Health literacy is a vital competence when working toward successful management of Type II
Diabetes (T2D). The ability to understand, assess, and apply health information in order to make judgements and decisions every day to maintain or improve quality of life is important.
Sufficient health literacy is linked to an individual’s knowledge, motivation, and self-efficacy
resulting in better health conditions and self-efficacy in people with T2D (Finbraten et al., 2020).
This quality improvement project aimed at initiating health literacy screenings and utilizing
English and Spanish multimodal low literacy diabetes self-management education (DSME) to
increase diabetes knowledge in adult patients with T2D.
A Registered Dietitian health educator in the health and wellness program of a community health center administered the Brief Health Literacy Screening (BHLS) and a pre-intervention Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD) to 20 adult patients with T2D to screen literacy levels and diabetes knowledge prior to their DSME session. The DSME was then offered in English and Spanish with low literacy handouts and audiovisual videos. A post-intervention SKILLD survey was conducted one week after the DSME to test the association between low health literacy DSME and diabetes knowledge.
Thirty-four patients signed up to participate in the DSME group session, but only twenty-four
patients attended the low literacy screening and low literacy DSME session. The BHLS
screening indicated that 41.7 % of the participants had adequate health literacy, 37.5 % had
moderate health literacy, and 20.8 % had limited health literacy. A two-tailed sample t-test was
conducted to examine whether the mean difference of the pre-intervention SKILLD survey and the post intervention SKILLD survey were significantly impacted by the language specific low
literacy DSME session. An alpha value of .05, t(23) = -4.10, p < .001 revealed that low literacy
DSME educational handouts and audiovisual videos significantly improved diabetes knowledge
in the participants of this intervention.
The primary outcome of administering health literacy screenings on patients with T2D was
successful. Evidence of limited health literacy and diabetes knowledge were noted in several
participants prior to the DSME session. The post-intervention SKILLD survey revealed
significant improvements in diabetes knowledge with the utilization of language specific
multimodal low-literacy DSME.