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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
1-14
Vandenbosch, Jessica
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Van den Broucke, Stephan
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Schinckus, Louise
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Schwarz, Peter
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Doyle, Gerardine
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Pelikan, Jürgen
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Muller, Ingrid
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Levin-Zamir, Diane
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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
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Schinckus, Louise
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Schwarz, Peter
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Doyle, Gerardine
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Pelikan, Jürgen
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Muller, Ingrid
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Levin-Zamir, Diane
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Schillinger, Dean
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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, 1-14. (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
Keywords: Health literacy, patient education, self-management education programmes, type 2 diabetes

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Local EPrints ID: 418650
URI: http://eprints.soton.ac.uk/id/eprint/418650
ISSN: 0017-8969
PURE UUID: f8eabd95-f4f2-450d-8d7d-2acd5ade8d67

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Date deposited: 14 Mar 2018 17:30
Last modified: 16 Dec 2019 18:23

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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
Author: Diane Levin-Zamir
Author: Dean Schillinger
Author: Peter Chang
Author: Helle Terkildsen-Maindal

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