Trial reportJournal of general internal medicine2013
Low literacy is associated with increased risk of hospitalization and death among individuals with heart failure.
Trial report in Journal of general internal medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05928026 (Financial Support in an Underserved and Low-Income Population With Heart Failure), which is not on this map. Cited by 61 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Financial Support in an Underserved and Low-Income Population With Heart Failure
Who cites it
61 citing papers in PubMed, 3 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- Health Literacy and Outcomes Among Patients With Heart Failure: A Systematic Review and Meta-Analysis.JACC. Heart failure · 2020Pooled it
- The impact of health literacy in the care of surgical patients: a qualitative systematic review.BMC surgery · 2015Pooled it
- Health Literacy and Heart Failure: A Systematic Review.The Journal of cardiovascular nursingPooled it
- [Protocolo para la evaluación de una intervención de alfabetización en salud sobre morbimortalidad y calidad de vida en pacientes con insuficiencia cardíaca.]Revista espanola de salud publica · 2023Trial
- Design and Rationale of a Randomized Trial of a Care Transition Strategy in Patients With Acute Heart Failure Discharged From the Emergency Department: GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure).Circulation. Heart failure · 2017Trial
- Health Literacy Mediates the Relationship Between Age and Health Outcomes in Patients With Heart Failure.Circulation. Heart failure · 2016Trial
- Health Literacy Predicts Morbidity and Mortality in Rural Patients With Heart Failure.Journal of cardiac failure · 2015Trial
- Health Literacy and Outcomes of a Community-Based Self-Help Intervention: A Case of Korean Americans With Type 2 Diabetes.Nursing researchTrial
- A multi-component, family-focused and literacy-sensitive intervention to improve medication adherence in patients with heart failure-A randomized controlled trial.Heart & lung : the journal of critical careTrial
- The Association Between Family Health and Proactive Health Risk Management With the Mediating Role of Health Literacy: Nationwide Cross-Sectional Study.JMIR public health and surveillance · 2026Article
- Experiences and Needs Regarding Information Provision in Children With Haemophilia: A Qualitative Study on Caregivers' and Healthcare Providers' Perspectives.Haemophilia : the official journal of the World Federation of Hemophilia · 2025Article
- Validity and reliability of Health Literacy for School-Aged Children (HLSAC) scale to understand the health literacy among adolescents in Bangladesh: An observational study.BMC public health · 2025Observational
- Exploring the Health Literacy Behavior Patterns of Male Patients Using an Interpretable Method.Risk management and healthcare policy · 2024Article
- Cost-utility analysis of valsartan, enalapril, and candesartan in patients with heart failure in Iran.Health economics review · 2023Article
- The Most Popular YouTube Videos About Shoulder Replacement Are of Poor Quality for Patient Education.Arthroscopy, sports medicine, and rehabilitation · 2023Article
- Evaluation of Health Literacy Levels and Associated Factors Among Patients with Acute Coronary Syndrome and Heart Failure in Qatar.Patient preference and adherence · 2023Article
- Changes in the health literacy of residents aged 15-69 years in central China: A three-round cross-sectional study.Frontiers in public health · 2023Article
- Health literacy in gastrointestinal diseases: a comparative analysis between patients with liver cirrhosis, inflammatory bowel disease and gastrointestinal cancer.Scientific reports · 2022Article
- Prognostic implications of a one-item health literacy screen on health status outcomes among heart failure patients with depression.American heart journal plus : cardiology research and practice · 2022Article
- Trends in Uptake and Adherence to Oral Anticoagulation for Patients With Incident Atrial Fibrillation at High Stroke Risk Across Health Care Settings.Journal of the American Heart Association · 2022Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundLow literacy increases the risk for many adverse health outcomes, but the relationship between literacy and adverse outcomes in heart failure (HF) has not been well studied.
methodsWe studied a cohort of ambulatory patients with symptomatic HF (NYHA Class II-IV within the past 6 months) who were enrolled in a randomized controlled trial of self-care training recruited from internal medicine and cardiology clinics at four academic medical centers in the US. The primary outcome was combined all-cause hospitalization or death, with a secondary outcome of hospitalization for HF. Outcomes were assessed through blinded interviews and subsequent chart reviews, with adjudication of cause by a panel of masked assessors. Literacy was measured using the short Test of Functional Health Literacy in Adults. We used negative binomial regression to examine whether the incidence of the primary and secondary outcomes differed according to literacy.
resultsOf the 595 study participants, 37 % had low literacy. Mean age was 61, 31 % were NYHA class III/IV at baseline, 16 % were Latino, and 38 % were African-American. Those with low literacy were older, had a higher NYHA class, and were more likely to be Latino (all p < 0.001). Adjusting for site only, participants with low literacy had an incidence rate ratio (IRR) of 1.39 (95 % CI: 0.99, 1.94) for all-cause hospitalization or death and 1.36 (1.11, 1.66) for HF-related hospitalization. After adjusting for demographic, clinical, and self-management factors, the IRRs were 1.31 (1.06, 1.63) for all-cause hospitalization and death and 1.46 (1.20, 1.78) for HF-related hospitalization.
conclusionsLow literacy increased the risk of hospitalization for ambulatory patients with heart failure. Interventions designed to mitigate literacy-related disparities in outcomes are warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.