Literacy-appropriate educational materials and brief counseling improve diabetes self-management

Patient Educ Couns. 2009 Jun;75(3):328-33. doi: 10.1016/j.pec.2008.12.017. Epub 2009 Jan 23.


Objective: In this pilot study, we evaluated the impact of providing patients with a literacy-appropriate diabetes education guide accompanied by brief counseling designed for use in primary care.

Methods: We provided the Living with Diabetes guide and brief behavior change counseling to 250 English and Spanish speaking patients with type 2 diabetes. Counseling sessions using collaborative goal setting occurred at baseline and by telephone at 2 and 4 weeks. We measured patients' activation, self-efficacy, diabetes distress, knowledge, and self-care at baseline and 3-month follow-up.

Results: Statistically significant (p<or=0.001) and clinically important (effect sizes=0.29-0.42) improvements were observed in participants' activation, self-efficacy, diabetes-related distress, self-reported behaviors, and knowledge. Improvements were similar across literacy levels. Spanish speakers experienced both greater improvement in diabetes-related distress and less improvement in self-efficacy levels than English speakers.

Conclusion: A diabetes self-management support package combining literacy-appropriate patient education materials with brief counseling suitable for use in primary care resulted in important short-term health-related psychological and behavioral changes across literacy levels.

Practice implications: Coupling literacy-appropriate education materials with brief counseling in primary care settings may be an effective and efficient strategy for imparting skills necessary for diabetes self-management.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus*
  • Directive Counseling*
  • Educational Measurement
  • Educational Status
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Health Promotion
  • Humans
  • Male
  • Middle Aged
  • Models, Educational
  • Patient Education as Topic / methods*
  • Self Care*