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

Connections (1)

This publication is referenced by other Labnodes entities:

Links