TY - JOUR
T1 - Health communication, self-care, and treatment satisfaction among low-income diabetes patients in a public health setting
AU - White, Richard O.
AU - Eden, Svetlana
AU - Wallston, Kenneth A.
AU - Kripalani, Sunil
AU - Barto, Shari
AU - Shintani, Ayumi
AU - Rothman, Russell L.
N1 - Funding Information:
The authors would like to thank the administration, staff, and patients at the Middle TN Department of Health system for their collaboration in the PRIDE program. We thank the staff at the Mayo Clinic Florida Office of Academic and Research Support for helpful input on later drafts. ROW is supported by a NIDDK Career Development Award (05DK092470). The project described was supported by the following grants: NIDDK , 5R18 DK083264 and Vanderbilt University CTSA , 5UL1TR000445 . Study data were collected and managed using REDCap electronic data capture hosted at Vanderbilt University. Content of this manuscript was presented in poster format at the 36th Annual SGIM meeting in Denver, CO, April 25–27, 2013. ROW was the lead author of the manuscript. SE and AS provided statistical input. RLR and SK provided health communication expertise and mentorship to ROW. ROW, KAW, RLR, and SK provided substantive editorial input. All authors approved the final version of the manuscript.
Funding Information:
No author has any conflicts of interest to report. ROW is supported by a NIDDK Career Development Award (05DK092470)
Publisher Copyright:
© 2014 Elsevier Ireland Ltd.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Objective: Diabetes patients with limited resources often experience suboptimal care. Less is known about the role of effective health communication (HC) in caring for low income diabetes patients. Methods: Ten health department clinics in TN participated in a trial evaluating a literacy-sensitive communication intervention. We assessed the quality of baseline HC and measured associations with diabetes outcomes. Assessments included: demographics, measures of HC, health literacy, self-care behaviors, self-efficacy, medication non-adherence, treatment satisfaction, and A1C. Unadjusted and adjusted multivariable regression models were used to test associations. Results: Participants (N= 411) were 49.7. ±. 9.5 years, 61% female, uninsured (96%), with A1C 9.6. ±. 2.1. In unadjusted analyses, better communication, was associated with lower medication non-adherence (OR 0.40-0.68, all p<. 0.05), higher treatment satisfaction (OR 1.76-1.96, all p<. 0.01), portion size reduction (OR 1.43, p<. 0.05), diabetes self-efficacy (OR 1.41, p<. 0.05), and lower A1C (β= -0.06, p<. 0.01). In adjusted analyses, communication quality remained associated with lower medication non-adherence (AOR 0.39-0.68, all p<. 0.05), and higher treatment satisfaction (AOR 1.90-2.21, all p<. 0.001). Conclusions: Better communication between low-income patients and providers was independently associated with lower medication non-adherence and higher treatment satisfaction. Practice Implications: Communication quality may be an important modifiable approach to improving diabetes care for vulnerable populations.
AB - Objective: Diabetes patients with limited resources often experience suboptimal care. Less is known about the role of effective health communication (HC) in caring for low income diabetes patients. Methods: Ten health department clinics in TN participated in a trial evaluating a literacy-sensitive communication intervention. We assessed the quality of baseline HC and measured associations with diabetes outcomes. Assessments included: demographics, measures of HC, health literacy, self-care behaviors, self-efficacy, medication non-adherence, treatment satisfaction, and A1C. Unadjusted and adjusted multivariable regression models were used to test associations. Results: Participants (N= 411) were 49.7. ±. 9.5 years, 61% female, uninsured (96%), with A1C 9.6. ±. 2.1. In unadjusted analyses, better communication, was associated with lower medication non-adherence (OR 0.40-0.68, all p<. 0.05), higher treatment satisfaction (OR 1.76-1.96, all p<. 0.01), portion size reduction (OR 1.43, p<. 0.05), diabetes self-efficacy (OR 1.41, p<. 0.05), and lower A1C (β= -0.06, p<. 0.01). In adjusted analyses, communication quality remained associated with lower medication non-adherence (AOR 0.39-0.68, all p<. 0.05), and higher treatment satisfaction (AOR 1.90-2.21, all p<. 0.001). Conclusions: Better communication between low-income patients and providers was independently associated with lower medication non-adherence and higher treatment satisfaction. Practice Implications: Communication quality may be an important modifiable approach to improving diabetes care for vulnerable populations.
KW - Diabetes
KW - Health communication
KW - Primary care
KW - Provider education
KW - Public health
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U2 - 10.1016/j.pec.2014.10.019
DO - 10.1016/j.pec.2014.10.019
M3 - Article
C2 - 25468393
AN - SCOPUS:84920847202
SN - 0738-3991
VL - 98
SP - 144
EP - 149
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 2
ER -