The association of health literacy, social support, self-efficacy and interpersonal interactions with health care providers in low-income Latina mothers.

OBJECTIVE: We explored relationships between maternal health literacy (HL), communicative self-efficacy (SE), social support (SS) and maternal perception of interactions with health care providers (HCPs). METHODS: Using a cross-sectional, correlational design, we assessed sociodemographic characteristics, maternal HL, social support, communicative self-efficacy, and interpersonal interactions with HCPs among 124 low-income Latina mothers of young children. RESULTS: Informal SS significantly predicted maternal SE in interactions. SE predicted maternal perception of a HCP's ability to "elicit and respond to her concerns." DISCUSSION: Interventions to improve maternal self-efficacy in interacting with HCPs among low health literate Latina mothers may positively impact pediatric health outcomes.

Self-report adherence measures in chronic illness: retest reliability and predictive validity.

BACKGROUND: Patient self-report is a practical method for measuring adherence, but little is known about its optimal use. OBJECTIVES: To examine the retest reliability and predictive validity of 3 different types of self-report adherence measures among patients with common chronic illnesses. RESEARCH DESIGN: Correlation and regression analyses of data from an ongoing randomized controlled trial. SUBJECTS: Patients (N = 415) aged >or=40 years recruited from a primary care network with arthritis, asthma, chronic lung disease, congestive heart failure, depression, and/or diabetes mellitus, plus impairment in >or=1 basic activity and/or a score of >or=4 on the 10-item Center for Epidemiologic Studies Depression Scale. MEASURES: : Self-report adherence (administered variously at baseline, 2, 4, and 6 weeks, and 6 months): number of pills taken/number of pills prescribed (PT/PP), using 1-7 days recall, and global reports of medication adherence and overall adherence tendencies. Six-month functional outcomes: Health Assessment Questionnaire (HAQ) and Short Form-36 (SF-36). RESULTS: Correlation coefficients among contemporaneously administered 1-7 days PT/PP measures were >or=0.78. Correlations among PT/PP measures and global adherence measures, and among PT/PP measures at 2 and 4 weeks, ranged from 0.11 to 0.54. PT/PP measures using >or=3-4 days recall significantly predicted adjusted 6-month HAQ but not SF-36 score. CONCLUSIONS: Self-report PT/PP and general medication adherence measures tap different behavioral constructs. Self-reported PT/PP at a given point in time is not necessarily representative of medication adherence over time. Among chronically ill patients, 3-4 days recall of PT/PP yield adherence estimates, which are practically as reliable and valid as longer intervals and which predict functional outcomes.

Health literacy and interpersonal interactions as predictors of maternal perception of ambulatory care for low-income, Latino children.

OBJECTIVE: This study explores whether maternal HL (MHL) and maternal perception of health care provider (HCP) interpersonal interactions predict maternal perception of quality of pediatric ambulatory care received. METHODS: This cross-sectional study included 124 low-income Latina mothers of children 3 months to 4 years. Maternal HL, perception of maternal-HCP interpersonal interactions, and perception of pediatric ambulatory care were measured using well-validated surveys. RESULTS: In adjusted hierarchical regression models, HCP fail to speak clearly (ß=-.225, 95% CI -13.998, -1.960, p=.01) and explain results (ß=.344, 95% CI 3.480, 13.010, p=.001) predicted perception of quality of developmental guidance received. Explaining results (ß=.422, 95% CI 5.700, 14.089, p=<.001), working out treatment together (ß=.441, 95% CI 6.657, 13.624, p<.001) and MHL (ß=-.301, 95% CI -7.161, -2.263, p<.001) predicted perception of family centeredness of care. CONCLUSIONS: Speaking with clarity, explaining results fully and working with the mother to determine a child's plan of care is most predictive of whether she feels her child is receiving high quality pediatric ambulatory care services. PRACTICE IMPLICATIONS: Interventions that target mother and provider interaction may improve perception of care.