Association Between Health Literacy and Perceived Confidence for Communicating with Physicians Among African-American Men

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Background: Patient involvement during medical consultations helps improve patient readiness for informed decision making. Research suggests that factors such as health literacy affect patient’s confidence to interact with physicians. The purpose of this pilot project was to investigate the relationship between health literacy status and perceived confidence to discuss prostate cancer issues with physicians among a sample of African-American men.

Methods: Forty‐nine men ages 35 and above were recruited to participate using a purposive sampling scheme. All participants completed a 30‐45 minute interviewer‐administered survey that allowed for the collection of: (1) demographic information, (2) information about health literacy, and (3) information regarding perceived confidence in interacting with physicians. Perceived confidence was assessed using the short version of the Perceived Efficacy in Patient‐Physician Interactions (PEPPI‐5) scale (α=.81). Health literacy status was measured using the Test of Functional Health Literacy in Adults (TOFHLA), which allowed men to be classified into a Low Functional Health Literacy (LFHL), Marginal Functional Health Literacy (MFHL) or Adequate Functional Health Literacy (AFHL) group.

Results: Participants were between the ages of 37 and 91 years of age (μ=59.34 years). Most were married (74%), had private insurance (58%) and had a high‐school diploma or greater (79.6%). According to TOFHLA scores, 20.4% of the sample was classified as having LFHL,18.4% had MFHL and 61.2% had AFHL. Results from Analysis of Variance (ANOVA) indicated there were no statistically significant differences in mean levels of perceived confidence by health literacy status (F2,46 = 1.393; p = .259). However, when examining health literacy status by individual situations listed in the PEPPI‐5, results indicated there were two specific situations in which having LFHL affected men’s confidence in their ability to communicate with physicians.

Conclusions: Results from this pilot project suggest that interventions are needed for African-American men with low health literacy to help them gain confidence in their ability to get a doctor to answer all of their questions and their ability to get a doctor to do something about their chief health concern.


University of Alabama at Birmingham (UAB) Annual Health Disparities Research Symposium


Birmingham, AL