Purpose Low health literacy is common among patients with type 2 diabetes mellitus and is associated with less disease knowledge, poorer understanding of the disease and its complications, and worse glycemic control. The purpose of this study was to evaluate the relationship between health literacy and patients' readiness to take health actions to help explain patients' level of glycemic control.
Methods Sixty-eight diabetic patients, receiving care in an academic general internal medicine clinic, were administered the Rapid Estimate of Adult Literacy in Medicine (REALM) literacy instrument, Diabetes Health Belief Model (DHBM) scale, and Diabetes Knowledge Test (DKT). Multivariable linear regression was used to assess association between REALM literacy level, DKT score, DHBM scale score, and most recent hemoglobin A1c while controlling for other covariates of interest.
Results After controlling for covariates of interest, no significant association between DHBM scale score and REALM literacy level was found (p = .29). However, both DKT score and most recent hemoglobin A1c level were found to be significantly associated with patient literacy (p = .004 and p = .02, respectively). Based on the multivariable model, patients with less than a 4th grade literacy level had 13% lower DKT scores (95% CI = 228% to 22%, p = .08) and 1.36% higher most recent hemoglobin A1c levels (95% CI = 1.06% to 1.73%, p = .02) relative to those with a high school literacy level.
Conclusions While low health literacy was significantly associated with worse glycemic control and poorer disease knowledge in patients with type 2 diabetes, there was no significant relationship with their readiness to take action in disease management.
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