Kontakt 2018, 20(4):e319-e325 | DOI: 10.1016/j.kontakt.2018.10.009

Relationships among interventions and health literacy outcomes for sub-populations: A data-driven approachNursing - Original article

Martin Michalowski^a,*, Robin R. Austin^a, Michelle A. Mathiason^a, Sasank Maganti^b, Erica Schorr^a, Karen A. Monsen^a

^a University of Minnesota School of Nursing, Minneapolis, MN, USA

^b University of Minnesota Computer Science and Engineering, Minneapolis, MN, USA

Objectives: The goals of this study were to examine relationships among health literacy and outcomes for sub-populations identified within a large, multi-dimensional Omaha System dataset. Specific aims were to extract sub-populations from the data using Latent Class Analysis (LCA); and quantify the change in knowledge score from pre- to post-intervention for common sub-populations.

Design: Data-driven retrospective study using statistical modeling methods.
Sample: A set of admission and discharge cases, captured in the Omaha System, representing 65,468 cases from various health care providers.
Measures: Demographic information and the Omaha System terms including problems, signs/symptoms, and interventions were used as the features describing cases used for this study. Development of a mapping of demographics across health care systems enabled the integration of data from these different systems.

Results: Knowledge scores increased for all five sub-populations identified by latent class analysis. Effect sizes of interventions related to health literacy outcomes varied from low to high, with the greatest effect size in populations of young at-risk adults. The most significant knowledge gains were seen for problems including Pregnancy, Postpartum, Family planning, Mental health, and Substance use.

Conclusions: This is the first study to demonstrate positive relationships between interventions and health literacy outcomes for a very large sample. A deeper analysis of the results, focusing on specific problems and relevant interventions and their impact on health literacy is required to guide resource allocation in community-based care. As such, future work will focus on determining correlations between interventions for specific problems and knowledge change post-intervention.

Keywords: Statistical learning; Knowledge; Health literacy; Nursing interventions; Omaha System

Received: July 31, 2018; Accepted: November 11, 2018; Published: November 30, 2018  Show citation