Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai‘i
Abstract
:1. Introduction
1.1. Health Literacy and Health Disparities among People with Serious Mental Illness
1.2. Individual and Social Factors Associated with Health Literacy
1.3. Clubhouses: Socially-Oriented Community Mental Health Centers
1.4. The Present Study
2. Materials and Methods
2.1. Overview
2.2. Sample and Procedures
2.3. Measures
2.3.1. Demographics
2.3.2. Self-Efficacy
2.3.3. Stigma
2.3.4. Health Literacy
2.3.5. Social Networks/Health Discussion Partners
2.3.6. Mental and Physical Health
2.4. Data Analysis
3. Results
3.1. Participant Demographic Characteristics and Average Health Literacy
3.2. Social Network Characteristics and Average Health Literacy
3.3. Health Literacy Associations with Individual and Social Factors
Health Literacy and Staff Health Discussion Partner Social Network Visualizations
4. Discussion
4.1. Associations with Health Literacy Defined by Confidence Filling out Medical Forms
4.2. Associations with Health Literacy Defined by Needing Assistance Reading Pamphlets or Other Written Materials
4.3. Limitations and Opportunities for Future Research
4.4. Potential Utility of This Work
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Needs Help Reading Instructions or Pamphlets | Confidence Filling Out Medical Forms Independently | ||||
---|---|---|---|---|---|
Total (n = 163) | Low Literacy (n = 67) | Adequate Literacy (n = 96) | Low Literacy (n = 91) | Adequate Literacy (n = 72) | |
Avg (SD) | Avg (SD) | Avg (SD) | Avg (SD) | Avg (SD) | |
Age | 51.52 (12.52) | 52.01 (13.85) | 51.18 (11.56) | 53.26 (12.26) | 49.32 (12.58) |
Gender | n (%) | n (%) | n (%) | n (%) | n (%) |
Male | 83 (50.92%) | 34 (50.75%) | 49 (51.04%) | 52 (57.14%) | 31 (43.06%) |
Female | 76 (46.63%) | 31 (46.27%) | 45 (46.88%) | 36 (39.56%) | 40 (55.56%) |
Non-Binary | 1 (0.61%) | 1 (1.49%) | 0 (0.00%) | 1 (1.10%) | 0 (0.00%) |
Missing or Preferred not to Answer | 3 (1.84%) | 1 (1.49%) | 2 (2.08%) | 2 (2.20%) | 1 (1.39%) |
Race/Ethnicity * | n (%) | n (%) | n (%) | n (%) | n (%) |
Native Hawaiian or Pacific Islander | 54 (33.13%) | 20 (29.85%) | 34 (35.42%) | 31 (34.07%) | 23 (31.94%) |
Filipino | 43 (26.38%) | 21 (31.34%) | 22 (22.92%) | 27 (29.67%) | 16 (22.22%) |
Japanese | 34 (20.86%) | 14 (20.90%) | 20 (20.83%) | 18 (19.78%) | 16 (22.22%) |
Chinese | 33 (20.25%) | 16 (23.88%) | 17 (17.71%) | 20 (21.98%) | 13 (18.06%) |
White ** | 22 (13.50%) | 7 (10.45%) | 15 (15.63%) | 12 (13.19%) | 10 (13.89%) |
Other | 24 (14.72%) | 9 (13.43%) | 15 (15.63%) | 13 (14.29%) | 11 (15.28%) |
Missing or Preferred not to Answer | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) |
Education | n (%) | n (%) | n (%) | n (%) | n (%) |
Did not complete high school or GED | 22 (13.50%) | 14 (20.90%) | 8 (8.33%) | 13 (14.29%) | 9 (12.50%) |
Completed high school or obtained GED | 141 (86.50%) | 53 (79.10%) | 88 (91.67%) | 78 (85.71%) | 63 (87.50%) |
Missing or Preferred not to Answer | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) |
Avg (SD) | Avg (SD) | Avg (SD) | Avg (SD) | Avg (SD) | |
Stigma | 54.51 (8.99) | 56.38 (9.32) | 53.20 (8.55) | 54.68 (7.75) | 54.28 (10.39) |
