Impact of health literacy on outcomes and effectiveness of an educational intervention in patients with chronic diseases

Patient Educ Couns. 2012 May;87(2):143-51. doi: 10.1016/j.pec.2011.07.020. Epub 2011 Sep 16.


Objective: Study impact of health literacy on educational intervention for patients "Living with Coronary Artery Disease."

Methods: 187 patients were randomized to: VHS/DVD plus printed booklet; or booklet alone prior to scheduled visit. Main outcome measures included CAD knowledge assessment, clinical outcomes (weigh and blood pressure) and health behaviors (diet, exercise, and smoking); while functional health literacy was assessed as a possible predictor variable.

Results: Knowledge scores and health behaviors improved following both interventions. Those receiving the booklet and video also had a significant improvement in exercise, and weight loss. There was a trend (p=0.07) towards greater improvement in test scores among those receiving the booklet plus video. Patients with lower health literacy benefited as much as higher literacy patients.

Conclusions: Incorporation of an educational program into clinical visits for patients with chronic disease improved disease-specific knowledge and prompted patients to become activated and involved in their care, improving health behaviors and outcomes. Lower health literacy was not a barrier to this beneficial effect.

Practice implications: Patients with lower health literacy may also benefit from educational, shared decision-making interventions.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Coronary Artery Disease* / therapy
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Health Literacy / methods*
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Pamphlets
  • Patient Education as Topic / methods*
  • Program Evaluation
  • Surveys and Questionnaires
  • Videotape Recording