Health Literacy and Outcomes of a Community-Based Self-Help Intervention: A Case of Korean Americans With Type 2 Diabetes.
Miyong T Kim, Kim B Kim, Jisook Ko and 4 others
PMID 31972848WHAT IT FOUND
Health literacy did not directly change A1C or quality of life, but the intervention raised health literacy, and higher health literacy was associated with higher self-efficacy, which was associated with A1C change and quality of life.
Key findings
01The intervention group improved on health literacy measures more than the control group, and most changes were statistically significant.
02Health literacy had no significant direct effect on A1C change or quality of life, but it had a significant direct effect on self-efficacy.
03Health literacy was indirectly linked to A1C change and quality of life through self-efficacy, and self-efficacy was directly linked to both.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis included only participants who completed 12 months, so it does not show what happened to those who dropped out. The control group and the full intervention content are not described in this paper, so the comparison and dose are unclear. The sample was highly motivated and specific to Korean American immigrants with type 2 diabetes, so results may not generalise to other groups. The path model was based on 209 participants, which the authors call relatively small, and model fit was imperfect because RMSEA was .111. The direct effects of health literacy on the primary outcomes A1C and quality of life were not significant. One quality-of-life subscale had low internal consistency (.66).
Declared interests
The article is tagged as receiving NIH extramural research support. The supplied text does not include a conflicts-of-interest declaration or a statement about who designed the study.
The easy way to misread this
Do not conclude that health literacy education alone improved A1C or quality of life. The direct effect of health literacy on these primary outcomes was not significant, and the intervention also included telephone counseling, glucose self-monitoring, and emotional support.