Health Literacy and Family Factors in the Transition to Adult Care in Adolescents with Type I Diabetes

Abstract

Successful management of type 1 diabetes (T1DM) in adolescence involves multiple daily tasks, developmental changes, and the expectation of transition to an adult provider. Health literacy is one variable to consider in the context of transition, as studies have demonstrated the correlation of parental health literacy with health behaviors and outcomes, yet not studied adolescent health literacy in T1DM. Family factors (e.g., management responsibility, diabetes-specific family conflict, parental support) also are important to behavior and health outcomes in adolescents with T1DM. Study aims were to: 1) examine the association of adolescent health literacy to transition readiness and health outcome in T1DM; and 2) explore the extent to which family factors serve as moderators in health literacy predicting transition readiness and health outcome. Sixty-five youth and their caregivers completed measures. Results indicated a significant positive correlation among health literacy and T1DM knowledge. Higher parental responsibility was significantly correlated with greater written health literacy, greater transition readiness, and fewer parental supportive behaviors. Higher written health literacy was associated with lower family conflict. The relations among health literacy and transition readiness and glycemic control were not significant. No family factors were found to be moderators for health literacy and transition readiness or glycemic control. Given the complex definition of health literacy and dearth of comprehensive validated measures in adolescents, our measures may not have adequately reflected global health literacy in the context of disease management. Future directions include studying additional aspects of health literacy and other variables potentially impacting health behaviors.

The Role of Health Literacy in Health Behavior, Health Service Use, Health Outcomes, and Empowerment in Pediatric Patients with Chronic Disease: A Systematic Review

“…Overall, studies on associations between health literacy and health outcomes, including physiological parameters, morbidity, and HRQoL, showed mixed results. Contrary to findings on the influence of parental health literacy on, for example, child blood glucose levels [42,43], no significant association with physiological parameters was identified for pediatric patients' health literacy [54]. Dore-Stites et al described parental health literacy having a stronger impact on health outcomes, such as liver function, when compared to children's health literacy [51].…”