Addressing Literacy and Numeracy to Improve Diabetes Care

Autor: Tebeb Gebretsadik, Darren A. DeWalt, Mary Margaret Huizinga, Rebecca Pratt Gregory, Kerri L. Cavanaugh, Kenneth A. Wallston, Dianne Davis, Tom A. Elasy, Robb Malone, Michael Pignone, Ayumi Shintani, Russell L. Rothman
Jazyk: angličtina
Rok vydání: 2009
Předmět:
Research design
Adult
Blood Glucose
Male
medicine.medical_specialty
Health Knowledge
Attitudes
Practice
Activities of daily living
Endocrinology
Diabetes and Metabolism
media_common.quotation_subject
Literacy
law.invention
Randomized controlled trial
Patient Education as Topic
law
Numeracy
Diabetes mellitus
Activities of Daily Living
Internal Medicine
medicine
Diabetes Mellitus
Humans
Hypoglycemic Agents
Insulin
Glycemic
media_common
Original Research
Randomized Controlled Trials as Topic
Advanced and Specialized Nursing
Glycated Hemoglobin
Insurance
Health
business.industry
Blood Glucose Self-Monitoring
Clinical Care/Education/Nutrition/Psychosocial Research
Middle Aged
medicine.disease
Clinical trial
Knowledge
Diabetes Mellitus
Type 2
Physical therapy
Income
Educational Status
Female
business
Mathematics
Zdroj: Diabetes Care
ISSN: 1935-5548
0149-5992
Popis: OBJECTIVE Diabetic patients with lower literacy or numeracy skills are at greater risk for poor diabetes outcomes. This study evaluated the impact of providing literacy- and numeracy-sensitive diabetes care within an enhanced diabetes care program on A1C and other diabetes outcomes. RESEARCH DESIGN AND METHODS In two randomized controlled trials, we enrolled 198 adult diabetic patients with most recent A1C ≥7.0%, referred for participation in an enhanced diabetes care program. For 3 months, control patients received care from existing enhanced diabetes care programs, whereas intervention patients received enhanced programs that also addressed literacy and numeracy at each institution. Intervention providers received health communication training and used the interactive Diabetes Literacy and Numeracy Education Toolkit with patients. A1C was measured at 3 and 6 months follow-up. Secondary outcomes included self-efficacy, self-management behaviors, and treatment satisfaction. RESULTS At 3 months, both intervention and control patients had significant improvements in A1C from baseline (intervention −1.50 [95% CI −1.80 to −1.02]; control −0.80 [−1.10 to −0.30]). In adjusted analysis, there was greater improvement in A1C in the intervention group than in the control group (P = 0.03). At 6 months, there were no differences in A1C between intervention and control groups. Self-efficacy improved from baseline for both groups. No significant differences were found for self-management behaviors or satisfaction. CONCLUSIONS A literacy- and numeracy-focused diabetes care program modestly improved self-efficacy and glycemic control compared with standard enhanced diabetes care, but the difference attenuated after conclusion of the intervention.
Databáze: OpenAIRE
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