By Katherine O’Neal, Pharm.D., MBA, BCACP, CDE, BC-ADM, AE-C, CLS
Disparities in health literacy greatly affect self-management, particularly for those hit hard by type 2 diabetes in racial and ethnic minority communities. In fact, across disease states, health literacy is one of the greatest hurdles to improved outcomes.
As diabetes care and education specialist, we are in a position to make such a significant impact on an individual’s understanding of various diabetes self-management principles. To help increase their success, however, we need to be cognizant of communication strategies that take into consideration health literacy principles.
The Institute of Medicine defines health literacy as, “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions”.
The availability of information a person can access is increasing and includes options such as the internet, phone apps, media and the more traditional health education. It is well documented in literature that people who have chronic illnesses and lower health literacy have higher rates of hospitalization, less knowledge of managing their illness and suboptimal health outcomes. For a chronic condition such as diabetes, it is critical for individuals to understand and utilize self-management principles.
People with type 1 diabetes and taking insulin, for example, need to recognize what a carbohydrate is, identify how many carbohydrates are being eaten, understand and apply insulin to carbohydrate ratios as well a correction factor ratios and then, draw up the appropriate dose for administration.
Even oral medications can have health literacy implications. Recognizing that there are maximum doses of the various medications is critical. People with diabetes must be taught and have their understanding confirmed that oral medications are not to be taken anytime blood sugar levels are checked and found to be elevated. Additionally, how the medications work and why the medication is to be taken a specific way is critical to empower patients.
Therefore, incorporating these 5 communication techniques can help improve a person’s self-management success.
- Use plain, simple language. Using shorter sentences and avoiding words with multiple syllables and medical jargon can help improve understanding.
- Keep the message simple. Focus on a few key messages at a time. Giving individuals a short list of action items helps with remembering and follow-through. A good number of messages to target is four.
- Break up written communication with bulleted points and pictures or illustrations. People have different styles of learning and having pictures can appeal to visual learners.
- Use 12-point font and simple fonts with plenty of white space in any educational handouts.
- Use the teach-back technique. This provides the opportunity to have the person repeat back what they heard in their own words to confirm understanding.
A quote from a former Surgeon General sums up the urgency of addressing health literacy well, “Health literacy can save lives, save money, and improve the health and well-being of millions of Americans”.
For practice guidance and other resources, visit DiabetesEducator.org/HealthLiteracy.
AADE Perspectives on Diabetes Care
The American Association of Diabetes Educators Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the American Association of Diabetes Educators.
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