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Minal R. Patel, MPH; Melissa A. Valerio, PhD; Georgiana Sanders, MD; Lara J. Thomas, MPH; Noreen M. Clark, PhD
Author and Funding Information

From the Center for Managing Chronic Disease (Drs Valerio, Sanders, and Clark and Mss Patel and Thomas), the Department of Health Behavior and Health Education (Ms Patel and Drs Valerio and Clark), University of Michigan School of Public Health; and the Division of Allergy and Clinical Immunology (Dr Sanders), Department of Internal Medicine, University of Michigan.

Correspondence to: Noreen M. Clark, PhD, Center for Managing Chronic Disease, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029; e-mail: nmclark@umich.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be dis­cussed in this article.

Funding/Support: This work was supported by the National Institutes of Health [Grant 1 R18 HL60884–01].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(6):1687-1688. doi:10.1378/chest.12-2292
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To the Editor:

Drs S. S. Bains and S. N. Bains point out that health literacy status is an important factor to consider when ascertaining self-management behavior and patient-physician communication among those with chronic illnesses. Although in our study1 in CHEST we could not measure health literacy when examining relationships among asthma action plans, self-management behaviors, and satisfaction, we agree that adequate health literacy is an important fac­tor in health behavior.2,3 To date, measures of health literacy are limited in their ability to capture the full array of skills necessary for effective self-management behavior and patient-provider com­munication.4,5 The Institute of Medicine has highlighted the need for more comprehensive assessments that include reading, writing, speaking, listening, and numeracy.4 Better tools with strong psychometric properties are certainly needed. Health literacy is an important area that deserves further study to understand the range of factors that promote or impede self-management and patient-provider relationships.

Acknowledgments

Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript.

Patel MR, Valerio MA, Sanders G, Thomas LJ, Clark NM. Asthma action plans and patient satisfaction among women with asthma. Chest. 2012;142(5):1143-1149.
 
Williams MV, Baker DW, Honig EG, Lee TM, Nowlan A. Inadequate literacy is a barrier to asthma knowledge and self-care. Chest. 1998;114(4):1008-1015. [CrossRef] [PubMed]
 
Mancuso CA, Rincon M. Asthma patients’ assessments of health care and medical decision making: the role of health literacy. J Asthma. 2006;43(1):41-44. [CrossRef] [PubMed]
 
Institute of Medicine. Health Literacy: a Prescription to End Confusion. Washington, DC: The National Academies Press; 2004.
 
Berkman ND, DeWalt DA, Pignone MP, et al. Literacy and Health Outcomes, Evidence Report/Technology Assessment No. 87.Rockville, MD: Agency for Healthcare Research and Quality; 2004. AHRQ Publication No. 04-E007-2.
 

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References

Patel MR, Valerio MA, Sanders G, Thomas LJ, Clark NM. Asthma action plans and patient satisfaction among women with asthma. Chest. 2012;142(5):1143-1149.
 
Williams MV, Baker DW, Honig EG, Lee TM, Nowlan A. Inadequate literacy is a barrier to asthma knowledge and self-care. Chest. 1998;114(4):1008-1015. [CrossRef] [PubMed]
 
Mancuso CA, Rincon M. Asthma patients’ assessments of health care and medical decision making: the role of health literacy. J Asthma. 2006;43(1):41-44. [CrossRef] [PubMed]
 
Institute of Medicine. Health Literacy: a Prescription to End Confusion. Washington, DC: The National Academies Press; 2004.
 
Berkman ND, DeWalt DA, Pignone MP, et al. Literacy and Health Outcomes, Evidence Report/Technology Assessment No. 87.Rockville, MD: Agency for Healthcare Research and Quality; 2004. AHRQ Publication No. 04-E007-2.
 
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