TY - JOUR
T1 - The impact of health literacy on diabetes self-management education
AU - Vandenbosch, Jessica
AU - Van den Broucke, Stephan
AU - Schinckus, Louise
AU - Schwarz, Peter
AU - Doyle, Gerardine
AU - Pelikan, Jürgen
AU - Muller, Ingrid
AU - Levin-Zamir, Diane
AU - Schillinger, Dean
AU - Chang, Peter
AU - Terkildsen-Maindal, Helle
N1 - Funding Information:
This study was part of the Diabetes Literacy Project carried out between 2013 and 2015 by the Diabetes Literacy Consortium, composed of researchers from the Catholic University of Louvain, Belgium; Clalit Health Services, Israel; the Ludwig Boltzmann Institute Health Promotion Research, Austria; Maastricht University, the Netherlands; Taipei Medical University, Taiwan; Dresden University of Technology, Germany; University College Dublin, Ireland; the University of California San Francisco, USA; and the University of Southampton, UK, together with Aarhus University, Denmark and the University of Pretoria, South Africa as collaborating partners. The authors would like to thank all stakeholders and researchers who contributed to the study development and data collection and who provided relevant comments and feedback on this manuscript.
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Diabetes Literacy Project was funded by the European Union’s (EU) 7th Framework Programme for research, technological development and demonstration (grant agreement 306186) and the national organisations taking part in the project. D.S. was also supported by NIH grant 2P30 NIDDK092924-06.
Publisher Copyright:
© 2018, © The Author(s) 2018.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background: Diabetes self-management education (DSME) is generally considered to be a key determinant of the treatment outcomes and related costs of diabetes mellitus. While DSME programmes generally have positive outcomes, their effects may depend on certain factors, such as the type of programmes provided and patients’ level of health literacy (HL). Low HL has been associated with poorer self-management behaviours and poor medication adherence in diabetic patients, but its impact on the effects of DSME has not yet been systematically investigated. This study aimed to investigate the influence of HL on the self-reported effects of DSME programmes while taking the type of programme into consideration. Method: A total of 366 diabetic patients from nine countries completed a questionnaire measuring HL, self-management behaviours, problem perception, coping, perceived general health and well-being, before and after participating in a DSME programme. Results: DSME programmes were found to have positive effects on self-reported self-management behaviours and almost all psychological and health outcomes, regardless of HL level. Patients with high HL scored better on several diabetes outcomes than those with low HL, but all patients described benefiting from DSME. Individual and group-based programmes resulted in more positive effects on several diabetes outcomes than self-help groups, but no interaction with HL was found. Conclusion: Our findings confirm those of previous studies showing that DSME programmes have positive effects and that low HL is associated with lower diabetes outcomes but do not support the assumption that the effects of DSME programmes are influenced by the patient’s HL. However, due to the limitations of this study, further investigation is necessary to support these findings and improve our understanding about the impact of HL on DSME programmes’ effectiveness.
AB - Background: Diabetes self-management education (DSME) is generally considered to be a key determinant of the treatment outcomes and related costs of diabetes mellitus. While DSME programmes generally have positive outcomes, their effects may depend on certain factors, such as the type of programmes provided and patients’ level of health literacy (HL). Low HL has been associated with poorer self-management behaviours and poor medication adherence in diabetic patients, but its impact on the effects of DSME has not yet been systematically investigated. This study aimed to investigate the influence of HL on the self-reported effects of DSME programmes while taking the type of programme into consideration. Method: A total of 366 diabetic patients from nine countries completed a questionnaire measuring HL, self-management behaviours, problem perception, coping, perceived general health and well-being, before and after participating in a DSME programme. Results: DSME programmes were found to have positive effects on self-reported self-management behaviours and almost all psychological and health outcomes, regardless of HL level. Patients with high HL scored better on several diabetes outcomes than those with low HL, but all patients described benefiting from DSME. Individual and group-based programmes resulted in more positive effects on several diabetes outcomes than self-help groups, but no interaction with HL was found. Conclusion: Our findings confirm those of previous studies showing that DSME programmes have positive effects and that low HL is associated with lower diabetes outcomes but do not support the assumption that the effects of DSME programmes are influenced by the patient’s HL. However, due to the limitations of this study, further investigation is necessary to support these findings and improve our understanding about the impact of HL on DSME programmes’ effectiveness.
KW - Health literacy
KW - patient education
KW - self-management education programmes
KW - type 2 diabetes
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U2 - 10.1177/0017896917751554
DO - 10.1177/0017896917751554
M3 - Article
AN - SCOPUS:85042092921
SN - 0017-8969
VL - 77
SP - 349
EP - 362
JO - Health Education Journal
JF - Health Education Journal
IS - 3
ER -
