Health communication, self-care, and treatment satisfaction among low-income diabetes patients in a public health setting.

White RO, Eden S, Wallston KA, Kripalani S, Barto S, Shintani A, Rothman RL
Patient Educ Couns. 2015 98 (2): 144-9

PMID: 25468393 · PMCID: PMC4282939 · DOI:10.1016/j.pec.2014.10.019

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.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

MeSH Terms (19)

Adult Aged Diabetes Mellitus, Type 2 Female Glycated Hemoglobin A Health Communication Health Knowledge, Attitudes, Practice Health Literacy Humans Hypoglycemic Agents Male Medication Adherence Middle Aged Personal Satisfaction Poverty Self Care Self Efficacy Tennessee Treatment Outcome

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