ArticleMayo Clinic proceedings2018
Health Literacy and 1-Year Mortality: Mechanisms of Association in Adults Hospitalized for Cardiovascular Disease.
Article in Mayo Clinic proceedings, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Optimization of the multimorbidity management model for older adults: a study on the mediating effect of health literacy on self-efficacy and health status.BMC geriatrics · 2026Article
- Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Article
- Association of Social Determinants of Health With Hospital Readmission and Mortality: A Prospective Cohort Study.Health literacy research and practice · 2024Article
- Health literacy in patients participating in cardiac rehabilitation: A prospective cohort study with pre-post-test design.International journal of cardiology. Cardiovascular risk and prevention · 2024Article
- Patient-reported predictors of postdischarge mortality after cardiac hospitalization.Journal of hospital medicine · 2024Article
- World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update.Global heart · 2024Article
- Monitoring a cohort of trainees: changes over time and associations between health literacy, health behaviour and health.Journal of occupational medicine and toxicology (London, England) · 2023Article
- Mediators, Moderators, and Covariates: Matching Analysis Approach for Improved Precision in Cognitive-Communication Rehabilitation Research.Journal of speech, language, and hearing research : JSLHR · 2022Article
- Health Care Professionals' Perspectives on Universal Screening of Social Determinants of Health: A Mixed-Methods Study.Population health management · 2022Article
- Article
- No Healthcare Utilization and Death.Journal of general internal medicine · 2022Article
- Differences in Social Hardships in Women and Men with Acute Myocardial Infarction: Impact on 30-Day Readmission.Women's health reports (New Rochelle, N.Y.) · 2022Article
- Health literacy interventions for secondary prevention of coronary artery disease: a scoping review.Open heart · 2022Article
- Insight into global research on health literacy and heart diseases: A bibliometric analysis.Frontiers in cardiovascular medicine · 2022Article
- How Does Health Literacy Modify Indicators of Health Behaviour and of Health? A Longitudinal Study with Trainees in North Germany.Healthcare (Basel, Switzerland) · 2021Article
- Teaching plain language to medical students: improving communication with disadvantaged patients.BMC medical education · 2021Article
- Association between health literacy and mortality: a systematic review and meta-analysis.Archives of public health = Archives belges de sante publique · 2021Review
- Health Literacy, Health Behavior and States of Health among Trainee Personnel in Northern Germany.Healthcare (Basel, Switzerland) · 2021Article
- Should We Implement Geographic or Patient-Reported Social Determinants of Health Measures In Cardiovascular Patients.Ethnicity & disease · 2021Article
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Funding
Abstract
objectiveTo test theorized patient-level mediators in the causal pathway between health literacy (HL) and 1-year mortality in adults with cardiovascular disease (CVD). PATIENTS AND
methodsA total of 3000 adults treated at Vanderbilt University Hospital from October 11, 2011, through December 18, 2015, for acute coronary syndrome or acute decompensated heart failure (ADHF) participated in the Vanderbilt Inpatient Cohort Study. Participants completed a bedside-administered survey and consented to health record review and longitudinal follow-up. Multivariable mediation models examined the direct and indirect effects of HL (a latent variable with 4 indicators) with 1-year mortality after discharge (dichotomous). Hypothesized mediators included social support, health competence, health behavior, comorbidity index, type of CVD diagnosis, and previous-year hospitalizations.
resultsOf the 2977 patients discharged from the hospital (60% male; mean age, 61 years; 83% non-Hispanic white, 37% admitted for ADHF), 17% to 23% had inadequate HL depending on the measure, and 10% (n=304) died within 1 year. The total effect of lower HL on 1-year mortality (adjusted odds ratio [AOR]=1.31; 95% CI, 1.01-1.69) was decomposed into an indirect effect (AOR=1.50; 95% CI, 1.35-1.67) via the mediators and a nonsignificant direct effect (AOR=0.87; 95% CI, 0.66-1.14). Each SD decrease in HL was associated with an absolute 3.2 percentage point increase in the probability of 1-year mortality via mediators admitted for ADHF, comorbidities, health behavior, health competence, and previous-year hospitalizations (listed by contribution to indirect effect).
conclusionPatient-level factors link low HL and mortality. Health competence and health behavior are modifiable mediators that could be targeted by interventions post hospitalization for CVD.
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