The role of functional health literacy in long-term treatment outcomes in psychosocial care for adolescents
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ORIGINAL CONTRIBUTION
The role of functional health literacy in long‑term treatment outcomes in psychosocial care for adolescents L. Beukema1 · S. A. Reijneveld1 · M. Jager1 · J. Metselaar2 · A. F. de Winter1 Received: 29 March 2019 / Accepted: 19 December 2019 © The Author(s) 2020
Abstract Although among adolescents with psychosocial problems low health literacy may increase the risk of poor treatment outcomes, the contributing mechanisms within treatment remain unclear. A better understanding of these mechanisms could contribute to improved treatment processes and outcomes. This study aims to examine the relationship between functional health literacy, treatment processes (treatment adherence, learning processes), and treatment outcome (level of psychosocial problems) in adolescents in psychosocial care. We used data from a prospective cohort study among adolescents aged 12–18 (N = 390), collected in four successive measurements: at entry into care, and 3, 12, and 24 months thereafter. We used a mixed effect model to investigate the association between level of functional health literacy (adequate vs. inadequate) and treatment processes (treatment adherence, learning processes) and treatment outcome (level of psychosocial problems). Between adolescents with adequate and inadequate functional health literacy, we found no differences or change over time in adherence or learning processes. The level of psychosocial problems significantly declined over time (β = − 1.70, 95% CI [− 2.72, − 0.69], p = .001) to a similar degree in both groups, though, in all measurements, the level was consistently higher for adolescents with inadequate health literacy. We conclude that health literacy levels did not affect change in treatment processes nor in outcomes of psychosocial treatment. However, the consistently higher level of psychosocial problems among adolescents with inadequate health literacy suggests an unaddressed need in psychosocial care. Keywords Health literacy · Adolescent · Psychosocial problems · Psychosocial care · Treatment adherence · Longitudinal
Introduction Psychosocial problems—emotional, behavioural, and social problems—are the third largest contributor to the global burden of disease in adolescents [1–3]. It is estimated that psychosocial problems affect up to 20% of children and adolescents [2, 4, 5] and that up to half of all adult psychopathologies have their roots in adolescence [4, 6]. Experiencing psychosocial problems in adolescence is related to Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00787-019-01464-9) contains supplementary material, which is available to authorized users. * L. Beukema [email protected] 1
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV Groningen, The Netherlands
Department of Special Needs Education and Youth Care, University of Groningen, Groningen, The Netherlands
2
a higher risk of poorer educational, social, occupational
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