Health Literacy of Diabetics at a Free Community Health Clinic

Background: According to the National Assessment of Adult Literacy, only 12% of U.S. adults have proficient health literacy and over 77 million people have difficulty with common health related tasks, including following directions on a prescription drug label. Even with extensive research discoveries related to the pathology of diabetes, the complications of the disease state continue to rise. In diabetes, health literacy includes knowledge of the disease, self-care behaviors, and glycemic control. Individuals with inadequate health literacy levels have poorer health outcomes regardless of illness, social and economic status, education, gender, and age. Individuals with diabetes who attend a free community health clinic may have limited resources and education, which further compound their health outcomes.

Purpose: The purpose of this study was to assess health literacy of individuals with diabetes who attend a free community health clinic.

Theoretical/Conceptual Framework: Orem’s Self-Care Deficit Theory was used as the guiding framework. Self-care is an essential component to managing diabetes. Nurses need to educate individuals on self-care practices in accordance with their health literacy level.

Methods: The sample consisted of individuals who attend a free community health clinic ages 18 years and older who self-identify as having been diagnosed with diabetes. Individuals received an overview of the study and provided informed consent. Participants answered demographic and health questions and responded to 3 health literacy questions using a Likert scale.

Results: To date, 29 type 2 and 2 type 1 diabetics (21 females, 10 males) ages 27-84 years, 71% (22) white, 16% (5) Latino/Hispanic, and 13% (4) black/African American completed the study. Of these 58% had more than high school education and 41.9% were unemployed. Health literacy questions indicated that 38.1% were not at all confident in filling out medical forms by themselves, 35.5% had problems understanding written information, and 23.8% required help to read hospital materials.

Limitations: This was a convenience sample of a single community health clinic with unequal representation by race and gender.

Conclusions: Preliminary findings suggest that health literacy level should be considered when providing self-care education to diabetics. Written health care information should be appropriate to the identified health literacy level, discussed with the individual and other support care person. Comprehension of information should be reassessed.