Patient Data Access News

What Consumer Characteristics Predict High Health Literacy?

Patients with more experience with the healthcare industry seem to have higher health literacy, research shows.

By Sara Heath

Patients who manage chronic illnesses, have more experience with the healthcare industry, and higher education levels tend to have higher health literacy, says a recent article in the Journal of Medical Internet Research.


Lead researcher Mary Zide, MLIS, PhD, along with her research team, sought to examine patterns in health literacy administering a crowd-sourced survey. The survey, which garnered 500 responses, specifically focused on patient health literacy with regard to managing lung cancer.

The survey showed that patients managing chronic illnesses tended to be more health literate and better understand healthcare terminology.

However, chronic illness status was not the only predictor of better health literacy. Characteristics such as education level, time spent online, income, smoking habit, sex, and patient portal use habits also predicted health literacy.

Characteristics such as time spent online and education level may have resulted in higher health literacy because of better general health knowledge, Zide and colleagues posited.

READ MORE: Internet Familiarity Tied to Patient Digital Health Literacy

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Interestingly, the research team also suggested that some of these characteristics may have overlapped to create patients with higher health literacy. The survey showed that patients with higher levels of educational attainment were also more likely to be managing a chronic illness.

A patient’s knowledge of their own illness, combined with their general knowledge produced by their education level, may have created a patient with higher health literacy.

“In our work, it may be that the higher performance we observed relates to higher levels of educational attainment, as those respondents reporting chronic illness in our survey more frequently had Associate, Bachelor’s, and Master’s degrees than those reporting no chronic illness (14.6% vs 12.9%, 39.8% vs 36.8%, and 9.7% vs 8.8% respectively),” Zide and colleagues said.

The researchers also focused on perceptions of patient portals, adding survey questions regarding patient satisfaction with the technology.

Patients with chronic illnesses tended to have better perceptions of patient portals, potentially because patients managing a chronic illness may spend more time using a portal, and therefore are more familiar with the technology.

Females were also more likely to view the patient portal more favorably, specifically with regard to usability. On a Likert scale question asking respondents to rate portals’ ease of use, females averaged a score of 5.32 out of ten versus males’ 4.97 out of ten.

This trend, too, could be credited to more frequent use of the patient portal.

“While use does not equal preference, positive ratings may be influenced by the higher use of portals we observed in this survey (19.7% of women had used a portal over ten times, compared to 14.3% of men), which is consistent with higher eHealth resource use observed in women,” Zide and the research team explained.

Although the survey showed that chronically ill patients viewed the portal better than their peers, it showed one significant commonality between the two: one third of patients are put off from patient portals due to security concerns.

Zide and colleagues noted that these security concerns may be a significant barrier to patient portal adoption because they directly affect patient satisfaction.

“Security has also been a concern,” the researchers said. “This common theme suggests that eHealth users may associate eHealth tools with a lack of security. This concern has the potential to impact portal use, as it would likely limit satisfaction and perceived usability and, thus, feasibility.”

Patient portal security concerns are a common issue, as the researchers noted. However, leading healthcare organizations have made efforts to ensure that these tools be secure.

The Office of the National Coordinator for Health Information Technology (ONC) has released information regarding the technical safeguards necessary for protecting patient portal data:

  • To make sure that your private health information is safe from unauthorized access, patient portals are hosted on a secure connection and accessed via an encrypted, password-protected logon.

  • EHRs also have an “audit trail” feature that keeps a record of who access your information, what changes were made, and when.

  • Although patient portals use safeguards, there are other safety tips you should follow when accessing the patient portal. Always remember to protect your username and password from others and make sure to only log on to the patient portal from a personal computer or secure computer.

The Department of Health and Human Services has also made clear HIPAA guidelines regarding patient portals. These guidelines spell out who and who is not allowed to access EHR-tethered health data.

Although HIPAA is a set of guidelines, rather than some sort of physical protector of health data, these provisions act as a legal standard that guides health data into the correct hands.

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