We propose an innovative project that will identify and examine the compensatory strategies and resources used by low literate and low health-literate Latino diabetes patients when faced with literacy-demanding healthcare-related tasks. By comparing strategies and resources of patients who, despite their limited literacy, have good diabetes control, to those who have poor control, we seek to identify and distinguish between effective and ineffective strategies. Moreover, we will explore how the strategies used, and the effectiveness of these strategies, are influenced by personal and healthcare resources. We will limit our study to older Latino patients who have type 2 diabetes because there is tremendous opportunity to improve the health of older Latinos with low literacy and diabetes. Our experienced interdisciplinary team will perform in-depth interviews with 120 older limited English proficient Spanish-speakers with diabetes, 60 of whom are illiterate and 60 of whom have some, but limited, health literacy skills (""""""""low literate""""""""). We will recruit all participants from an urban safety-net hospital. This study will be the critical initial exploratory phase needed to concentrate intervention-development efforts on approaches that complement, augment, or utilize successful strategies. Our research team will use this project's findings to (a) develop a larger survey to quantitatively assess for personal and health care characteristics that may influence the use and effectiveness of strategies and resources;and, (b) develop and empirically test patient-centered interventions to reduce health disparities for older illiterate and low-literate Spanish-speaking patients with diabetes and other comparable chronic illnesses.
The proposed project will provide insight into literacy-compensatory strategies and resources used by Latino diabetes patients with low literacy and low health literacy. This insight will guide researchers in developing powerful patient-centered interventions that have a high potential for decreasing literacy-associated disparities in diabetes outcomes among Latinos.
| Cordasco, Kristina M; Homeier, Diana C; Franco, Idalid et al. (2012) Health literacy screening of geriatric monolingual Spanish-speaking patients using single-item literacy screening questions and education. Health Educ J 71:597-605 |
