Prevalence and Risk Factors of Limited Musculoskeletal Health Literacy in the Outpatient Setting: A Logistic Regression Model.

Abstract

The purpose of this study was to determine the risk factors of limited musculoskeletal health literacy (MHL) in a general population of orthopaedic patients. Patients presenting to either a foot or ankle surgeon or hand or wrist surgeon were given the Literacy in Musculoskeletal Problems (LiMP) questionnaire, a nine-item survey for assessing "limited" MHL (LiMP score < 6). After confirming group homogeneity, the two populations were analyzed together to determine factors significantly correlated with and predictive of limited MHL. Overall, 231 patients were included in the analysis. Average LiMP score was 5.4 ± 1.8, and 49% of participants had "limited" MHL. Chi-square analysis revealed that being non-Caucasian, using cigarettes, and having a less than college-level education were associated with a higher prevalence of "limited" MHL (P < 0.05). Logistic regression revealed that being of non-Caucasian race (P = 0.04) or having less than college-level education (P = 0.03) were significant independent predictors of "limited" MHL, with adjusted relative risks of 1.37 and 1.40, respectively. In this study, the patients at the greatest risk of limited MHL are often at the risk of many other complications. These results should be used as a groundwork to craft directives aimed at improving MHL and outcomes in these patients.