Association of Health Literacy With Self-Management Behavior in Patients With Diabetes

Kim, Sarang; Love, Frances M.; Quistberg, D. Alex; Shea, Judy A.

doi:10.2337/diacare.27.12.2980

Cited by 229 publications

(214 citation statements)

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“…A similar threshold has also previously been applied (7,28). At baseline, we compared patients by group assignment and literacy subgroup using t tests or Mann-Whitney U tests for continuous variables and 2 or Fisher's exact tests for categorical variables.…”

Section: Discussionmentioning

confidence: 99%

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Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

et al. 2005

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OBJECTIVE -To evaluate a clinic-based multimedia intervention for diabetes education targeting individuals with low health literacy levels in a diverse population.RESEARCH DESIGN AND METHODS -Five public clinics in Chicago, Illinois, participated in the study with computer kiosks installed in waiting room areas. Two hundred forty-four subjects with diabetes were randomized to receive either supplemental computer multimedia use (intervention) or standard of care only (control). The intervention includes audio/video sequences to communicate information, provide psychological support, and promote diabetes self-management skills without extensive text or complex navigation. HbA 1c (A1C), BMI, blood pressure, diabetes knowledge, self-efficacy, self-reported medical care, and perceived susceptibility of complications were evaluated at baseline and 1 year. Computer usage patterns and implementation barriers were also examined.RESULTS -Complete 1-year data were available for 183 subjects (75%). Overall, there were no significant differences in change in A1C, weight, blood pressure, knowledge, self-efficacy, or self-reported medical care between intervention and control groups. However, there was an increase in perceived susceptibility to diabetes complications in the intervention group. This effect was greatest among subjects with lower health literacy. Within the intervention group, time spent on the computer was greater for subjects with higher health literacy.CONCLUSIONS -Access to multimedia lessons resulted in an increase in perceived susceptibility to diabetes complications, particularly in subjects with lower health literacy. Despite measures to improve informational access for individuals with lower health literacy, there was relatively less use of the computer among these participants. Diabetes Care 28:1574 -1580, 2005T here is a growing awareness of the impact of low health literacy on diabetes (1,2). Low health literacy poses a major barrier to education and self-management (3). Health literacy directly impacts health outcomes, such as hospitalization risk, particularly in those with chronic diseases (4,5). In one crosssectional study (5) measuring the health literacy level of type 2 diabetic patients, patients with inadequate health literacy were less likely than those with adequate health literacy to achieve tight glycemic control. However, there is limited data from longitudinal studies regarding the impact of health literacy on changes in clinical outcomes over time (2).Despite increasing concern about the impact of low health literacy on diabetes care, there are few proven interventions available that address low health literacy (6). Recent evidence (6,7) suggests that diabetes education improves selfmanagement and glycemic control in those with limited health literacy. Simultaneously, clinicians are faced with less time and resources for disseminating information. Regular attendance in diabetes education classes is disappointingly low, particularly for those with lower socioeconomic status and those who...

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Section: Discussionmentioning

confidence: 99%

“…Recent evidence (6,7) suggests that diabetes education improves selfmanagement and glycemic control in those with limited health literacy. Simultaneously, clinicians are faced with less time and resources for disseminating information.…”

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confidence: 99%

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

et al. 2005

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“…Common approaches to providing this additional self-management support include telephonebased counseling (7)(8)(9)(10)(11)(12), group medical visits (13)(14)(15)(16)(17)(18)(19)(20)(21), and, increasingly, computer or internetbased programs (22)(23)(24)(25)(26)(27)(28)(29)(30). Efficacy studies of self-management support have shown improvements in patient satisfaction, healthy behaviors, self-efficacy, and, in some cases, utilization and clinical outcomes (31)(32)(33).…”

Section: Introductionmentioning

confidence: 99%

Preferences for self-management support: Findings from a survey of diabetes patients in safety-net health systems

Sarkar

Piette

Gonzales

et al. 2008

Patient Education and Counseling

131

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Objectives-We sought to identify interest in different modes of self-management support among diabetes patients cared for in public hospitals, and to assess whether demographic or disease-specific factors were associated with patient preferences. We explored the possible role of a perceived communication need in influencing interest in self-management support.Methods-Telephone survey of a random sample of 796 English and Spanish-speaking diabetes patients (esponse rate 47%) recruited from 4 urban US public hospital systems. In multivariate models, we measured the association of race/ ethnicity, primary language, self-reported health literacy, self-efficacy, and diabetes-related factors on patients' interest in three self-management support strategies (telephone support, group medical visits, and internet -based support). We explored the extent to which patients believed that better communication with providers would improve their diabetes control, and whether this perception altered the relationship between patient factors and selfmanagement support acceptance. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. CI 0.33-0.93). African-Americans were more interested than Whites in all 3 self-management support strategies. Patients with limited self-reported health literacy were more likely to be interested in telephone support than those not reporting literacy deficits. Forty percent reported that their diabetes would be better controlled if they communicated better with their health care provider. This perceived communication benefit was independently associated with interest in self-management support (p<0.001), but its inclusion in models did not alter the strengths of the main associations between patient characteristics and self-management support preferences. NIH Public AccessConclusion-Many diabetes patients in safety-net settings report an interest in receiving selfmanagement support, but preferences for modes of delivery of self-management support vary by race/ethnicity, language proficiency, and self-reported health literacy.Practice Implications-Public health systems should consider offering a range of selfmanagement support services to meet the needs of their diverse patient populations. More broad dissemination and implementation of self-management support may help address the unmet need for better provider communication among diabetes patients in these settings.

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“…Internasjonale undersøkelser har vist at lav helsefremmende allmenndannelse forekommer ofte hos personer som blir gjentagende ganger hospitalisert for typiske livsstilssykdommer, som for eksempel diabetes type 2, hvilket indikerer at det kan vaere utfordrende for mange å vite hva de faktisk bør gjøre for å forsøke å forebygge denne sykdommen i hverdagen (Ishikawa, Takeuchi og Yano 2008;Kim, Love, Quistberg og Shea 2004;Safeer og Keenan 2005;Sarkar, Fisher og Schillinger 2006;Schillinger, D, Grumbach, K, Piette, J, Wang, F, Osmond, D, og Daher, C et al 2002;Tang, Pang, Chan, Yeung og Yeung 2008). I Norge er det nylig vist at kvinner med pakistansk innvandrerbakgrunn kan ha vanskeligheter med å forstå helsepersonells informasjon om hva som utgjør et diabetesforebyggende kosthold (Hjellset 2010).…”

Section: Helsefremmende Allmenndannelseunclassified

En norsk pilotstudie av helsesøstres oppfatninger av pasienters health literacy: helsefremmende allmenndannelse

Finbråten¹,

Pettersen

2012

NorTidHelse

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Association of Health Literacy With Self-Management Behavior in Patients With Diabetes

Cited by 229 publications

References 18 publications

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

Preferences for self-management support: Findings from a survey of diabetes patients in safety-net health systems

En norsk pilotstudie av helsesøstres oppfatninger av pasienters health literacy: helsefremmende allmenndannelse

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