Miyong T Kim1, Kim B Kim, Jisook Ko, Nicole Murry, Bo Xie, Kavita Radhakrishnan, Hae-Ra Han. 1. Miyong T. Kim, PhD, RN, FAAN, is Professor, School of Nursing, The University of Texas at Austin. Kim B. Kim, PhD, is President, Korean Resource Center, Ellicott City, Maryland. Jisook Ko, PhD, RN, is Assistant Professor, The University of Texas Health Science Center at San Antonio. Nicole Murry, RN, PhD, is Assistant Professor, School of Nursing, The University of Texas at Austin. Bo Xie, PhD, is Professor, School of Nursing, The University of Texas at Austin. Kavita Radhakrishnan, RN, PhD, is Associate Professor, School of Nursing, The University of Texas at Austin. Hae-Ra Han, PhD, RN, FAAN, is Professor, Johns Hopkins University School of Nursing, Baltimore, Maryland.
Abstract
BACKGROUND: Although scientific reports increasingly document the negative impact of inadequate health literacy on health-seeking behaviors, health literacy's effect on health outcomes in patients with diabetes is not entirely clear, owing to insufficient empirical studies, mixed findings, and insufficient longitudinal research. OBJECTIVE: The aim of this study was to empirically examine underlying mechanisms of health literacy's role in diabetes management among a group of Korean Americans with Type 2 diabetes mellitus. METHODS: Data from a randomized clinical trial of a health literacy-focused Type 2 diabetes self-management intervention conducted during 2012-2016 in the Korean American community were collected at baseline and at 3, 6, 9, and 12 months. A total of 250 Korean Americans with Type 2 diabetes participated (intervention, 120; control, 130). Participants were first-generation Korean American immigrants. Health literacy knowledge was measured with the original Rapid Estimate of Adult Literacy in Medicine and the diabetes mellitus-specific Rapid Estimate of Adult Literacy in Medicine. Functional health literacy was measured with the numeracy subscale of the Test of Functional Health Literacy in Adults and the Newest Vital Sign screening instrument, which also uses numeracy. Primary outcomes included glucose control and diabetes quality of life. Multivariate analyses included latent variable modeling. RESULTS: A series of path analyses identified self-efficacy and self-care skills as significant mediators between health literacy and glucose control and quality of life. Education and acculturation were the most significant correlates of health literacy. DISCUSSION: Despite inconsistent findings in the literature, this study indicates that health literacy may indirectly influence health outcomes through mediators such as self-care skills and self-efficacy. The study highlights the importance of health literacy, as well as underlying mechanisms with which health literacy influences processes and outcomes of diabetes self-management.
RCT Entities:
BACKGROUND: Although scientific reports increasingly document the negative impact of inadequate health literacy on health-seeking behaviors, health literacy's effect on health outcomes in patients with diabetes is not entirely clear, owing to insufficient empirical studies, mixed findings, and insufficient longitudinal research. OBJECTIVE: The aim of this study was to empirically examine underlying mechanisms of health literacy's role in diabetes management among a group of Korean Americans with Type 2 diabetes mellitus. METHODS: Data from a randomized clinical trial of a health literacy-focused Type 2 diabetes self-management intervention conducted during 2012-2016 in the Korean American community were collected at baseline and at 3, 6, 9, and 12 months. A total of 250 Korean Americans with Type 2 diabetes participated (intervention, 120; control, 130). Participants were first-generation Korean American immigrants. Health literacy knowledge was measured with the original Rapid Estimate of Adult Literacy in Medicine and the diabetes mellitus-specific Rapid Estimate of Adult Literacy in Medicine. Functional health literacy was measured with the numeracy subscale of the Test of Functional Health Literacy in Adults and the Newest Vital Sign screening instrument, which also uses numeracy. Primary outcomes included glucose control and diabetes quality of life. Multivariate analyses included latent variable modeling. RESULTS: A series of path analyses identified self-efficacy and self-care skills as significant mediators between health literacy and glucose control and quality of life. Education and acculturation were the most significant correlates of health literacy. DISCUSSION: Despite inconsistent findings in the literature, this study indicates that health literacy may indirectly influence health outcomes through mediators such as self-care skills and self-efficacy. The study highlights the importance of health literacy, as well as underlying mechanisms with which health literacy influences processes and outcomes of diabetes self-management.
Authors: Nancy D Berkman; Stacey L Sheridan; Katrina E Donahue; David J Halpern; Karen Crotty Journal: Ann Intern Med Date: 2011-07-19 Impact factor: 25.391
Authors: Miyong T Kim; Kim B Kim; Boyun Huh; Tam Nguyen; Hae-Ra Han; Lee R Bone; David Levine Journal: Am J Prev Med Date: 2015-07-14 Impact factor: 5.043
Authors: Barry D Weiss; Mary Z Mays; William Martz; Kelley Merriam Castro; Darren A DeWalt; Michael P Pignone; Joy Mockbee; Frank A Hale Journal: Ann Fam Med Date: 2005 Nov-Dec Impact factor: 5.166
Authors: Candace D McNaughton; Sunil Kripalani; Courtney Cawthon; Lorraine C Mion; Kenneth A Wallston; Christianne L Roumie Journal: Med Care Date: 2014-04 Impact factor: 2.983
Authors: Miyong T Kim; Hae-Ra Han; Hee-Jung Song; Jong-Eun Lee; Jiyun Kim; Jai P Ryu; Kim B Kim Journal: Diabetes Educ Date: 2009 Nov-Dec Impact factor: 2.140
Authors: Judy A Shea; Benjamin B Beers; Vanessa J McDonald; D Alex Quistberg; Karima L Ravenell; David A Asch Journal: Fam Med Date: 2004-09 Impact factor: 1.756