Health literacy (HL) is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Low HL has been associated with poorer self-reported health status, inability to manage chronic conditions, and less use of preventive services. More research is needed to explore the relationship between HL and sugar-sweetened beverage (SSB) intake and physical activity (PA). Although numerous HL interventions are evident in the literature, those that test HL as a moderator of effectiveness are lacking. Additionally, it has been recognized that systems-level HL efforts are necessary to lessen the burden of low HL. This dissertation addresses these needs with three unique studies that took place within the rural, medically underserved southwest Virginia region.
Study 1 was a secondary analysis that examined the relationship and responsiveness of the Stanford Leisure-Time Activity Categorical Item (L-Cat) and adapted Godin Leisure-Time Exercise Questionnaire (GLTEQ) and determined if baseline HL status moderated intervention effects. There was high agreement L-Cat and adapted GLTEQ for classifying individuals as meeting PA recommendations. Baseline HL status did not moderate change in L-Cat or adapted GLTEQ measures.
Study 2 was a secondary analysis that determined if 6-month change in SSB intake predicted 6-month change in body mass index (BMI), weight, and quality of life (QOL), and determined if HL moderated these relationships. The regression models for weight and QOL were not significant. The BMI model was significant. Six-month change in SSB intake, experimental condition, and age were significant predictors for the BMI model. As hypothesized, HL did not moderate relationships in any models.
Study 3 details a multilevel mixed-methods needs assessment and collaboratively developed organizational HL improvement plan within the Virginia Department of Health (VDH). Staff responses revealed about half reported doing well across HL domains (written communication, oral communication, self-management and empowerment, supportive systems). However, needs were observed across all domains, with most improvement needed in written communication domain. There were significant correlations between clients' HL status and their perceptions of VDHs' HL practices, indicating potential areas of improvement within VDH. / Ph. D. / Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Low health literacy has been associated with poorer self-reported health status, inability to manage chronic conditions, and less use of preventive services. More research is needed to explore the relationship between health literacy and sugar-sweetened beverage intake and physical activity. Specifically, interventions that test the moderation of health literacy (i.e., how health literacy affects the strength of a relationship) are needed. Additionally, it has been recognized that systems-level health literacy efforts are necessary to lessen the burden of low health literacy. This dissertation addresses these needs within the rural, medically underserved southwest Virginia region.
Study 1 aimed to test the utility of two physical activity measures (Stanford Leisure-Time Activity Categorical Item and adapted Godin Leisure-Time Exercise Questionnaire) with a population of varying health literacy status with hopes of coming closer to identifying pragmatic standardized assessment of and detection of clinically meaningful change in physical activity behaviors, and to determine if health literacy moderated this change. Study 2 expanded upon existing research that has determined that a decrease in sugar-sweetened beverage intake can result in a decrease in weight and body mass index (BMI), and improvement in quality of life (QOL) by aiming to determine if six-month change in SSB intake predicted six-month change in BMI, weight, and QOL and if health literacy moderated these relationships. Study 3 responds to national and state-wide initiatives by detailing the first use of the AHRQ Toolkit within a public health setting, Virginia Department of Health, to conduct a needs assessment and organizational health literacy improvement plan.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/82867 |
| Date | 23 April 2018 |
| Creators | Kruzliakova, Natalie Anne |
| Contributors | Human Nutrition, Foods and Exercise, Zoellner, Jamie M., Harden, Samantha M., Hedrick, Valisa E., Frisard, Madlyn I. |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf, application/pdf, application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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