Self-Efficacy | 44.51 (12.37) | 42.51 (12.73) | 45.90 (11.99) | 41.54 (12.06) | 48.27 (11.81) |
Number of Physically Unhealthy Days in Past Month | 7.29 (9.84) | 8.61 (10.53) | 6.38 (9.27) | 7.46 (9.84) | 7.08 (9.91) |
Number of Mentally Unhealthy Days in Past Month | 8.06 (10.33) | 11.06 (11.02) | 5.96 (9.31) | 8.82 (10.23) | 7.08 (10.44) |
Needs Help Reading Instructions or Pamphlets | Confidence Filling Out Medical Forms Independently | ||||
---|---|---|---|---|---|
Total (n = 163) | Low Literacy (n = 67) | Adequate Literacy (n = 96) | Low Literacy (n = 91) | Adequate Literacy (n = 72) | |
Mean Count (Range) | Mean Count (Range) | Mean Count (Range) | Mean Count (Range) | Mean Count (Range) | |
Staff Network Mean Size (Range) | 2.20 (0–9) | 1.78 (0–8) | 2.50 (0–9) | 2.16 (0–9) | 2.25 (0–9) |
Member Network Mean Size (Range) | 0.94 (0–12) | 1.07 (0–12) | 0.85 (0–5) | 0.89 (0–12) | 1.01 (0–5) |
Outside Network Mean Size (Range) | 1.47 (0–12) | 1.45 (0–12) | 1.49 (0–7) | 1.48 (0–12) | 1.46 (0–7) |
Adequate Health Literacy | ||||
---|---|---|---|---|
Predictor Variables | Never or Rarely Needs Help Reading Instructions or Pamphlets | Quite a Bit or Extremely Confident Filling Out Medical Forms Independently | ||
OR | 95% CI | OR | 95% CI | |
Gender ** | ||||
Non-male | 1.53 | 0.71–3.27 | 2.34 * | 1.10–4.97 |
Male | ||||
Age | 0.99 | 0.96–1.02 | 0.97 * | 0.94–1.00 |
Race/Ethnicity | ||||
Native Hawaiian or Pacific Islander | 1.49 | 0.57–3.89 | 0.33 * | 0.12–0.88 |
Japanese | 1.13 | 0.46–2.76 | 1.17 | 0.48–2.80 |
Filipino | 0.70 | 0.31–1.58 | 0.55 | 0.24–1.29 |
Chinese | 0.62 | 0.25–1.59 | 0.88 | 0.35–2.23 |
Other | 1.23 | 0.37–4.06 | 0.64 | 0.24–2.39 |
White (non-multiracial) | ||||
Education | ||||
High School Diploma/GED | 3.74 * | 1.21–11.52 | 0.81 | 0.28–2.36 |
Did not complete high school/GED | ||||
Mental Health Not Good in Past 30 Days | 0.97 | 0.93–1.01 | 0.99 | 1.00–1.03 |
Physical Health Not Good in Past 30 Days | 0.99 | 0.95–1.03 | 1.00 | 0.96–1.04 |
Stigma | 0.97 | 0.93–1.02 | 1.01 | 0.96–1.05 |
Self-Efficacy | 1.01 | 0.97–1.04 | 1.07 * | 1.03–1.10 |
Size of Clubhouse Member Social Network | 0.78 | 0.61–1.02 | 1.00 | 0.78–1.28 |
Size of Clubhouse Staff Social Network | 1.42 * | 1.13–1.79 | 1.11 | 0.91–1.37 |
Size of Non-Clubhouse Social Network | 0.95 | 0.76–1.18 | 0.90 | 0.72–1.14 |
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Agner, J.; Meyer, M.; Kaukau, T.M.; Liu, M.; Nakamura, L.; Botero, A.; Sentell, T. Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai‘i. Int. J. Environ. Res. Public Health 2023, 20, 837. https://doi.org/10.3390/ijerph20010837
Agner J, Meyer M, Kaukau TM, Liu M, Nakamura L, Botero A, Sentell T. Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai‘i. International Journal of Environmental Research and Public Health. 2023; 20(1):837. https://doi.org/10.3390/ijerph20010837
Chicago/Turabian StyleAgner, Joy, Monet Meyer, Tyra Mahealani Kaukau, Maileen Liu, Lisa Nakamura, Adriana Botero, and Tetine Sentell. 2023. "Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai‘i" International Journal of Environmental Research and Public Health 20, no. 1: 837. https://doi.org/10.3390/ijerph20010837