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Health Services Research & Development

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2005 HSR&D National Meeting Abstract


3063 — Health Literacy in the Diabetes Population at VA Eastern Colorado Health Care System

Author List:
Thrall DT (Denver VA Eastern Colorado Health Care System)
Bent KN (Denver VA Eastern Colorado Health Care System)

Objectives:
The objective of this study is to assess and describe the health literacy level of patients with diabetes from VAECHCS and to compare their health literacy to the level of readability and understandability of available patient education materials. The long-term goal of the program of research is to incorporate health literacy principles in educational processes and materials to best assist those patients who seek to prevent the complications of diabetes and manage the economic impact of this disease.

Methods:
Patients attending diabetes group education classes at VAECHCS were asked to complete the shortened Test of Functional Health Literacy in Adults (S-TOFHLA), a 38-question instrument used to measure reading comprehension. Five additional questions were added to elicit demographic information. Printed handouts provided to class participants were also collected. The Gunning-Fog readability scale was used to assess the understandability and readability of the verbal and printed information presented to these patients.

Results:
All but one of the participants was male with a mean age of 55. Twenty-five are high school graduates, thirteen of whom have had some college education. Four of the twenty-five were college graduates. Seventy-three percent of patients tested have adequate functional health literacy (n=30). Twenty-seven percent scored inadequate (10%) or marginal (17%). Overall, the oral presentation was taught at the 11.5 grade level. The mean grade level of the printed materials was 10th grade. A moderate negative correlation was discovered between age and health literacy level with a Pearson’s r = -.5 (n=29). A weak to moderate negative correlation was also found between years of schooling and literacy score, Pearson’s r = -.3 (n=28).

Implications:
Although the majority of the subjects in this study have adequate functional health literacy, the needs of 27% of patients are not being met. This study confirms what has been illustrated in previous studies; reading ability declines with age and low level of education.

Impacts:
Results of this research along with data from the existing body of research on this subject can be used to improve readability and understandability of written patient education materials and course content of diabetes group education classes. This research has created a greater awareness of literacy issues and will lead to health literacy trainings for practitioners on how to improve health communications and incorporate health literacy principles in health materials.


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