Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jun;75(3):386-91.
doi: 10.1016/j.pec.2009.01.003. Epub 2009 Feb 13.

Linking numeracy and asthma-related quality of life

Andrea J Apter  1 , Xingmei Wang, Daniel Bogen, Ian M Bennett, Rebecca M Jennings, Laura Garcia, Tamie Sharpe, Carmen Frazier, Thomas Ten Have
Affiliations

Linking numeracy and asthma-related quality of life

Andrea J Apter et al. Patient Educ Couns. 2009 Jun.

Abstract

Objective: To examine the correlation of numerical skills used in patients' self-management of asthma with asthma-related quality of life (AQOL).

Methods: Adults with moderate-severe asthma completed the Asthma Numeracy Questionnaire (ANQ), assessments of reading comprehension and self-efficacy, and the mini-Asthma Quality of Life Questionnaire (miniAQLQ). The numeracy-AQOL relationship was evaluated in the context of potential confounders (demographic variables) and mediators (e.g. income and self-efficacy), using tests of correlation then multivariable models to assess for confounders and mediators.

Results: 80 adults with moderate or severe asthma were evaluated. Mean ANQ score was 2.3+/-1.2 (range 0-4). ANQ was correlated with miniAQLQ (rho=0.24, p=0.03). This association was sustained (rho=0.27, p=0.02) when controlling for potential confounders significantly associated with AQOL (age, Latino ethnicity). The ANQ-miniAQLQ association was mediated by household income; the correlation was reduced by 81% when adjusting for income (rho=0.05, p=0.65). In contrast, self-efficacy less strongly mediated this association; the correlation was reduced by 26% when controlled for self-efficacy (rho=0.20, p=0.08).

Conclusion: Numerical skills needed for asthma self-management influence AQOL primarily through their impact on income and, to a lesser extent, on self-efficacy.

Practice implications: Adults with asthma will benefit from self-management instructions employing the simplest mathematical constructs whose understanding is confirmed by clinicians.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Conceptual model postulating how numeracy could influence asthma-related quality of life
We hypothesize that numerical skills are associated with asthma-related quality of life and that this relationship is in part mediated by income and self-efficacy. That is, poor numerical skills limit income, educational opportunities, access to jobs with health insurance, access to low-allergen housing, and the acquisition of further numerical skills used in asthma self-management. Numerical concepts are embedded in self-management instructions, as depicted here for asthma. In our model, confounders are demographic variables that conceptually impact numeracy and quality of life. Mediators are variables conceptually influenced by numeracy and impact on quality of life.
Figure 2
Figure 2
Asthma Numeracy Questionnaire
See this image and copyright information in PMC

References

    1. Berkman ND, DeWalt DA, M.P. P, Sheridan SL, Lohr KN, Sutton SF, et al. Literacy and Health Outcomes. Agency for Healthcare Research and Quality; Rockville, MD: 2004. Report No. AHRQ Publication No. 04-E007−2.
    1. Rudd RE, Anderson JE, Oppenheimer S, Nath C. Health literacy: an update of medical and public health literature. In: Comings JP, Garner B, Smith C, editors. Review of Adult Learning and Literacy. Vol. 7. Lawrence Erbaum Associates; Mahwah, NJ: 2007. pp. 175–204.
    1. Apter AJ, Paasche-Orlow MK, Remillard JT, Bennett IM, Ben-Joseph EP, Batista RM, et al. Numeracy and communication with patients: they are counting on us. J Gen Intern Med. 2008;23:2117–24. - PMC - PubMed
    1. Gal I. Adult Numeracy Development. Hampton Press; Cresskill, NJ: 2000.
    1. Montori VM, Rothman RL. Weakness in numbers. The challenge of numeracy in health care. J Gen Intern Med. 2005;20:1071–2. - PMC - PubMed

Publication types

LinkOut - more resources