Online Program

Association between health literacy and diabetes outcomes and self-management behaviors among older US adults

Sunday, November 3, 2013

Maria F. Montoya, PhDc, M.P.H, School of Public Health, Department of Behavioral and Community Health, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX
Dennis Thombs, PhD, FAAHB, Chair, Department of Behavioral and Community Health, University of North Texas Health Science Center, Fort Worth, TX
Subhash Aryal, PhD, MS, School of Public Health, Department of Biostatistics, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX
Emily Spence-Almaguer, PhD, MSW, School of Public Health, Department of Health Systems and Health Behaviors, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX
Introduction: Diabetes Mellitus (DM) affects an estimated 10.9 million people aged 65 and older in the U.S. The prevalence of diabetes in the U.S. is expected to increase given the continued increase in the prevalence of associated risk factors.Chronic complications such as blindness, amputations, nephropathy, retinopathy, higher rates of hospitalizations, and increased mortality risk, tend to be more severe among older adults. DM requires patients to alter their lifelong behaviors, engage in routine self-monitoring, and adhere to recommended self-care behaviors. Studies have suggested that limited health literacy (HL) may be a potential new determinant of diabetes outcomes.Poor HL disproportionately affects people from low economic status,low educational attainment, recent immigrants, the elderly, ethnic minorities, and patients with chronic conditions.

Methods: The sample consisted of 1063 participants who were age 55 years and older AND diagnosed with DM by self-report or through bio-marker laboratory testing. A proxy HL score was derived from four demographic variables. Logistic regressions, multiple and multivariate linear regressions were performed to test the hypotheses and the strength of the relationship between the proxy HL scores and dependent variables.

Results:In Progress

Conclusion: The novel approach for measuring HL enlisted in this study has potential for advancing our understanding of the association between HL and diabetes outcomes and self-management behaviors. To date, previous research is inconclusive, though none have analyzed data obtained from a national probability sample. This approach allows researchers the opportunity to measure HL at a population level and to contribute to the limited body of knowledge.

Learning Areas:

Chronic disease management and prevention
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Analyze the relationship between diabetes biomarkers (hemoglobin A1c, two-hour glucose tolerance test, and fasting glucose) and poor health literacy using a novel imputed measure of health literacy known as the Demographic Assessment for Health Literacy or DAHL; (respondents are classified into three groups: adequate, marginal, and inadequate health literacy. We also evaluate whether DAHL status is associated with known indicators of proper diabetes self-management such as recommended physical activity requirement, diabetes education, medication adherence, regular physician follow-up, achieving target blood pressure and LDL levels. We conducted secondary analysis on two variables: (v) foot exam and (vi) eyes exam; these variables are also indicators of proper diabetes self-management behaviors by the American Diabetes Association but have been shown in previous literature to be of small association to health literacy.

Keyword(s): Health Literacy, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the design, analysis, interpretation and writing of this work. It have previous research and publications on the following topics related to older adults(cancer screenings, domestic violence, access to vaccines, and food insecurity).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.