Low Health Literacy: Overview, Assessment, and Steps Toward Providing High-Quality Diabetes Care

Wallace, Andrea S.

doi:10.2337/diaspect.23.4.220

Cited by 12 publications

(6 citation statements)

References 64 publications

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“…A three-arm trial showed that both automated telephone disease management and group medical visits led to increased diabetes self-care compared to standard care in people with low literacy [ 57 , 58 ]. Another study tested an intervention that consisted of a brief counseling session, a low literacy appropriate education guide on diabetes, and follow-up counseling sessions over the telephone [ 59 , 60 ]. The study found similar improvements in diabetes self-management behavior across patients with different health literacy levels.…”

Section: Resultsmentioning

confidence: 99%

The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review

et al. 2015

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BackgroundLow health literacy is a common problem among older adults. It is often suggested to be associated with poor adherence. This suggested association implies a need for effective adherence interventions in low health literate people. However, previous reviews show mixed results on the association between low health literacy and poor adherence. A systematic meta-review of systematic reviews was conducted to study the association between health literacy and adherence in adults above the age of 50. Evidence for the effectiveness of adherence interventions among adults in this age group with low health literacy was also explored.MethodsEight electronic databases (MEDLINE, ERIC, EMBASE, PsycINFO, CINAHL, DARE, the Cochrane Library, and Web of Knowledge) were searched using a variety of keywords regarding health literacy and adherence. Additionally, references of identified articles were checked. Systematic reviews were included if they assessed the association between health literacy and adherence or evaluated the effectiveness of interventions to improve adherence in older adults with low health literacy. The AMSTAR tool was used to assess the quality of the included reviews. The selection procedure, data-extraction, and quality assessment were performed by two independent reviewers. Seventeen reviews were selected for inclusion.ResultsReviews varied widely in quality. Both reviews of high and low quality found only weak or mixed associations between health literacy and adherence among older adults. Reviews report on seven studies that assess the effectiveness of adherence interventions among low health literate older adults. The results suggest that some adherence interventions are effective for this group. The interventions described in the reviews focused mainly on education and on lowering the health literacy demands of adherence instructions. No conclusions could be drawn about which type of intervention could be most beneficial for this population.ConclusionsEvidence on the association between health literacy and adherence in older adults is relatively weak. Adherence interventions are potentially effective for the vulnerable population of older adults with low levels of health literacy, but the evidence on this topic is limited. Further research is needed on the association between health literacy and general health behavior, and on the effectiveness of interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2251-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review

et al. 2015

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“…Although education and especially the theory or model-based education are effective in controlling the blood pressure of patients, there is some evidence suggesting that limited health literacy of patients could act as a barrier in the result of the interventions [ 19 ]. Evidence suggests that limited health literacy patients may understand less than half of what is told to them during medical communication [ 20 ] Moreover, patients with low health literacy may be ashamed by their condition and hide their low level of literacy from healthcare providers who could possibly help [ 21 ]. In this regard, the results of a study on diabetic patients showed that despite the fact that 73% of patients with inadequate health literacy participated in diabetes education classes, 50% of them did not know the signs and symptoms of low blood sugar and 62% of them were unaware of the treatment methods for reducing blood glucose [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

A Theory-Based Self-Care Intervention with the Application of Health Literacy Strategies in Patients with High Blood Pressure and Limited Health Literacy: A Protocol Study

Javadzade

Larki

Tahmasebi

et al. 2018

International Journal of Hypertension

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The purpose of this study is to assess the effectiveness of a theory-based self-care intervention with the application of health literacy strategies in patients with high blood pressure and limited health literacy. This is a randomized controlled trial, with measurements at baseline and 1 and 3 months follow-up. 100 patients with high blood pressure and limited health literacy will be randomly allocated to either an intervention group or a usual care control group. We will mainly establish the intervention model based on the principal health belief model components. Patients randomized to the intervention group will receive four educational sessions during four weeks. Considering the limited health literacy level of the patients of the study, health literacy strategies will be used in educational material design for enhancing the quality of the intervention. In order to cover these strategies, we will design four standard animated comics and fact sheets with illustrations and photos consistent with the health belief model constructs and educational sessions' topics. Data will be collected using some questionnaires and will be analyzed using the SPSS software. The findings of this study may assist with the development of a theoretical model for self-care intervention in patients with high blood pressure and limited health literacy.

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“…Provider focus groups and interviews both acknowledged that the fear of being shamed hindered the resolution of communication breakdowns between patients and their caregivers. [25][26][27] This increased patient vulnerability and reduced their willingness to request clarification regarding points of importance to their condition.…”

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confidence: 99%

Patients’ and providers’ perceptions of the impact of health literacy on communication in pulmonary rehabilitation

2013

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Chronic obstructive pulmonary disease (COPD) is the most prevalent form of chronic respiratory diseases worldwide. Pulmonary rehabilitation, including self-management education, highlights the importance of good patient-provider communication in establishing optimal care. There is a growing awareness of the potential impact of health literacy (HL) on the patients' access to and understanding of medical information. This study was designed to explore the patients' and health care professionals' (HCPs) perceptions of the role of HL in health communication.Semi-structured interviews and focus groups were conducted with 12 patients and 20 HCPs at a Pulmonary Rehabilitation Center in Metropolitan Toronto.Although the term health literacy was not familiar to many patients, the contribution of knowledge to patient well-being was consistently identified by patients and HCPs. Barriers to communication included provider time constraints and the use of medical jargon. For providers they also included patient characteristics, language, culture and awareness of health resources. Approaches that might improve communication incorporated family support, peer support, better print and visual teaching material and a trusting empathic patientprovider relationship.The findings provide an increased understanding of patients' and providers' perceptions of HL as a barrier to effective communication of medical information to patients with COPD as well as approaches that might improve this communication.

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Low Health Literacy: Overview, Assessment, and Steps Toward Providing High-Quality Diabetes Care

Cited by 12 publications

References 64 publications

The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review

The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review

A Theory-Based Self-Care Intervention with the Application of Health Literacy Strategies in Patients with High Blood Pressure and Limited Health Literacy: A Protocol Study

Patients’ and providers’ perceptions of the impact of health literacy on communication in pulmonary rehabilitation

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