Health Literacy: Assessing the “Health Literacy Assessment Using Talking Touchscreen Technology” Survey in HIV Participants

Purpose: Health literacy is “the ability to obtain, process, and understand health information needed to make informed health decisions”. Limited health literacy is related to poorer health and outcomes due to deficiencies in understanding basic health information. To address literacy needs, a baseline assessment is needed. The purpose of the survey is to assess the health literacy level of HIV patients in North Texas using a validated, online tool that can be used even in resource limited environments. Methods: Participants at 4 distinct urban locations (an HIV specialty clinic, pharmacy, housing unit, and peer support group) gave verbal consent to complete the anonymous, online, audio-driven, validated “Health Literacy Assessment Using Talking Touchscreen Technology” (Health LiTT) survey. Questions assess ability to recall disease and medication understanding, read prescription labels and recall information after a simulated physician consultation. Results: A total of 78 participants completed the survey (approx. 80% response rate). The average respondent was male (73%), non-White (28%), 43 years old (+/- 3.2 yr), completed high school (90%) and resided in an urban setting (93%). In interpretation of prescription labels, respondents performed better when figures were presented, with 94% (Take With Food) and 69% (Take With Water) correctly selected when prompted whereas questions on actions to take regarding label directions without images provided only 19% (Take on empty stomach) answered correctly. In disease state knowledge comprehension, 90% of respondents correctly understood both why medications were being used and consequences of incorrect administration. While 63% were able to correctly recall how the drug worked and less than half of respondents could recall the likelihood of side effects (44%) after a simulated physician counseling session. Conclusions: Respondents performed better regarding general medication knowledge and following directions when images were provided, but performed worse when recalling specific drug information based on a pre-recorded simulation. HealthLiTT may improve patient education efforts by facilitating targeting of patient specific knowledge gaps in resource limited settings.