Diabetes and Low-Health Literacy: A Preliminary Outcome Report of a Mediated Intervention to Enhance Patient-Physician Communication

Abstract

Patients with diabetes who experience low-health literacy often struggle in their roles as health consumers. A multi-disciplinary group of educators and researchers collaborated to develop a video intervention to help these patients better understand their disease and communicate more effectively with their physician. We describe the assessment study and report preliminary patient perception outcome data regarding the utility of the videos as a communication and health education intervention. Generally, the participants found the intervention to be helpful and informative. For many, the intervention led them to consider behavior changes. For others, the intervention was a prompt for diabetes-related conversations with their physicians. Participant responses also provided empirical support that the intervention was consistent with key principles of message design for patients with low-health literacy.

Keywords:

• Diabetes
• Low–Health Literacy
• Mediated Interventions
• Patient–Physician Communication

Notes

1. One notable exception is the work of Seligman et al. (2007), which outlines guidelines for the development of appropriate interventions for encouraging this priority population to participate more fully in the patient–physician interaction.

2. Due to space constraints we are unable to provide a thorough discussion of the design of our intervention. For more detailed information regarding the development of the intervention including the topic selection process, design element decisions (i.e., our narrative approach, character development, message construction), pilot testing, and negotiation of patients and physicians' conflicting feedback during the pilot testing phase of the project see O'Hara, Shue, Marini, Flanagan, & McKenzie (2008) or contact the corresponding author.

3. The SILS assesses the degree to which patients need help reading health-related information. The SILS was originally evaluated using participants with diabetes and compared with results obtained from the Short Test of Functional Health Literacy in Adults (S-TOFHLA) (Parker, Baker, Williams, & Nurss, 1995), a standard health literacy assessment tool (Morris et al., 2006). The advantage of using SILS is time savings; the S-TOFHLA is a 36-item, 7-minute timed assessment (Baker et al., 1999). A limitation of the SILS is the possibility of a false negative result; patients may self-report higher health literacy levels due to lack of understanding, shame, or misunderstanding of the question (Morris et al., 2006).

4. Contact the corresponding author for a copy of the video transcripts that illustrates Charlene's use of simple language and strong empathy (e.g., comparisons between her own experience and the viewers' experience and use of the pronoun “you” and “our”).

5. Chi-square analyses were computed using first the SILS score and then insurance type as a potential indicator of low-health literacy.

Additional information

Notes on contributors

Carolyn K. Shue

Carolyn K. Shue, Ph.D., Ball State University, Muncie, IN

Laura L. S. O'Hara

Laura L. S. O'Hara, Ph.D., Ball State University, Muncie, IN

David Marini

David Marini, Ph.D., Ball State University, Muncie, IN

Jim McKenzie

Jim McKenzie, Ph.D., Ball State University, Muncie, IN

Melanie Schreiner

Melanie Schreinder, M.D. Ball Memorial Hospital Family Medicine Residency Program, Muncie, IN