Impact of health literacy on outcomes and effectiveness of an educational intervention in patients with chronic diseases

Objective: Study impact of health literacy on educational intervention for patients "Living with Coronary Artery Disease." Methods: 187 patients were randomized to: VHS/DVD plus printed booklet; or booklet alone prior to scheduled visit. Main outcome measures included CAD knowledge assessment, clinical outcomes (weigh and blood pressure) and health behaviors (diet, exercise, and smoking); while functional health literacy was assessed as a possible predictor variable. Results: Knowledge scores and health behaviors improved following both interventions. Those receiving the booklet and video also had a significant improvement in exercise, and weight loss. There was a trend (p = 0.07) towards greater improvement in test scores among those receiving the booklet plus video. Patients with lower health literacy benefited as much as higher literacy patients. Conclusions: Incorporation of an educational program into clinical visits for patients with chronic disease improved disease-specific knowledge and prompted patients to become activated and involved in their care, improving health behaviors and outcomes. Lower health literacy was not a barrier to this beneficial effect. Practice implications: Patients with lower health literacy may also benefit from educational, shared decision-making interventions. (C) 2011 Elsevier Ireland Ltd. All rights reserved.