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 - 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 -