Health literacy plays a role in the way individuals find, understand and use health information, however, associations between health literacy and understanding of osteoporosis status are unknown. Previous research has reported poor agreement between self-reported osteoporosis and BMD results with or without fracture; health literacy is likely to influence this association.
We aimed to explore associations between health literacy and agreement between self-report and confirmed osteoporosis based upon BMD and/or combined BMD and fracture criteria in older women.
Data were collected for participants aged ≥50yr at the most recent follow-up of women enrolled in the Geelong Osteoporosis Study, a population-based cohort located in south-eastern Australia. BMD was measured by DXA (Lunar DPX-L). We defined osteoporosis as BMD T-score less than -2.5 at the hip and/or spine, or the combination of BMD in the osteopenic range (T-score -1 to -2.5) and any adult (aged ≥20yr) fracture. Health literacy was ascertained using the Health Literacy Questionnaire (HLQ), a multi-dimensional tool that generates scores across nine domains. In this sample, 426 participants had DXA results, self-reported diagnoses, fracture history, and HLQ scores. Effect sizes (ES) [95%CI] were calculated for differences in mean HLQ domain scores between participants who correctly vs. incorrectly self-reported osteoporosis.
Of the 426 participants (median age: 65.95 (IQR 58.5-74.1)), 114 (26.8%) incorrectly self-reported (105 had study defined osteoporosis but did not self-report, nine self-reported osteoporosis but did not meet study criteria for osteoporosis). Compared to participants who self-reported correctly, those who self-reported incorrectly had lower mean scores for two HLQ domains; ‘Ability to find good health information’ (ES -0.08 [-0.15, -0.01] p=0.029), and ‘Understanding health information’ (ES -0.08 [-0.17, 0.00] p=0.047). No differences in mean scores were seen for remaining domains.
These data suggest that individuals who incorrectly self-report osteoporosis status may have difficulty finding and also understanding health information.