1. 4/6/2012
Link between health status, health literacy and
Internet use among rural low income mothers
Kimberly Greder, Ph.D., Associate Professor and Extension Specialist,
Department of Human Development & Family Studies
Iowa State University
Yoshie Sano, Ph.D., Assistant Professor, Department of Human
Development, Washington State University- Vancouver
Sheila Mammen, Ph.D. Associate Professor, Department of Resource
Economics, University of Massachusetts Amherst
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2. 4/6/2012
Health literacy
The capacity to obtain, process, and
understand basic health information and
services needed to make appropriate health
decisions (Ratzan & Parker 2000).
Health literacy Adult health status
• Years of formal schooling
• Health status
• Income/poverty level
• Age Health literacy
• Race/ethnicity
• Citizenship status
• Reading practices
• Civic behavior
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3. 4/6/2012
Who is most vulnerable for
low health literacy?
Racial/ethnic minorities
Rural residents
People with less than a high school education
People who are over the age of 65
Low Health literacy Worse Health
• Poorer health choices
• Riskier behaviors
• Higher mortality
• More hospitalizations
• Higher health costs
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4. 4/6/2012
Internet usage increases social capital by
facilitating communication with strong and weak
social ties, across distance and time.
While most U.S. residents like online sources of health information,
rural residents are less likely to report general Internet use or
health-related Internet use. Potential reasons: lower education
levels and less broadband access among rural residents
Conference theme:
Partnerships to Improve the
Health of the Nation
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5. 4/6/2012
Wave 1: 186 families
IA, MA, WA
http://ruralfamiliesspeak.org/
2% 2% 1% Hispanic/Latino
Non-Hispanic White
African American
Native American
Multi-Racial
41% 54%
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6. 4/6/2012
70
60
50
Number of mothers
40
30
20
10
0
8th grade or less Some high school High school/GED Technical training Some college College graduate
including AA and above
Marital Status
Single/Never married
Divorced/Widowed
18%
23% Married
Language of Interview
Living with Partner
11% English
Spanish
48%
47%
53%
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7. 4/6/2012
What is the relationship between mothers who speak
Spanish and mothers who speak English and their use of
the Internet to find health information for themselves or
their children?
What is the relationship between…
•mothers’ health status and use of
the Internet to find health information?
•children’s health status and use of
the Internet to find health information?
* Mothers who used the Internet for
Do you use the Internet to find information information about child’s health,
about your or your child’s health? rated child’s health status better .
70%
Spanish
60% English
50%
40%
30%
20%
10%
0%
For mother For child
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8. 4/6/2012
Where do you access the Internet most often?
70%
Spanish
60% English
50%
40%
30%
20%
10%
0%
Home Library Relative/Friend Work Other
50
45
40
35
Number of mothers
30
25 English
Spanish
20
15
10
5
0
Excellent Very Good Good Fair Poor
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9. 4/6/2012
35
30
25
Number of mothers
20
English
Spanish
15
10
5
0
Excellent Very good Good Fair
60
50
40
Number of mothers
Internet users
30
Non-internet
users
20
10
0
Excellent Very Good Good Fair Poor
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10. 4/6/2012
40
35
30
Internet users
Number of mothers
25
Non-internet
20 users
15
10
5
0
Excellent Very good Good Fair
How often do you need to have someone help you when you read
instructions, pamphlets, or other written materials from your doctor,
pharmacy, or insurance company?
80% Spanish
70% English
60%
50%
*Children’s health was significantly related to
40%
needing assistance in reading print materials
30%
20%
10%
0%
Never Sometimes Often
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11. 4/6/2012
• How can you apply these findings to your
work with rural, low-income families that
have young children?
• What are you currently doing that you should
continue to do?
• What could you do differently?
• What additional research is needed?
• Print remains relevant option for providing health information
• Hire/train bi-cultural, bi-lingual Latinos who understand
acculturation issues to design and deliver health education
• Educational programs available in Spanish - minimum, an
interpreter available
• Consent, program enrollment forms, promotional and program
materials reviewed or developed by people fluent in Spanish and
English and who have a good understanding of Latino culture,
acculturation issues, and principles/practices of effectively
translating written information.
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12. 4/6/2012
• Training needed to…
• recognize specific health literacy needs of ethnically/racially
diverse rural low income families
• help families navigate health service systems
• Review forms/written activities and office signage to ensure
information is understandable; ask families for feedback to improve
forms.
• Review information you prepare for the media (radio psa’s, news
articles) to ensure health literacy principles and practices are
followed.
• Bring stakeholders, including low income families, together to learn
how poor health literacy is detrimental to individual and population
health. Brainstorm potential do-able action steps for families and
the community.
• Explore rural low income mother’s preferences for receiving
health information
• Explore effectiveness of the structure and design of health
materials in prompting rural low income mothers to take
specific actions to maintain or improve their health.
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