Pilot for Identifying the Relationship between Depression and Anxiety to Health Literacy within the Primary Care Population (Spotlight Poster)

Purpose: The purpose of this cross-sectional correlational pilot was to determine the relationship between depression and/or anxiety to health literacy within the primary care population.

Background/significance: Little is known about the impacts mental health has on health literacy. Previous studies researched health literacy and its relationship to depression from the perspective of aggregated and disaggregated racial/ethnic groups or looked at the relationship between parental health literacy and depression to the risk of injury for children. However, there is a lack of understanding related to the relationship between anxiety and depression to health literacy.

Method(s): Manual chart reviews were conducted to identify patients who qualified for the study. The patients who met the inclusion criteria of 18-99 years old, English speaking, patient health questionnaire (PHQ-9) greater than 3, geriatric depression scale (GDS) greater than 5, diagnosis or follow-up visit with office since January 2022 with the ability to return to the clinic were identified. Patients were outreached through the electronic medical record requesting participation in the study. If interested, patients were scheduled to meet with the principle investigator (PI). The PI obtained consent from the participant, and then the participant completed the following questionnaires: PHQ-9 (or GDS), general anxiety disorder (GAD-7), and health literacy skills instrument short form (HLSI-SF).

Result(s): A total of 93 individuals were qualified for the study. 23 individuals indicated they were interested in completing the study and nine were able to complete the study. Three individuals tested for adequate health literacy, and six had inadequate health literacy. One individual tested with adequate health literacy and completed the study within the estimated amount of time of 20 minutes. The average amount of time to complete the study was 29.5 minutes, with a range of 17-80 minutes. As depression increased in severity, health literacy decreased. As anxiety increased in severity, health literacy decreased.

Conclusions/implications: There is a correlation that as depression and anxiety increase, health literacy decreases. Two-thirds of the individuals that had adequate health literacy did not complete the study in the estimated amount of time. The average amount of time for a primary care appointment is 20 minutes. However, this study indicates that patients with mental health concerns require extended time to understand and navigate the healthcare system. Increasing awareness of a patient's health literacy needs may impact compliance rates for patients. Having a better understanding of the risk factors (comorbidities and demographics) attributing to high depression/anxiety scores and low health literacy may help staff better identify potential patients at higher risk for depression/anxiety and health literacy.