalani S, Bengtzen R, Henderson LE, Jacobson TA. Clinical research in low-literacy populations: using teach-back to assess comprehension of informed consent and privacy information. IRB. 2008;30:13–9.Google Scholar
- 20.Roumie CL, Shirey-Rice J, Kripalani S. MidSouth CDRN - coronary heart disease algorithm. PheKB. 2014. https://phekb.org/phenotype/234.