Literacy and health outcomes: A cross-sectional study in 1002 adults with diabetes

被引：80
作者：
Morris N.S. [1 ]
MacLean C.D. [2 ]
Littenberg B. [1 ,2 ]
机构：
[1] College of Nursing and Health Sciences, University of Vermont, Burlington, VT
[2] College of Medicine, University of Vermont, Burlington, VT
来源：
BMC Family Practice | / 7卷 / 1期
关键词：
Glycemic Control; Health Literacy; Disease Management Program; Diabetes Education; Good Glycemic Control;
D O I：
10.1186/1471-2296-7-49
中图分类号：
学科分类号：
摘要：
Background: Inconsistent findings reported in the literature contribute to the lack of complete understanding of the association of literacy with health outcomes. We evaluated the association between literacy, physiologic control and diabetes complications among adults with diabetes. Methods: A cross-sectional study of 1,002 English speaking adults with diabetes, randomly selected from the Vermont Diabetes Information System, a cluster-randomized trial of a diabetes decision support system in a region-wide sample of primary care practices was conducted between July 2003 and March 2005. Literacy was assessed by the Short-Test of Functional Health Literacy in Adults. Outcome measures included glycated hemoglobin, low density lipoprotein, blood pressure and self-reported complications. Results: After adjusting for sociodemographic characteristics, duration of diabetes, diabetes education, depression, alcohol use, and medication use we did not find a significant association between literacy and glycemic control (beta coefficent,+ 0.001; 95% confidence interval [CI], -0.01 to +0.01; P = .88), systolic blood pressure (beta coefficent, +0.08; 95% CI, -0.10 to +0.26; P = .39), diastolic blood pressure (beta coefficent, -0.03; 95% CI, -0.12 to +0.07, P = .59), or low density lipoprotein (beta coefficent, +0.04; 95% CI, -0.27 to +0.36, P = .77. We found no association between literacy and report of diabetes complications. Conclusion: These findings suggest that literacy, as measured by the S-TOFHLA, is not associated with glycated hemoglobin, blood pressure, lipid levels or self-reported diabetes complications in a cross-sectional study of older adults with diabetes under relatively good glycemic control. Additional studies to examine the optimal measurement of health literacy and its relationship to health outcomes over time are needed. © 2006 Morris et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 32 条
[1]  
Kirsch I.S., The International Adult Literacy Survey (IALS): Understanding What Was Measured, (2001)
[2]  
Nielsen-Bohlman, Health Literacy, a Prescription to End Confusion, (2004)
[3]  
Arnold C.L., Davis T.C., Berkel H.J., Jackson R.H., Nandy I., London S., Smoking status, reading level, and knowledge of tobacco effects among low-income pregnant women, Prev Med, 32, 4, pp. 313-320, (2001)
[4]  
Bennett C.L., Relation between literacy, race, and stage of presenation among low-income patients with prostate cancer, Journal of Clinical Oncology, 16, 9, pp. 3101-3104, (1998)
[5]  
Fortenberry J.D., McFarlane M.M., Hennessy M., Bull S.S., Grimley D.M., St Lawrence J., Stoner B.P., VanDevanter N., Relation of health literacy to gonorrhoea related care, Sex Transm Infect, 77, 3, pp. 206-211, (2001)
[6]  
Lindau S.T., Tomori C., Lyons T., Langseth L., Bennett C.L., Garcia P., The association of health literacy with cervical cancer prevention knowledge and health behaviors in a multiethnic cohort of women, Am J Obstet Gynecol, 186, 5, pp. 938-943, (2002)
[7]  
Scott T.L., Gazmararian J.A., Williams M.V., Baker D.W., Health literacy and preventive health care use among Medicare enrollees in a managed care organization, Med Care, 40, 5, pp. 395-404, (2002)
[8]  
Williams M.V., Baker D.W., Honig E.G., Lee T.M., Nowlan A., Inadequate literacy is a barrier to asthma knowledge and self-care, Chest, 114, 4, pp. 1008-1015, (1998)
[9]  
Williams M.V., Baker D.W., Parker R.M., Nurss J.R., Relationship of functional health literacy to patients' knowledge of their chronic disease. A study of patients with hypertension and diabetes, Arch Intern Med, 158, 2, pp. 166-172, (1998)
[10]  
Baker D.W., Gazmararian J.A., Williams M.V., Scott T., Parker R.M., Green D., Ren J., Peel J., Functional health literacy and the risk of hospital admission among Medicare managed care enrollees, Am J Public Health, 92, 8, pp. 1278-1283, (2002)
1234