The Role of Health Literacy in Assessing Rumination and Depression


Health literacy has been shown to be a key component of patient understanding of medical diagnoses, adherence, and self-efficacy. Limited health literacy has been associated with a number of negative outcomes— including more severe illness, increased use of emergency services, and mortality. The concept of mental health literacy has arisen from this literature to reflect the importance of mental health awareness, identification, and treatment-seeking behavior, especially in the presence of high stigma. Accurate assessment of health literacy is important to provide both clinical insight and ground research on health literacy. Additionally, it is possible to identify psychometric differences in pre-established questionnaires by health literacy level. This series of studies will validate and provide a cut-point for a short for Health Literacy Using Talking Touchscreen Technology (Health LiTT), an innovative, electronically delivered assessment of health literacy formulated using principles of item response theory. Using this assessment, differential item functioning of the Ruminative Response Scale, the primary measure of depressive rumination, will be examined. Finally, the third study will provide an applied example of how health literacy can impact the assessment of depression and common demographic correlates, somatic symptoms, and rumination. Together, these studies add an important contribution to the assessment of health literacy, its effect on the assessment of rumination, and how health literacy can impact depression symptom report.

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