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Grant Details

Grant Number: 5R01CA128455-04 Interpret this number
Primary Investigator: Shaw, Susan
Organization: University Of Arizona
Project Title: The Impact of Cultural Differences on Health Literacy & Chronic Disease Outcomes
Fiscal Year: 2009


DESCRIPTION (provided by applicant): Health literacy, defined as the ability to understand or act on medical/therapeutic instructions, is increasingly recognized as an important factor in patient compliance and chronic disease outcomes. Health care providers are beginning to assess patient education and other materials from the perspective of readability and patient literacy. Less work has been done, however, to place health literacy in the broader context of socioeconomic and cultural differences among patients and between providers and patients that hinder communication and compliance. The proposed project aims to broaden our understanding of health literacy by identifying and accounting for the cultural factors that shape health literacy in low-income, ethnic minority and immigrant populations. To better understand the cultural influences on low health literacy and the effects of health literacy on health, the proposed project combines qualitative and quantitative methods to meet the following specific aims: 1. To assess variation in health literacy among native and non-native English speakers; 2. To identify factors associated with health literacy, including a) language spoken at home, b) recency of immigration, c) sources of health information, and d) other cultural beliefs and practices; 3. To use a prospective multimethod research design to explore the impact of health literacy on chronic disease outcomes (e.g., asthma, diabetes, and hypertension), including: a. the association between health literacy and patient compliance with therapeutic regimens, and b. the role of health literacy in patient-provider communication; 4. To identify effective ways to combine qualitative and quantitative research methods to further knowledge of health literacy; and 5. To develop recommendations for primary health care providers on chronic disease management for ethnically diverse patients with low health literacy. To achieve these aims, we propose to conduct epidemiological surveys with a targeted sample of 500 patients from 5 ethnic groups (100 per group) recruited from Caring Health Center, a Section 330 health center in western Massachusetts. Chart abstracts will collect chronic disease outcomes at baseline and two 12-month follow-ups. Focus groups, ethnographic interviews, chronic disease diaries and home observations with a subsample of patients will provide greater contextualization and detail, aiding in survey development and the interpretation of survey findings.


The pharmaceutical regulation of chronic disease among the U.S. urban poor: an ethnographic study of accountability.
Authors: Shaw S.J. .
Source: Critical public health, 2018; 28(2), p. 165-176.
EPub date: 2017-05-29.
PMID: 31571734
Related Citations

Breast self-examination beliefs and practices, ethnicity, and health literacy: Implications for health education to reduce disparities.
Authors: Armin J. , Torres C.H. , Vivian J. , Vergara C. , Shaw S.J. .
Source: Health education journal, 2014 May; 73(3), p. 274-284.
PMID: 25284844
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Diet and exercise adherence and practices among medically underserved patients with chronic disease: variation across four ethnic groups.
Authors: Orzech K.M. , Vivian J. , Huebner Torres C. , Armin J. , Shaw S.J. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2013 Feb; 40(1), p. 56-66.
EPub date: 2012-04-13.
PMID: 22505574
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Consistency in attitudes across cancer screenings in medically underserved minority populations.
Authors: Shaw S.J. , Vivian J. , Orzech K.M. , Torres C.H. , Armin J. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2012 Mar; 27(1), p. 165-71.
PMID: 22105657
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Chronic disease self-management and health literacy in four ethnic groups.
Authors: Shaw S.J. , Armin J. , Torres C.H. , Orzech K.M. , Vivian J. .
Source: Journal of health communication, 2012; 17 Suppl 3(0 3), p. 67-81.
PMID: 23030562
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The role of culture in health literacy and chronic disease screening and management.
Authors: Shaw S.J. , Huebner C. , Armin J. , Orzech K. , Vivian J. .
Source: Journal of immigrant and minority health, 2009 Dec; 11(6), p. 460-7.
PMID: 18379877
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