Patient-provider interactions: a missing piece of health literacy and effective use of the health care system

Increasing the health literacy of the nation has become a national priority for major health care agencies in attempt to improve effective use of the health care system and overall health outcomes. The present study sought to explore the impact of patient-provider interactions on health literacy and the effect of demographic characteristics on both health literacy and perceptions of patient-provider interactions. Perceptions of patient-provider interactions were evaluated via four communicative dimensions: understanding and communicative ability, respect and trust, participatory decision making, and receptionist helpfulness. A closed-ended questionnaire was administered orally to 82 participants to gather their perceptions of interactions with health care providers, assess their health literacy, and record various demographic characteristics. Results indicated that those with perceptions of better quality interactions with health care providers had higher average health literacy scores. There were statistically significant differences in health literacy between those reporting high and low levels of each communicative dimension, with the exception of the receptionist helpfulness variable for which no significant differences were found. The oldest age groups reported significantly more understanding, communicative ability, respect, and trust with health care providers than the younger age group. Annual household income also had an effect on perceptions of understanding and communicative ability, with those in lower income groups reporting less understanding and communicative ability. The present findings support past literature that found higher health literacy to be associated with more educational achievement. Contrary to past research, the oldest age group had a significantly higher average health literacy score than the younger age group and those identifying as black/African American had the highest average health literacy score. Based on the findings of the current study, health care providers may want to increase their focus on facilitating quality interactions and effective communication with patients in order to improve health literacy, care adherence, and outcomes. The results that suggest a possible change in the demographic characteristics that make people at-risk for low health literacy provide a rationale for health care providers to use a universal health literacy approach. This approach seeks to provide easy-to-understand explanations and medical resources to all patients without any assumptions of low or high health literacy. Overall, the current study suggests the importance of patient-provider interactions as part of the complex system impacting health literacy