Clark D.1, Lein Jr D.H.1, Snyder S.2
1The University of Alabama at Birmingham, Physical Therapy, Birmingham, United States, 2The University of Alabama at Birmingham, School of Education, Birmingham, United States
Background: Individuals with limited health literacy skills are more likely to report having poor health, experience poorer health outcomes and incur higher healthcare costs than individuals with adequate health literacy skills. Older adults are particularly vulnerable as many read at or below a 5th grade level and may experience cognitive, visual or other impairments that further limit their ability to meaningfully use health information. A growing awareness that healthcare professionals' skills in management of health literacy issues are as critical individuals' abilities has led to an increased focus on research regarding provider competency.
Purpose: The purpose of this study was to describe physical therapists' (PTs) and physical therapist assistants' (PTAs) knowledge of health literacy, and perceived benefits and barriers to assessing individuals' understanding of and ability to follow instructions, a primary intervention used by physical therapy professionals to manage movement dysfunction. A secondary aim was to compare differences in health literacy knowledge between PTs and PTAs.
Methods: The nominal group technique (NGT) was used with six separate groups of PTs and PTAs (n = 42) to describe perceived benefits and barriers to the assessment of individuals understanding of and ability to follow instruction. Each participant completed a questionnaire to assess health literacy knowledge. Descriptive statistics were obtained and mean scores compared between PTs and PTAs.
Results: Physical therapy professionals performed poorly on the knowledge questionnaire with PTAs scoring significantly lower than PTs in all areas. Improved patient safety, satisfaction, adherence and outcomes were most frequently cited as benefits to assessing individuals understanding of and ability to follow instruction. Major perceived barriers as to why physical therapy professionals did not consistently assess individuals understanding of and ability to follow instruction were time constraints and assumptions that patients understood instructions when given during a visit or that a colleague would check for individuals understanding of physical therapy instructions at a subsequent visit. No group identified knowledge as a barrier. Overall, the investigators categorized 17 perceived barriers and 15 perceived benefits associated with physical therapy professionals assessment of individuals understanding of and ability to follow instruction.
Conclusion(s): Health care reform efforts to lower costs and improve care have targeted health literacy as an area in which healthcare professionals will need to demonstrate competency. Improved understanding of physical therapy professionals knowledge of and perceived barriers and beliefs in the use of best practices in health literacy may lead to the development of interventions that improve our skills. Physical therapy educational programs should be at the forefront in addressing this challenge.
Implications: Increasing awareness among of physical therapy professionals of the importance of using best practices in health literacy is essential to improving outcomes. Continuing education related to the use of best practices in health literacy may further enhance physical therapy professionals knowledge and skills.
Funding acknowledgements: A Faculty Development Grant and matching funds from the UAB Department of Physical Therapy supported this project.
Topic: Professional issues
Ethics approval: This project was approved by the Institutional Review Board at The University of Alabama at Birmingham.
All authors, affiliations and abstracts have been published as submitted.
