Browsing by Subject "Self-care activities"

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    The impact of health literacy on self-care activities among underserved patients with type 2 diabetes
    (2018-10-09) Murry, Nicole Streuding; Kim, Miyong; Carter, Patricia A; Radhakrishnan, Kavita; Mackert, Michael S.
    To maintain good health, patients with Type 2 diabetes (T2DM) must perform self-care activities (SCA), many of which require health literacy – the ability to obtain, find, and use healthcare information to make decisions about health. In this dissertation, using the information-motivation-behavioral skills theoretical framework, I assess and examine health literacy in relation to SCA among underserved people with T2DM. This descriptive correlational study is a secondary analysis of data from a larger study of participants from six federally qualified health centers in an urban county in South Central Texas. The sample comprised 388 patients with T2DM (261 English-speaking, 127 Spanish-speaking; 53±10.33 years old), with the majority reporting an annual income of less than $10,000. Functional health literacy was measured with the Newest Vital Sign screening tool; diabetes-specific oral health literacy, with the DM-REALM – a modification of the original REALM instrument. Only 18.3% of participants exhibited adequate functional health literacy; 10.4%, adequate oral health literacy. In bivariate analysis, functional health literacy was related to age, gender, language, acculturation, income, education, and marital status. Oral health literacy was related to gender, employment status, and type of insurance. Significant predictors of functional health literacy included gender, education, and type of insurance. Significant predictors of oral health literacy included gender, employment status, and years with T2DM. In bivariate analysis, diabetes self-efficacy and health information-seeking behaviors were related to diabetes SCA. In hierarchical multiple regression, functional health literacy, health information-seeking behaviors, and diabetes self-efficacy were significant predictors of diabetes SCA. Although health literacy did not exhibit a significant direct effect on diabetes SCA, health information-seeking behaviors mediated the relationship between oral health literacy and diabetes SCA. These findings add to previous findings showing the high prevalence of limited health literacy among underserved people and the negative influence of limited health literacy on SCA among people with T2DM. Further studies of the impact of limited health literacy on diabetes SCA in diverse, underserved populations of people with T2DM are warranted. Future health literacy interventions should incorporate individual- and systems-level approaches in addressing promotion of diabetes SCA.