eP711 - Association of Health Literacy and Patient-Reported Outcomes Among Colorectal Surgery Patients

ePoster Presenter(s)

• 

  Bayley A. Jones, MD

  Resident
  University of Alabama at Birmingham Department of Surgery
  Birmingham, AL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Senior Author(s)

• 

  Daniel I. Chu, MD MSPH

  Professor
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, Alabama, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Author(s)

• LW

  Lauren Wood, MSPH

  Data analyst
  University of Alabama at Birmingham
  Birmingham, Alabama, United States

  Disclosure information not submitted.
• 

  Wendelyn M. Oslock, MD, MBA (she/her/hers)

  General Surgery Resident
  University of Alabama Birmingham Department of Surgery; Birmingham Veterans Affairs Medical Center
  University of Alabama Birmingham
  Birmingham, AL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• NE

  Nathan C. English, MBChB (he/him/his)

  Resident
  University of Cape Town, Department of General Surgery
  University of Cape Town
  Birmingham, AL, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• MR

  Michael Rubyan, PhD, MPH

  Assistant Professor
  University of Michigan School of Public Health
  Ann Arbor, Michigan, United States

  Disclosure information not submitted.
• 

  Robert Hollis, MD MSPH

  Assistant Professor
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: Patient-reported outcome measures (PROMs) are used to understand a patient’s perspective of their health and the impact that treatment such as surgery has on their mental and physical wellbeing. Low health literacy has been shown to be associated with worse patient-reported outcomes among non-surgical patients. However, this association has yet to be evaluated among colorectal surgery patients.Methods/Interventions: We performed a cohort study of colorectal surgery patients at our institution from March 2019 to July 2023. Patients were included if they enrolled in a patient engagement technology (used to deliver PROMs) and completed the preoperative and at least one postoperative PROM (30 and/or 90 day). The 10-question PROMIS Global Health instrument was used which includes physical and mental health T-scores. Responses were scored using the HealthMeasures Scoring service with a score of 50 representing the average for the general US population and a higher score representing better health. Health literacy was measured using the BRIEF survey. Bivariate analysis was performed to test the association of health literacy with PROMIS scores followed by a repeated measures regression analysis comparing PROMIS scores at preop, 30 days postop and 90 days postop.Results/Outcomes: Of 269 patients, the median age was 56.8 years. 64.7% were female and 17.1% were Black. Most had high health literacy (94.8% versus 5.2% for low). Low health literacy was associated with lower mental health preop scores (46.5 versus 49.3 for high health literacy, p=0.02). In addition, low health literacy was associated with a significant decrease of 7.4 points in mental health scores from 30 days to 90 days postoperatively versus a slight increase in mental health scores (0.4) for patients with high health literacy (p=0.04) (Table 1). On regression analysis, as patient age increased, physical health scores increased by 0.6 points (p=0.03) and mental health scores increased by 0.15 points (p < 0.01). Notably, patients with high health literacy had scores 1.1 points higher for physical health and 1.6 points higher for mental health compared to patients with low health literacy, though not statistically significant (p=0.49, p=0.48 respectively).Conclusion/

Discussion: Low health literacy is associated with worse mental health patient-reported outcomes among colorectal surgery patients. These patients may benefit from mental health-focused interventions (such as cognitive interventions, coaching, psychoeducation) prior to surgery with additional follow up post-surgery.Table 1. Health T-Scores by Health Literacy Level [mean (SD)].