Enhancing Health Literacy and Behavioural Change Within a Tele-care Education and Support Intervention for People with Type 2 Diabetes

Overview

Journal Health Expect

Publisher Wiley

Specialty Public Health

Date 2011 Apr 28

PMID 21521430

Citations 17

Authors

Andrew F Long

Tina Gambling

Affiliations

Soon will be listed here.

Abstract

Background: Behavioural change interventions for persons with chronic illness draw on a variety of theoretical approaches including motivational interviewing and shared decision making. Health literacy provides an additional, potentially powerful explanatory framework to guide research and practice.

Objective: To examine the changes in the depth and detail of diabetes-related knowledge and confidence for persons with type 2 diabetes.

Design: Two-year, prospective, observational study, using questionnaire data at two time points (baseline and 2 years later) and in-depth interviews with a theoretically selected subsample.

Setting And Participants: A total of 319 patients initially recruited from a deprived urban area in north-west England.

Intervention: Dedicated tele-carer education and support, tailored to the individual circumstances of the patient.

Main Outcome Measures: Perceptions of confidence, levels of empowerment, learning for self-care and most helpful aspects of the intervention.

Results: Over 90% expressed confidence in keeping their blood sugar controlled, and high levels of perceived empowerment (mean = 4.25; 95% CI, 4.17-4.33) were found. Changes in the depth and detail of diabetes-related knowledge and confidence, from the specific to the more general, were observed and enhanced competence in translating knowledge into practice.

Discussion And Conclusions: The intervention, built within a developed working partnership between tele-carer and patient, operated at two levels: health literacy, enhancing knowledge, developing personal skills and enabling self-control; and socio-psychological behavioural change, tailored to individuals within their socio-economic environments, enabling increased motivation and supportive problem-solving. Both approaches find reflection in the findings and provide powerful explanatory lenses to interrogate the data.

Citing Articles

Comparing the effects of premarital booklet- and video-based educations on the reproductive health literacy of engaged couples.

Bahrami-Samani S, Mohsenzadeh-Ledari F, Omidvar S, Khafri S, Mohsenian H Health Sci Rep. 2024; 7(10):e70116.

PMID: 39377020 PMC: 11456511. DOI: 10.1002/hsr2.70116.

The Effect of Health Literacy Intervention on Patients with Diabetes: A Systematic Review and Meta-Analysis.

Ran X, Chen Y, Jiang K, Shi Y Int J Environ Res Public Health. 2022; 19(20).

PMID: 36293659 PMC: 9602614. DOI: 10.3390/ijerph192013078.

Health literacy interventions for secondary prevention of coronary artery disease: a scoping review.

Beauchamp A, Talevski J, Niebauer J, Gutenberg J, Kefalianos E, Mayr B Open Heart. 2022; 9(1).

PMID: 35064057 PMC: 8785201. DOI: 10.1136/openhrt-2021-001895.

A theory of planned behavior-enhanced intervention to promote health literacy and self-care behaviors of type 2 diabetic patients.

Zeidi I, Morshedi H, Alizadeh Otaghvar H J Prev Med Hyg. 2021; 61(4):E601-E613.

PMID: 33628967 PMC: 7888399. DOI: 10.15167/2421-4248/jpmh2020.61.4.1504.

Development of health literacy among postgraduate students: From information literacy perspective.

Taheri A, Langarizadeh M, Dehkordi J, Yousefianzadeh O J Educ Health Promot. 2021; 9:338.

PMID: 33575374 PMC: 7871917. DOI: 10.4103/jehp.jehp_340_20.

