Health Literacy Impacts Knowledge and the Use of Education App in Heart Failure: A Pilot Study

Background and Introduction: The chronicity of heart failure (HF) requires patients to follow complex self-care regimen. Many factors impede patients’ ability to follow the prescribed multi-component self-care regimen that include lack of knowledge attributed to inadequate health literacy. Objective: This prospective pre- and post-intervention study assessed the usability and potential efficacy of a HFeducational application (APP) in a smartphone. The HF education App included ten educational modules at a reading level of 6th grade. The study examined the association of health literacy level of participants at baseline with HF knowledge improvement after using the App for 30-days. HF related hospital readmissions was assessed at 30, 60 and 90-days. Results: A total of 31 patients with HF and (15) family member dyads were recruited for the study. Health Literacy level was measured using the Rapid Estimate of Adult Literacy in Medicine - Short Form showed a strong association with HF knowledge measured using the validated Atlanta HF Knowledge Test (t=3.629; p=0.001). Knowledge of patients with HF improved significantly after 30-days of using the HF education App (t=13.03; p=0.001); as well the knowledge of caregivers (t=9.08; p=0.001). None of the patients with HF were hospitalized during 30-days and 60-days follow-up, while one patient was hospitalized in 90-days. Conclusion: Our data suggests evaluating alternative methods of communicating health information including written material at a low literacy level verbal communication that a person with inadequate literacy may understand, and presentations using videos and Apps targeting individuals with limited literacy at 6th grade level.