Caregiver Health Literacy Predicting Healthcare Communication and System Navigation Difficulty

Introduction: The role of caregiver health literacy in predicting difficulty communicating with health care professionals and navigating services and supports for older adults was examined and informed by the health literacy skills framework (Squiers, Peinade, Berkman, Boudewyns, & McCormack, 2012). Method: Secondary analyses of cross-sectional data from the Pittsburgh Regional Caregivers Survey in 2017 were conducted. A total of 761 caregivers of older adults reported communicating with health care providers and accessing services and supports. Health care provider communication and navigation of services and supports (HCNS) was assessed through self-report questions on communication about needs of the care recipient and caregiver, and the ability to locate and arrange services and supports for the care recipient. Health literacy was assessed with self-report questions on confidence filling out forms, need for help with reading information, and comprehension with written information. A logistic regression was conducted to determine the relationship between health literacy and high HCNS difficulty while controlling for demographic and contextual caregiving characteristics. Results: A fifth of the caregivers demonstrated low health literacy (n = 150, 19.7%). For a caregiver with low health literacy, the odds of having high levels of difficulty with HCNS was 2.52 times larger than the odds for a caregiver with adequate health literacy while controlling for demographic and contextual caregiving factors (odds ratio = 2.52, 95% confidence interval [1.57, 4.06]; p < .001). Discussion: Findings demonstrate that poor caregiver health literacy is an important factor associated with HCNS difficulty. The health literacy of caregivers should be considered for assessments and interventions designed to identify and reduce the difficulty caregivers experience with HCNS.