Diabetes teaching modules for those with low literacy

A series of diabetes low-literacy handouts and teaching modules for patients with low educational levels and limited English proficiency were developed. The development was based upon ideas from focus groups conducted with clinical staff, (nurses, dieticians, certified diabetes educators and medical assistants) from two Community Health Centers. The clinicians defined the topics and the target audience. They emphasized that materials must be written at a very-low reading level, with a single uncomplicated message that could be delivered in a brief encounter. Having Spanish versions available was also important. Draft versions of the pamphlets were reviewed in another focus group with staff and by a diabetes patient support group, and they were modified according to their comments.

The pamphlets address blood sugar, diabetes medication, healthy eating, physical activity, depression, stress management and support from family and friends. They are written at a fourth grade level with simple short phrases and illustrated with Word's Clip Art. They are low cost in that each is “Camera Ready,” so organizations can make their own. They are also available in Spanish. The teaching modules describe talking points that community health workers and medical assistants can use to reinforce the self-management practices in the pamphlets, and to begin conversations. In addition a colored poster entitled “Live free with Diabetes” was created illustrating the Statue of Liberty wearing sneakers and surrounded by icons that represent diabetes management. Electronic versions of the materials are available free of charge from the Connecticut Department of Public Health.