Inadequate health literacy skills are common and associated with poor health outcomes. Heart failure is an important cause of morbidity and mortality. Heart failure disease management programs that focus on building self-management skills can reduce rates of hospitalization. Our pilot randomized trial suggests that patients with inadequate literacy may derive greater benefit from such programs than patients with adequate literacy.
We aim to examine, in a multi-site randomized trial, whether a literacy-sensitive intervention to improve heart failure self-management skills can improve health outcomes for all patients, and particularly those with inadequate literacy. We will conduct a multi-site randomized trial of 600 patients with heart failure to determine whether a literacy-sensitive, multi-session intervention that teaches essential self-care skills until patients reach behavioral goals (Teach to Goal) is superior to a Brief Educational Intervention (BEI) consisting of a single educational session, for the outcomes of incidence of hospitalization or death and heart failure-related quality of life over 12 months. We will also examine differences in the proportion of patients achieving appropriate HF-related self-care knowledge and behaviors, and will examine the effect of TTG for patients with adequate and inadequate literacy separately. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL081257-03
Application #
7437394
Study Section
Special Emphasis Panel (ZRG1-RPHB-B (51))
Program Officer
Kaufmann, Peter G
Project Start
2006-09-01
Project End
2011-05-31
Budget Start
2008-06-01
Budget End
2009-05-31
Support Year
3
Fiscal Year
2008
Total Cost
$711,701
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
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Wu, Jia-Rong; DeWalt, Darren A; Baker, David W et al. (2014) A single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure. J Clin Nurs 23:2554-64
Wu, Jia-Rong; Holmes, George M; DeWalt, Darren A et al. (2013) Low literacy is associated with increased risk of hospitalization and death among individuals with heart failure. J Gen Intern Med 28:1174-80
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DeWalt, Darren A; Broucksou, Kimberly A; Hawk, Victoria et al. (2009) Comparison of a one-time educational intervention to a teach-to-goal educational intervention for self-management of heart failure: design of a randomized controlled trial. BMC Health Serv Res 9:99