Title: Tipping the scales: the effect of literacy on obese patients' knowledge and readiness to lose weight
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Objectives: The purpose of this study was to determine the association between the literacy level of overweight/obese patients and their weight-loss knowledge, attitudes, and readiness. Methods: Structured patient interviews and a literacy screening instrument were administered in two primary care clinics at a university-based public hospital. Results: A convenience sample of 210 overweight or obese adult outpatients (body mass index [greater than or equal to]25 kg/[m.sup.2] or [greater than or equal to]30 kg/[m.sup.2], respectively) were enrolled. Mean respondent age was 52 years; 74% were female, and 76% were black. Two thirds of patients read below a 9th grade level. Half of patients across all literacy levels reported currently attempting weight loss. There was a significant relation between literacy level and weight-loss knowledge, attitudes, and readiness (P Conclusions: Patients with low literacy were significantly less likely to understand the adverse health consequences of obesity and the need to lose weight and to report being ready to lose weight. Patient education and counseling for weight loss should be tailored for patients with low literacy skills. Key Words: health literacy, literacy, obesity, public hospital, weight loss ********** The incidence of obesity has increased dramatically in the United States; almost two thirds of adults (58 to 64%) are now overweight or obese. (1,2) Rates of obesity are highest for vulnerable populations, for example, those with low literacy, low incomes, minorities, the elderly, and the uninsured. (2) Nationally, there is a higher prevalence of obesity in southern states, particularly among patients cared for in public hospitals. (3) These patients often have low literacy, which may affect their understanding of the health consequences of obesity and appropriate weight loss strategies. Low literacy is an underrecognized problem in the United States that has been associated with poor health and poor health outcomes. (4-7) According to the National Adult Literacy Survey, 23% of US adults have low literacy skills. (4) Low-income individuals, minorities, the elderly, and those with chronic illness--populations similar to those with high rates of obesity--are disproportionately hindered by literacy barriers. Despite growing information on the magnitude and consequences of both obesity and low literacy, (2,5,8-10) very little is known about the relation between literacy and weight loss knowledge and attitudes. The purpose of this study was to examine the association between literacy and weight loss knowledge, attitudes, readiness, and experience of obese patients in public hospitals. Materials and Methods The study took place in 2002 in two primary care clinics at Louisiana State University Health Science Center-Shreveport. After their physician visit, overweight and obese patients (body mass index [BMI] [greater than or equal to]25 kg/[m.sup.2] or [greater than or equal to]30 kg/[m.sup.2], respectively) were approached for enrollment in the study. Patients with English as a second language were excluded. Height, weight, sociodemographic factors (sex, race, age, insurance, employment status) and obesity-related diagnoses were abstracted from patient charts. A trained research assistant interviewed participants privately, using a structured questionnaire developed by the authors and pilot tested for patient understanding in a low-literate population. The interview included...
Source Citation (MLA 8 th Edition)
Kennen, Estela M., et al. "Tipping the scales: the effect of literacy on obese patients' knowledge and readiness to lose weight." Southern Medical Journal, Jan. 2005, p. 15+. Academic OneFile, Accessed 16 Nov. 2018.

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