Development and pilot evaluation of literacy-adapted diabetes and CVD education in urban, diabetic African Americans

Felicia Hill-Briggs, Ronda Renosky, Mariana Lazo-Elizondo, Lee R Bone, Martha Hill, David Levine, Frederick L. Brancati, Mark Peyrot

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Abstract

BACKGROUND: Despite prevalent low literacy nationally, empirical research on the development and testing of literacy-adapted patient education remains limited. OBJECTIVE: To describe procedures for developing and evaluating usability and acceptability of an adapted diabetes and CVD patient education. DESIGN: Materials adaptation for literacy demand and behavioral activation criteria, and pre-/post-test intervention evaluation design. PARTICIPANTS: Pilot sample of 30 urban African-American adults with type 2 diabetes with Below Average literacy (n=15) and Average literacy (n=15). MEASUREMENTS: Wide Range Achievement Test (WRAT-3, Reading), assessment of diabetes and CVD knowledge, and patient rating scale. RESULTS: Reading grade levels were: >12th, 30%; 10th-12th, 20%; 7th-9th, 10%; 4th-6th grade, 10%; and ≥3rd grade or unable to complete WRAT-3, 30%. Education materials were modified to a reading level of ≥4th grade. Knowledge improved for Below Average (2.7 to 4.7, p=0.005) and Average (3.8 to 5.7, p=0.002) literacy groups, with up to a ten-fold increase, at post-education, in the number of participants responding correctly to some content items. The print materials and class received maximum usability and acceptability ratings from patients. CONCLUSIONS: Development of patient education meeting very low literacy criteria was feasible, effective for knowledge acquisition, and highly acceptable irrespective of literacy level.

Original languageEnglish (US)
Pages (from-to)1491-1494
Number of pages4
JournalJournal of General Internal Medicine
Volume23
Issue number9
DOIs
StatePublished - Sep 2008

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African Americans
Education
Patient Education
Reading
Empirical Research
Literacy
Type 2 Diabetes Mellitus
Research

ASJC Scopus subject areas

  • Internal Medicine

Cite this

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title = "Development and pilot evaluation of literacy-adapted diabetes and CVD education in urban, diabetic African Americans",
abstract = "BACKGROUND: Despite prevalent low literacy nationally, empirical research on the development and testing of literacy-adapted patient education remains limited. OBJECTIVE: To describe procedures for developing and evaluating usability and acceptability of an adapted diabetes and CVD patient education. DESIGN: Materials adaptation for literacy demand and behavioral activation criteria, and pre-/post-test intervention evaluation design. PARTICIPANTS: Pilot sample of 30 urban African-American adults with type 2 diabetes with Below Average literacy (n=15) and Average literacy (n=15). MEASUREMENTS: Wide Range Achievement Test (WRAT-3, Reading), assessment of diabetes and CVD knowledge, and patient rating scale. RESULTS: Reading grade levels were: >12th, 30{\%}; 10th-12th, 20{\%}; 7th-9th, 10{\%}; 4th-6th grade, 10{\%}; and ≥3rd grade or unable to complete WRAT-3, 30{\%}. Education materials were modified to a reading level of ≥4th grade. Knowledge improved for Below Average (2.7 to 4.7, p=0.005) and Average (3.8 to 5.7, p=0.002) literacy groups, with up to a ten-fold increase, at post-education, in the number of participants responding correctly to some content items. The print materials and class received maximum usability and acceptability ratings from patients. CONCLUSIONS: Development of patient education meeting very low literacy criteria was feasible, effective for knowledge acquisition, and highly acceptable irrespective of literacy level.",
author = "Felicia Hill-Briggs and Ronda Renosky and Mariana Lazo-Elizondo and Bone, {Lee R} and Martha Hill and David Levine and Brancati, {Frederick L.} and Mark Peyrot",
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AU - Renosky, Ronda

AU - Lazo-Elizondo, Mariana

AU - Bone, Lee R

AU - Hill, Martha

AU - Levine, David

AU - Brancati, Frederick L.

AU - Peyrot, Mark

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N2 - BACKGROUND: Despite prevalent low literacy nationally, empirical research on the development and testing of literacy-adapted patient education remains limited. OBJECTIVE: To describe procedures for developing and evaluating usability and acceptability of an adapted diabetes and CVD patient education. DESIGN: Materials adaptation for literacy demand and behavioral activation criteria, and pre-/post-test intervention evaluation design. PARTICIPANTS: Pilot sample of 30 urban African-American adults with type 2 diabetes with Below Average literacy (n=15) and Average literacy (n=15). MEASUREMENTS: Wide Range Achievement Test (WRAT-3, Reading), assessment of diabetes and CVD knowledge, and patient rating scale. RESULTS: Reading grade levels were: >12th, 30%; 10th-12th, 20%; 7th-9th, 10%; 4th-6th grade, 10%; and ≥3rd grade or unable to complete WRAT-3, 30%. Education materials were modified to a reading level of ≥4th grade. Knowledge improved for Below Average (2.7 to 4.7, p=0.005) and Average (3.8 to 5.7, p=0.002) literacy groups, with up to a ten-fold increase, at post-education, in the number of participants responding correctly to some content items. The print materials and class received maximum usability and acceptability ratings from patients. CONCLUSIONS: Development of patient education meeting very low literacy criteria was feasible, effective for knowledge acquisition, and highly acceptable irrespective of literacy level.

AB - BACKGROUND: Despite prevalent low literacy nationally, empirical research on the development and testing of literacy-adapted patient education remains limited. OBJECTIVE: To describe procedures for developing and evaluating usability and acceptability of an adapted diabetes and CVD patient education. DESIGN: Materials adaptation for literacy demand and behavioral activation criteria, and pre-/post-test intervention evaluation design. PARTICIPANTS: Pilot sample of 30 urban African-American adults with type 2 diabetes with Below Average literacy (n=15) and Average literacy (n=15). MEASUREMENTS: Wide Range Achievement Test (WRAT-3, Reading), assessment of diabetes and CVD knowledge, and patient rating scale. RESULTS: Reading grade levels were: >12th, 30%; 10th-12th, 20%; 7th-9th, 10%; 4th-6th grade, 10%; and ≥3rd grade or unable to complete WRAT-3, 30%. Education materials were modified to a reading level of ≥4th grade. Knowledge improved for Below Average (2.7 to 4.7, p=0.005) and Average (3.8 to 5.7, p=0.002) literacy groups, with up to a ten-fold increase, at post-education, in the number of participants responding correctly to some content items. The print materials and class received maximum usability and acceptability ratings from patients. CONCLUSIONS: Development of patient education meeting very low literacy criteria was feasible, effective for knowledge acquisition, and highly acceptable irrespective of literacy level.

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