ABCs or 123s? The independent contributions of literacy and numeracy skills on health task performance among older adults.
OBJECTIVE
To investigate the relationship between literacy and numeracy and their association with health task performance.


METHODS
Older adults (n=304) completed commonly used measures of literacy and numeracy. Single factor literacy and numeracy scores were calculated and used to predict performance on an established set of health self-management tasks, including: (i) responding to spoken information; (ii) comprehension of print and (iii) multimedia information; and (iv) organizing and dosing medication. Total and sub-scale scores were calculated.


RESULTS
Literacy and numeracy measures were highly correlated (rs=0.68; ps<0.001). In multivariable models adjusted for age, gender, race, education, and comorbidity, lower literacy (β=0.44, p<0.001) and numeracy (β=0.44, p<0.001) were independently associated with worse overall task performance and all sub-scales (literacy range, β=0.23-0.45, ps<0.001; numeracy range, β=0.31-0.41, ps<0.001). Multivariable analyses with both constructs entered explained more variance in overall health task performance compared with separate literacy and numeracy models (8.2% and 10% respectively, ps<0.001).


CONCLUSION
Literacy and numeracy were highly correlated, but independent predictors of health task performance. These skill sets are complementary and both are important for health self-management.


PRACTICE IMPLICATIONS
Self-management interventions may be more effective if they consider both literacy and numeracy skills rather than focusing on one specific ability.
['Smith|Samuel G|SG|', 'Curtis|Laura M|LM|', "O'Conor|Rachel|R|", 'Federman|Alex D|AD|', 'Wolf|Michael S|MS|']
D000368:Aged D032882:Comprehension D003430:Cross-Sectional Studies D003657:Decision Making D005260:Female D015438:Health Behavior D058015:Health Communication D007722:Health Knowledge, Attitudes, Practice D057220:Health Literacy D006801:Humans D007407:Interviews as Topic D008297:Male D008433:Mathematics D008875:Middle Aged D015999:Multivariate Analysis D010353:Patient Education as Topic D012648:Self Care D011795:Surveys and Questionnaires D013647:Task Performance and Analysis
Numeracy Health communication Health literacy Patient education