A dissertation research grant is helping researcher Molly Wylie study the connection between health literacy and access to non-medical home care services.
The Research Institute for Home Care awarded a 2024 Home Care Dissertation Research Grant to Molly Wylie, a research associate at the LeadingAge LTSS Center @UMass Boston. Wylie is pursuing a doctorate in gerontology at the University of Massachusetts Boston.
Wylie’s doctoral dissertation project, “The Role of Health Literacy in Home and Community-Based Services Utilization,” explores how health literacy may help older adults and their informal caregivers find non-medical home care services. The 18-month grant runs through January 2026.
The Research Institute for Home Care (RIHC) supports research and initiatives to improve the future of home care delivery. RIHC funds a range of research projects, including qualitative, quantitative, and clinical trial studies focusing on payment and delivery reform, person-centered care, technology, the home care workforce, and clinical innovation.
HOME CARE AND HEALTH LITERACY
Over half of the U.S. older adult population can expect to need long-term services and supports (LTSS) (Johnson & Dey, 2022). Yet, paid or formal LTSS, especially in nursing homes or assisted living communities, can be unaffordable for the average American. Home care can offer a lower-cost alternative (Genworth, 2024). Unfortunately, many older adults and their families lack awareness of available home care options and wish they had access to guidance regarding available services and providers (Macleod et al., 2017; Nexus Insights, 2022).
Wylie’s dissertation project will examine whether health literacy—the ability to find, understand, and use information to make health-related decisions—can help older adults and caregivers successfully access needed home care.
Individuals with higher levels of health literacy are more likely to find healthcare providers, use preventative services, and seek information about their health, reports Wylie. On the other hand, those with low health literacy levels are likely to face barriers when finding service information. Older adults are especially prone to low health literacy levels and may rely on family or friends to support their search for home care services.
Wylie is seeking to understand the health literacy skills of older adults and the kind of help informal caregivers provide during the search for home care.
DATA AND RESEARCH QUESTIONS
The dissertation project will rely on data from the University of Michigan Health and Retirement Study (HRS), a representative sample of adults 50 years and older in the United States, and interviews with informal caregivers of older adults using home care services provided by area agencies on aging in Massachusetts. Wylie is seeking to answer the following research questions:
- Are higher levels of health literacy related to greater use of non-medical home care?
- How do informal caregivers use their health literacy skills to help older adults find and evaluate non-medical home care information?
STUDY IMPLICATIONS
Wylie hopes that a better understanding of how health literacy promotes access to home care can help future researchers develop assessment and outreach tools for home care agencies, community aging service organizations, nursing home and hospital staff, and physicians. These tools could help providers identify individuals with low health literacy and implement best practices for sharing information with diverse older adults and their caregivers.
Wylie’s dissertation committee consists of researchers from the LTSS Center’s Washington, DC, and Boston offices, including Edward Alan Miller, Verena Cimarolli, Jane Tavares, and Jeffrey Burr. The LTSS Center will share study findings with providers across the continuum of aging services.