Tailored Education in a Novel Multimedia Diabetes Education Program

Objectives: To evaluate the effectiveness of Teach To Goal (TTG) as an adjunct to a novel multimedia diabetes educational program (MDEP), an educational intervention targeted to populations with low literacy. Subjects included patients with and without diabetes from 35 to 75 years of age visiting general medicine clinics at an academic institution or a federally qualified health center.

A pretest-posttest model for the MDEP-TTG intervention included a 17-item knowledge assessment and the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The posttest was conducted via telephone 2-6 weeks later. A comparison group acquired earlier from the same patient population received the MDEP only. The primary endpoints compared posttest knowledge scores and changes in knowledge.

In both the MDEP-TTG (n=19) and comparison groups (n=193), subjects tended to be in the sixth decade of life, female, African American, and have a high school diploma. Demographic characteristics between groups were not significantly different. Follow-up posttests were completed for 68% of MDEP-TTG subjects and 60% of comparison subjects. Two subjects in the MDEP-TTG and 21 in the comparison group had less than adequate literacy. Decrease in knowledge over the follow-up period (p=0.18) and overall increase in knowledge (p=0.39) were not significantly different between study groups.

TTG alone may be inadequate to achieve desired knowledge goals. Small sample size of the MDEP-TTG group may limit the study. Further recruitment is in progress. Additional research is needed to investigate the usefulness of TTG in effecting behavior change, improving health outcomes, and overcoming health literacy barriers.