Impact of a Culturally Oriented Low Health Literacy Education in Diabetes Related Knowledge among Hispanics with Diabetes

Hispanics have higher risk of developing type-2 diabetes and worse diabetes control compared to Whites. These and other findings provided impetus for conducting a study to evaluate the effectiveness of a low-literacy educational tool to enhance diabetes knowledge among Hispanics in Massachusetts. The tool (“La historia de Rosa”) uses first-person stories to convey information about diabetes diagnosis, prevention, blood glucose control, nutrition, medications and exercise. The study used a factorial design which included two treatment settings (i.e., community-based versus clinical setting) and two intervention approaches (i.e., standard educational intervention versus standard educational intervention + health literacy component). All participants (n=325) received a standard diabetes educational intervention, and completed baseline interviews to assess pre-intervention attitudes, beliefs, knowledge, and diabetes management strategies and post-intervention interviews as well as 3- and 6-month follow up interviews. More than 70% of the total sample reported annual household income of less than $15,000; and the majority of the participants were insured under Medicaid, Medicare, or both (81%). Almost 21% of the sample could not complete the health literacy screening tool (Newest Vital Sign) because they did not know how to read. Among those who could read, 72% scored at the limited literacy level. Diabetes knowledge increased after exposure to the educational intervention. At 3- and 6-month follow up, the knowledge scores declined but were still higher than baseline scores. Educational sessions like the ones delivered through the study could reduce the treatment cost of diabetes and preventable complications that result from lack of information about disease management practices.