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Prevalence and Risk Factors of Limited Musculoskeletal Health Literacy in the Outpatient Setting: A Logistic Regression Model

Noback, Peter C. BA; Seetharaman, Mani MD; Tantigate, Direk MD; Strauch, Robert J. MD; Rosenwasser, Melvin P. MD; Vosseller, J. Turner MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: May 15, 2019 - Volume 27 - Issue 10 - p e491-e498
doi: 10.5435/JAAOS-D-17-00712
Research Article

Introduction: The purpose of this study was to determine the risk factors of limited musculoskeletal health literacy (MHL) in a general population of orthopaedic patients.

Methods: Patients presenting to either a foot or ankle surgeon or hand or wrist surgeon were given the Literacy in Musculoskeletal Problems (LiMP) questionnaire, a nine-item survey for assessing “limited” MHL (LiMP score < 6). After confirming group homogeneity, the two populations were analyzed together to determine factors significantly correlated with and predictive of limited MHL.

Results: Overall, 231 patients were included in the analysis. Average LiMP score was 5.4 ± 1.8, and 49% of participants had “limited” MHL. Chi-square analysis revealed that being non-Caucasian, using cigarettes, and having a less than college-level education were associated with a higher prevalence of “limited” MHL (P < 0.05). Logistic regression revealed that being of non-Caucasian race (P = 0.04) or having less than college-level education (P = 0.03) were significant independent predictors of “limited” MHL, with adjusted relative risks of 1.37 and 1.40, respectively.

Discussion: In this study, the patients at the greatest risk of limited MHL are often at the risk of many other complications. These results should be used as a groundwork to craft directives aimed at improving MHL and outcomes in these patients.

From the Department of Orthopaedic Surgery, Trauma Training Center, Columbia University Medical Center, New York, NY.

Correspondence to Dr. Vosseller: ttc@columbia.edu

Dr. Strauch or an immediate family member serves as a board member, owner, officer, or committee member of the American Society for Surgery of the Hand. Dr. Rosenwasser or an immediate family member has received royalties from Newclip Technics, serves as a paid consultant to Acumed and Stryker, and has stock or stock options held in CoNexions and Radicle Orthopedics. Dr. Vosseller or an immediate family member has received royalties from Newclip Technics; serves as a paid consultant to DJO Global; and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Foot and Ankle Society. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Mr. Noback, Dr. Seetharaman, and Dr. Tantigate.

Copyright 2018 by the American Academy of Orthopaedic Surgeons.
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