Back to 2024 Abstracts
Development and Validation of the Vascular Surgery Literacy Assessment Tool
Sophia Trinh, Priscilla Tanamal, Pavan Guduri, Amanda Tullos, Denise Danos, Claudie Sheahan, Malachi Sheahan, III
Louisiana State University Health Sciences Center, New Orleans, LA
INTRODUCTION: Despite the known association of low health literacy with poor surgical outcomes, there are few studies or tools assessing health literacy in vascular surgery patients. The purpose of this study was to develop and validate a novel assessment instrument addressing this need.
METHODS: Face-to-face verbal interviews were conducted in two outpatient vascular surgery clinics. In addition to collecting patient demographics, the Single Item Literacy Screener (SILS), Test of Functional Health Literacy in Adults (TOFHLA), and a novel Vascular Surgery Literacy Assessment Tool (VSLAT) were conducted. Respondent’s area deprivation index (ADI) was calculated as 2022 national ranking, using the respondent’s ZIP code. Shapiro-Wilk test of normality was used to assess the distribution of vascular literacy scores in the sample. Construct validity was assessed as the correlation between continuous scores from the vascular literacy tool and results from the TOHFLA using ANOVA and Spearman correlation. Internal consistency was assessed using Cronbach’s alpha. For patient characteristics, categorical variables were summarized with frequency and percentage. The distribution of vascular literacy scores was compared using ANOVA. Correlation was assessed using Spearman correlation.
RESULTS: Between July 2022 and April 2024, 114 participants (median age 68, 54% female) were recruited. Distribution of vascular literacy scores were normally distributed for the sample (Figure 1). The mean score of the VSLAT was 12.3±5.1 (out of 24). Scores between the VSLAT and TOHFLA were correlated (Spearman rank correlation 0.5; P<.001). Cronbach’s alpha was 0.86, indicating sufficient internal consistency (Figure 2). Those who were white/Caucasian (P<.001), had a household yearly income of $100,000 or higher (P=.015), a bachelor’s degree or graduate degree (P<.001), or a diagnosis of hypertension (P=.007) or varicose veins (P=.019) were significantly associated with a higher vascular literacy score. Those who were married or widowed had higher scores compared to those who were single (P=.023). Patients who receive public assistance in the form of public housing were found to have a lower score (P=.029). Age was significantly correlated with vascular literacy (P=.002), but ADI was not (P=.162). Respondents answered “I don’t know” the most frequently to questions regarding the definition of claudication (63.7%, 31% answered correctly), fistula (65.8% didn’t know, 20.7% correct), ischemia (75.7% didn’t know, 14.4% correct), and malformation (61.1% didn’t know, 21.2% correct correct). Aneurysm was the term most likely to be incorrectly identified (18.3% didn’t know, 61.7% answered incorrect). Dialysis was the most frequently identified term (87.8%).
CONCLUSIONS: This study demonstrates the VSLAT is a valid instrument to evaluate literacy in vascular surgery patients. Its use as a screening tool, especially in individuals from lower income households or under-represented groups, may be useful in identifying patients who would benefit from educational interventions to improve surgical outcomes.
Back to 2024 Abstracts
