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Health Literacy in Women Presenting to a Urogynecology Practice

Sripad, Abhishek A., MD; Rupp, Betty M., MPH, BS; Gage, Jessica L., BA; Feliciano, Katherine M., BA; Willis-Gray, Marcella, MD; Wu, Jennifer M., MD, MPH

Female Pelvic Medicine & Reconstructive Surgery: November/December 2018 - Volume 24 - Issue 6 - p 435–439
doi: 10.1097/SPV.0000000000000494
Original Articles

Objective Health literacy (HL) is the degree to which an individual can obtain, process, and communicate basic health information to make appropriate health decisions. Understanding HL of patients can improve outcomes. Thus, we evaluated HL in women with pelvic floor disorders and investigated its relationship to patient demographics, reading level, and cognition.

Methods We conducted a cross-sectional study with a convenience sample of English-speaking women 18 years or older, recruited from female pelvic medicine and reconstructive surgery clinics from July 2016 to January 1, 2017. Patients with severe visual impairment or severe cognitive impairment were excluded. We used the reading comprehension passages of the short form of Test of Functional Health Literacy in Adults to assess HL, the reading subscale of the Wide Range Achievement Test 3 for reading level, and the Self-administered Gerocognitive Exam for cognition.

Results Among 196 participants, the mean age was 61.1 ± 13.3 years, 84.7% were white, and 54.1% were college educated. Most participants (95.4%) demonstrated adequate HL. Those with adequate HL were younger (60.5 ± 13.2 vs 71.8 ± 10.7, P = 0.01), had less cognitive impairment (12.5% vs 77.8%, P < 0.001), and more frequently had post–high school reading levels (70.1% vs 33.3%, P < 0.001).

Conclusions Overall HL in the pelvic floor disorder population is high, but older patients with cognitive impairment and lower reading levels are at risk of inadequate HL. Lowering reading levels of educational materials and screening for cognitive impairment may be beneficial to patient understanding and health outcomes.

From the Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Correspondence: Abhishek A. Sripad, MD, 3031 Old Clinic Bldg, CB#7570, Chapel Hill, NC 27599. E-mail:

The authors have declared they have no conflicts of interest.

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