References

Young R, Taylor J, Friede T, Hollis S, Mason J, Lee P . Pro-active call center treatment support (PACCTS) to improve glucose control in type 2 diabetes: a randomized controlled trial. Diabetes Care. 2005; 28(2):278-82. DOI: 10.2337/diacare.28.2.278. View

Freedman D, Bess K, Tucker H, Boyd D, Tuchman A, Wallston K . Public health literacy defined. Am J Prev Med. 2009; 36(5):446-51. DOI: 10.1016/j.amepre.2009.02.001. View

Panter-Brick C, Clarke S, Lomas H, Pinder M, Lindsay S . Culturally compelling strategies for behaviour change: a social ecology model and case study in malaria prevention. Soc Sci Med. 2005; 62(11):2810-25. DOI: 10.1016/j.socscimed.2005.10.009. View

Dalton C, Gottlieb L . The concept of readiness to change. J Adv Nurs. 2003; 42(2):108-17. DOI: 10.1046/j.1365-2648.2003.02593.x. View

Gambling T, Long A . Tailoring advice and optimizing response: a case study of a telephone-based support for patients with type 2 diabetes. Fam Pract. 2009; 27(2):179-85. DOI: 10.1093/fampra/cmp097. View

Long A, Gambling T, Young R, Taylor J, Mason J . Acceptability and satisfaction with a telecarer approach to the management of type 2 diabetes. Diabetes Care. 2005; 28(2):283-9. DOI: 10.2337/diacare.28.2.283. View

Nutbeam D . The evolving concept of health literacy. Soc Sci Med. 2008; 67(12):2072-8. DOI: 10.1016/j.socscimed.2008.09.050. View

Zarcadoolas C, Pleasant A, Greer D . Understanding health literacy: an expanded model. Health Promot Int. 2005; 20(2):195-203. DOI: 10.1093/heapro/dah609. View

Norris S, Engelgau M, Narayan K . Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 2001; 24(3):561-87. DOI: 10.2337/diacare.24.3.561. View

10.

Aujoulat I, Dhoore W, Deccache A . Patient empowerment in theory and practice: polysemy or cacophony?. Patient Educ Couns. 2006; 66(1):13-20. DOI: 10.1016/j.pec.2006.09.008. View

11.

Booker S, Morris M, Johnson A . Empowered to change: evidence from a qualitative exploration of a user-informed psycho-educational programme for people with type 1 diabetes. Chronic Illn. 2008; 4(1):41-53. DOI: 10.1177/1742395307086695. View

12.

Ishikawa H, Yano E . Patient health literacy and participation in the health-care process. Health Expect. 2008; 11(2):113-22. PMC: 5060442. DOI: 10.1111/j.1369-7625.2008.00497.x. View

13.

Gambling T, Long A . The realisation of patient-centred care during a 3-year proactive telephone counselling self-care intervention for diabetes. Patient Educ Couns. 2009; 80(2):219-26. DOI: 10.1016/j.pec.2009.11.007. View

14.

Donelle L, Hoffman-Goetz L . Health literacy and online health discussions of North American Black women. Women Health. 2008; 47(4):71-90. DOI: 10.1080/03630240802100689. View

15.

Charles C, Gafni A, Whelan T . Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997; 44(5):681-92. DOI: 10.1016/s0277-9536(96)00221-3. View

16.

Hsieh H, Shannon S . Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):1277-88. DOI: 10.1177/1049732305276687. View

17.

Norris S, Lau J, Smith S, Schmid C, Engelgau M . Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care. 2002; 25(7):1159-71. DOI: 10.2337/diacare.25.7.1159. View

18.

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M . Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008; 337:a1655. PMC: 2769032. DOI: 10.1136/bmj.a1655. View

19.

Taylor D, Bury M . Chronic illness, expert patients and care transition. Sociol Health Illn. 2007; 29(1):27-45. DOI: 10.1111/j.1467-9566.2007.00516.x. View

20.

Goudswaard A, Stolk R, Zuithoff N, de Valk H, Rutten G . Long-term effects of self-management education for patients with Type 2 diabetes taking maximal oral hypoglycaemic therapy: a randomized trial in primary care. Diabet Med. 2004; 21(5):491-6. DOI: 10.1111/j.1464-5491.2004.01153.x. View