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Health Literacy and Health Outcomes in Diabetes

  • Author / Creator
    Al Sayah, Fatima
  • 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.

  • Subjects / Keywords
  • Graduation date
    2013-11
  • Type of Item
    Thesis
  • Degree
    Doctor of Philosophy
  • DOI
    https://doi.org/10.7939/R3296V
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
    English
  • Institution
    University of Alberta
  • Degree level
    Doctoral
  • Department
    • School of Public Health Sciences
  • Supervisor / co-supervisor and their department(s)
    • Williams, Beverly (Faculty of Nursing, University of Alberta)
    • Johnson, Jeff A. (School of Public Health Sciences, University of Alberta)
  • Examining committee members and their departments
    • Rothman, Russell L. (Biomedical Research Education & Training, Vanderbilt University)
    • Simpson, Scot (Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta)