Baseline characteristics of participants in the enhancing health literacy in secondary prevention of cardiac events (ENHEARTEN) study.

Abstract

Background: Health literacy—the ability to find, understand, and use health information—is a determinant of health that contributes to health inequalities across several conditions. The ENHEARTEN study will be the first to examine the association between health literacy and long-term health outcomes in adults with cardiac disease. Here we present preliminary baseline data of this seminal study. Methods: ENHEARTEN is a 12-month multicentre, prospective, observational study with the primary outcome of unplanned hospital admissions within 6-months of myocardial infarction (MI). Adults with their first MI were recruited across three metropolitan and one regional hospital in Victoria. Baseline data included medical history, sociodemographic variables, health behaviour questionnaires, and health literacy assessed using the 12-item European Health Literacy Survey (HLS-Q12). Logistic regression was used to determine associations between health literacy and sociodemographic/health variables. Results: 450 participants were recruited between November 2021-January 2024 (mean age: 59.4yrs; 78% male; 39.9% born outside Australia; 15.5% spoke a primary language other than English; 35.3% resided in rural/regional Victoria; 59.9% had ≥two co-morbidities—20.6% with diabetes). Using defined HLS-Q12 cut-off scores, 41% had low, 37% intermediate and 22% high health literacy. Older age (>60yrs; p<0.01), not completing secondary education (p<0.05), lower cardiac self-efficacy (p<0.05) and higher depression/anxiety scores (p<0.01) were associated with low health literacy. Conclusions/Implications: The ENHEARTEN cohort is fully enrolled. This study will provide much needed evidence for the significance of health literacy as a contributing factor for cardiovascular outcomes, informing the development of cardiac secondary prevention interventions that target health literacy deficits.