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Permanent link (DOI): https://doi.org/10.7939/R34X25
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Health Literacy and Health Outcomes in Diabetes Open Access
- Other title
- Type of item
- Degree grantor
University of Alberta
- Author or creator
Al Sayah, Fatima
- Supervisor and department
Williams, Beverly (Faculty of Nursing, University of Alberta)
Majumdar, Sumit R. (Department of Medicine, University of Alberta)
Johnson, Jeff A. (School of Public Health Sciences, University of Alberta)
- Examining committee member and department
Rothman, Russell (Department of Medicine, Vanderbilt University)
Simpson, Scot (Pharmaceutical Sciences, University of Alberta)
Department of Public Health Sciences
Faculty of Nursing
- Date accepted
- Graduation date
Doctor of Philosophy
- Degree level
There is a general agreement that a relationship exists between health literacy (HL) and health outcomes. Nonetheless, there are critical gaps in the measurement of HL and in the evidence on the impact of inadequate HL on health outcomes, especially in the diabetes population. These gaps need to be addressed before any recommendations regarding HL screening or interventions are implemented.
To address these gaps, first we conducted two systematic reviews, one in which we reviewed the evidence on the relationship between HL and health outcomes in the diabetes population, and the other consisted of a review and evaluation of HL measures used in this population. Then we conducted a validation study that examined the measurement properties of a HL measure; a longitudinal study that examined the associations between HL and health outcomes in individuals with diabetes; and last, a qualitative study that examined the use of interactive communication loops and medical jargon in relation to HL in nurses’ interaction with individuals with diabetes.
We found that the evidence on the impact of HL on health outcomes in the diabetes population is limited and inconclusive; measures of HL are not comprehensive enough with limited evidence on their measurement properties; the 3-brief screening questions are potentially a useful measure for screening for inadequate HL; inadequate HL was not associated with worse health outcomes in individuals with diabetes and depressive symptoms; and healthcare providers may place high demands on patients through their communication and interaction with them.
Despite the use of rigorous research methods and the robust evidence generated, the overall available evidence on these relationships is still inconsistent and thus inconclusive. Our work highlights two crucial questions that need to be examined “how to comprehensively measure HL?” and “whether HL is modifiable?” Until, these questions – and others – are answered and conclusive evidence is available, we believe that, outside of the study setting, it might be premature to invest in routinely screening for HL or to trying to improve HL for the purposes of improving patient-related outcomes in diabetes, although there might be other reasons to do so.
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- Citation for previous publication
Al Sayah F, Majumdar SR, Williams B, Robertson S, Johnson JA. Health literacy and health outcomes in Diabetes: A systematic review. Journal of General Internal Medicine 2013 Mar; 28(3): 444-52.Al Sayah F, Williams B, Johnson JA. Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures. Health Education and Behavior 2013 Feb; 40(1): 42-55.
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