Development of patient education meeting very low literacy criteria was feasible, effective for knowledge acquisition, and highly acceptable irrespective of literacy level.

Objective: Develop an accessible education module and test whether presence of diabetes complications and functional impairments differentially impacted intervention usability. Method: 30 African Americans with type 2 diabetes completed 1 of 4 (90-min) group education classes. Preintervention measures included medical history, Medical Outcomes Study Short Form-8, Telephone Interview for Cognitive Status, and Diabetes and Cardiovascular Disease Knowledge Test. For outcomes comparisons, patients were categorized according to functional impairment (physical; physical ϩ cognitive or physical ϩ visual; physical ϩ cognitive ϩ visual) and number of diabetes complications (0 -1, 2-3, 4 -6). Outcome measures were knowledge test change scores and patient ratings of satisfaction and accessibility of class and materials. Results: Education resulted in increased mean knowledge scores, from 6.6 to 11.3 (p Ͻ .001), with significant learning found for participants in all functional impairment categories and with 0 -3 complications. Patient ratings of accessibility and satisfaction were high (42-43 of 45), with minor areas identified for improvement among persons with excess complications (4 -6) and impairment (physical ϩ cognitive ϩ visual). Conclusion: The diabetes education module demonstrated accessibility and effectiveness. It may be particularly useful in treating high-risk, diabetic adults with existing complications, functional impairment, or disability.