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The impact of health literacy on diabetes self-management education

The impact of health literacy on diabetes self-management education
The impact of health literacy on diabetes self-management education

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.

Health literacy, patient education, self-management education programmes, type 2 diabetes
0017-8969
349-362
Vandenbosch, Jessica
71762812-09de-44a4-bcc6-c5946cd98df6
Van den Broucke, Stephan
d5f8b478-5d79-4cd6-8534-a6f684429122
Schinckus, Louise
88f19b21-a9ad-4980-936a-a2f4e0cedf7f
Schwarz, Peter
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Doyle, Gerardine
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Pelikan, Jürgen
323736dc-bd1d-42a4-b12b-09763be45d27
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Levin-Zamir, Diane
6aa5604e-a390-473c-a55f-d34cf6bc8886
Schillinger, Dean
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Chang, Peter
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Terkildsen-Maindal, Helle
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Vandenbosch, Jessica
71762812-09de-44a4-bcc6-c5946cd98df6
Van den Broucke, Stephan
d5f8b478-5d79-4cd6-8534-a6f684429122
Schinckus, Louise
88f19b21-a9ad-4980-936a-a2f4e0cedf7f
Schwarz, Peter
46b8ec53-c04c-4a0d-99d5-a362175eddc2
Doyle, Gerardine
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Pelikan, Jürgen
323736dc-bd1d-42a4-b12b-09763be45d27
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Levin-Zamir, Diane
6aa5604e-a390-473c-a55f-d34cf6bc8886
Schillinger, Dean
c3e88480-07b9-493f-903c-c9b7b5e06d18
Chang, Peter
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Terkildsen-Maindal, Helle
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Vandenbosch, Jessica, Van den Broucke, Stephan, Schinckus, Louise, Schwarz, Peter, Doyle, Gerardine, Pelikan, Jürgen, Muller, Ingrid, Levin-Zamir, Diane, Schillinger, Dean, Chang, Peter and Terkildsen-Maindal, Helle (2018) The impact of health literacy on diabetes self-management education. Health Education Journal, 77 (3), 349-362. (doi:10.1177/0017896917751554).

Record type: Article

Abstract

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.

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HEJ-17-0250.R1 (Final version 2017-12-01) - Accepted Manuscript
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Accepted/In Press date: 1 January 2018
e-pub ahead of print date: 22 January 2018
Published date: 1 April 2018
Keywords: Health literacy, patient education, self-management education programmes, type 2 diabetes

Identifiers

Local EPrints ID: 418650
URI: http://eprints.soton.ac.uk/id/eprint/418650
ISSN: 0017-8969
PURE UUID: f8eabd95-f4f2-450d-8d7d-2acd5ade8d67
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133

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Date deposited: 14 Mar 2018 17:30
Last modified: 16 Mar 2024 03:59

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Contributors

Author: Jessica Vandenbosch
Author: Stephan Van den Broucke
Author: Louise Schinckus
Author: Peter Schwarz
Author: Gerardine Doyle
Author: Jürgen Pelikan
Author: Ingrid Muller ORCID iD
Author: Diane Levin-Zamir
Author: Dean Schillinger
Author: Peter Chang
Author: Helle Terkildsen-Maindal

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