In honor of Health Literacy Month in October, we’re revisiting our previous blog post with professor Hae-Ra Han, PhD, MSN, RN. Below we’ve highlighted five key points that she makes in that post to help health care professionals understand the importance of health literacy, specifically when working with patients who have diabetes. Additional health literacy resources are also available from the Office of Disease Prevention and Health Promotion, including a health literate care model tool that seeks to help patients become more engaged in prevention, decision-making, and self-management.

1. Health literacy is a vital skill for those with diabetes.

Health literacy is defined as the degree to which people can find, understand, and use information and services to inform their health-related decisions and actions for themselves, as well as others. … Health literacy is important for people with diabetes because managing diabetes is complex. People with diabetes must understand basic physiology, as well as the concept that behavior—taking medicines, self-monitoring blood glucose, maintaining a healthy diet, and being physically active—has an impact on blood glucose levels.

2. Many Americans lack the health literacy skills needed to understand health information and make informed health decisions.

The Health Literacy of America’s Adults—a report from the National Assessment of Adult Literacy, the most comprehensive assessment of U.S. adult literacy conducted to-date—found that 36% of U.S. adults have basic or below-basic health literacy, which means they have limited health literacy and fail to understand most health information. The report found that only 12% of U.S. adults have proficient health literacy, meaning they were able to understand and use printed health information effectively. … Limited health literacy is much more common among people with less education, older adults, people of lower socioeconomic status, ethnic minorities, and people with limited English proficiency.

3. Health literacy is closely linked with social determinants of health, which eventually affect health outcomes and drive health inequities.

Even if patients are fully informed about the behaviors needed to manage diabetes, they may not be able to keep up with those behaviors due to social determinants of health—such as living in an environment where access to affordable, healthier food and beverage options are limited. … Social determinants of health also affect how health literacy is formed. Health literacy isn’t a trait; it’s a set of skills that develop over time. If you have access to health care from an early age, go with your parents or caregiver to annual wellness visits, and hear conversations between your parents or caregiver and doctors, you may have a better understanding of health information. These conversations might help develop health literacy skills.

4. Limited health literacy can affect diabetes outcomes.

Limited health literacy is a major barrier to effectively managing diabetes because it severely limits a person’s ability to obtain, understand, process, and act on important health information. Evidence suggests that people with limited health literacy are less likely to follow diabetes self-care instructions and to seek care early in the course of the disease, which makes them more likely to experience complications. People with limited health literacy are also more likely to seek care in emergency rooms and be admitted to the hospital.

5. Health care professionals and health care organizations can adopt new skills to improve diabetes care when working with patients who have limited health literacy skills.

To improve organizational health literacy and how groups interact with patients, everyone in the health care organization—doctors, nurses, receptionists, and others—should avoid jargon and acronyms and use plain language. Organizations should make sure patient-facing documents, such as education materials and templates, follow plain language principles. When describing patient materials, “easy-to-read” is a better phrase than “lower reading level.” Patients may find “lower reading level” condescending. The Centers for Disease Control and Prevention (CDC) has a great health literacy website that discusses plain language principles and provides plain language alternatives for common medical terms.

Using the following strategies can also help your patients understand how to manage diabetes—or any other chronic disease:

• Convey two or three key messages that you want your patient to remember.
• Focus on what the patient needs to know and needs to do, as opposed to spending too much time on what the health condition is.
• Use the teach-back method to reinforce key messages and confirm the patient understands what he or she needs to do.
• Be positive, hopeful, and empowering. Avoid blaming or trying to identify where the patient is lacking. After a doctor’s office visit, you want the patient to understand what to do and to feel empowered to do it.

What strategies do you use to help your patients understand how to manage diabetes? Share below in the comments.