Association of Electronic Health Literacy With Health-Promoting Behaviors in Patients With Type 2 Diabetes

Background: Mobile health (mHealth) technology that addresses diabetes mellitus in pregnancy has the potential to improve maternal and child health while diminishing socioeconomic and racial disparities. Little is known about health literacy, electronic health literacy, or patient characteristics that contribute to increased mHealth use. In this pilot study, we aimed to examine patient factors associated with user engagement with a novel app for diabetes support during pregnancy. Method: Low-income pregnant individuals with gestational or type 2 diabetes mellitus were recruited for a 2-week usability assessment of a novel mHealth smartphone application, “SweetMama,” designed to improve diabetes care. This analysis of user characteristics was a pilot assessment of data from the usability study phase. Participants completed assessments of patient health literacy, electronic health literacy, diabetes self-efficacy, and activation. User metrics (eg, sessions and total duration of use) were evaluated by participant characteristics. Descriptive analyses were conducted to assess outcomes with respect to patient’s clinical history, health literacy, electronic health literacy, diabetes self-efficacy, and activation. Results: Twenty-two diverse, low-income pregnant patients with either gestational or type 2 diabetes engaged with SweetMama for 14 days. Participants with gestational diabetes had greater mean minutes of use per session and mean total duration of use than those with type 2 diabetes. Participants with greater electronic health literacy, lower patient activation, and greater self-efficacy demonstrated greater total duration of use. No user metrics differed significantly by participant general health literacy. Conclusions: Findings of this pilot study suggest engagement with a novel mHealth app for diabetes support during pregnancy varied by baseline behavioral and clinical characteristics. Results could indicate that digital health literacy better differentiates engagement patterns than general health literacy.

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Health literacy and health-promoting behaviors status among employees in Hamadan

hormozgan medical journal ◽

10.29252/hmj.22.2.122 ◽

2018 ◽

Vol 22 (2) ◽

pp. 122-129

Author(s):

Sahar Khoshravesh ◽

Fourozan Rezapur-Shahkolai ◽

Zahra Taheri-Kharameh ◽

Babak Moeini ◽

Khadijeh Bandehelahi ◽

...

Keyword(s):

Health Literacy ◽

Health Promoting Behaviors ◽

Health Promoting

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Mobile Virtual reality vs. Mobile 360 Video to Promote Enrollment in the Diabetes Prevention Program Amongst Hispanic Adults (Preprint)

10.2196/preprints.26013 ◽

2020 ◽

Author(s):

Bryan Gibson ◽

Sara Simonsen ◽

Jakob Jensen ◽

Leah Yingling ◽

Julia Schaeffer ◽

...

Keyword(s):

Type 2 Diabetes ◽

Virtual Reality ◽

Health Literacy ◽

Mobile Phone ◽

Prevention Program ◽

Diabetes Prevention ◽

Risk Perceptions ◽

Diabetes Prevention Program ◽

Pilot Test

BACKGROUND The Diabetes Prevention Program (DPP) reduces the risk of developing Type 2 Diabetes, however enrollment is very low. OBJECTIVE The goal of this project was to pilot test the efficacy of two brief, immersive mobile phone videos (presented either in virtual reality or 360 video) on risk perceptions and enrollment in the DPP. METHODS Adults with prediabetes were recruited at a clinic serving a low income Hispanic community. After consenting, participants completed a baseline survey that collected demographics and risk perceptions based on the tripartite model of risk perceptions.. They were then informed that they had prediabetes and provided with a link to an educational website that explains: what prediabetes and Type 2 Diabetes (T2DM) are, how lifestyle affects risk of T2DM, what the DPP is, and where to enroll. Participants then viewed two videos using their smartphone ; either with a cardboard VR headset (VR) or their smartphone alone (360 video), per random assignment. Two weeks later a follow-up survey collected measures of: enrollment in the DPP, risk perceptions, health literacy, the importance of contextual factors related to the DPP in their decision of whether or not to enroll in the DPP (e.g. distance to the class ), and qualitative feedback on the interventions. We used logistic regression to determine whether enrollment in the DPP differed by intervention mode, while accounting for heath literacy and contextual factors related to the DPP. We used unpaired t-tests to examine differences in change in risk perceptions between groups. We used paired t-tests to examine within-subject changes in risk perceptions. RESULTS 116 participants provided complete data. Most participants were middle-aged (mean age= 44.6 yrs.; SD= 11.9) Hispanic (114/116), female (79/116), with low health literacy (mean score =12.3/20; SD=3.4). Enrollment in the DPP was 44/116 overall (37.9% ) but did not differ by group ( OR for enrolling in VR group= 1.78 ; 95% CI: 0.75-4.3, p=0.19) . Individuals who rated t the distance needed to travel to attend the DPP as more important were less likely to enroll in the DPP (OR = 0.56, 95% CI:0.33-0.92; p=0.03) Risk perceptions did not differ by group ( mean change in 360 video group = -0.07, mean change in VR group = 0.03, t==0.6, p= 0.54) and did not change within subjects ( mean 0.02, t=0.21, p=0.83). Participants feedback suggested that the videos are emotionally engaging and educational. CONCLUSIONS We present a pilot test of immersive mobile phone videos which appear to be efficacious in promoting enrollment in the DPP. Further work to determine the replicability of these findings, the mechanism of action of the videos, and potential moderators of the efficacy of these videos is discussed.

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Association of electronic health literacy with health‐promoting behaviours in adolescents

International Journal of Nursing Practice ◽

10.1111/ijn.12921 ◽

2021 ◽

Vol 27 (2) ◽

Author(s):

Gülbahar Korkmaz Aslan ◽

Asiye Kartal ◽

Türkan Turan ◽

Gülay Taşdemir Yiğitoğlu ◽

Cansel Kocakabak

Keyword(s):

Health Literacy ◽

Health Promoting ◽

Electronic Health

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Gender Differences and Their Influences on T2DM Self-Management Among Spanish-Speaking Latinx Immigrants

Hispanic Health Care International ◽

10.1177/15404153211011727 ◽

2021 ◽

pp. 154041532110117

Author(s):

Cheryl A. Smith-Miller ◽

Diane C. Berry ◽

Cass T. Miller

Keyword(s):

Gender Differences ◽

Health Literacy ◽

English Language ◽

Educational Achievement ◽

Self Management ◽

Structured Interviews ◽

Health Promoting Behaviors ◽

History Of ◽

Health Promoting ◽

Excessive Alcohol

Introduction: Evidence suggests that gender may influence many aspects of type 2 diabetes (T2DM) self-management (SM) and we posit that limited English language–proficient Latinx immigrants face additional challenges. Methods: Instruments and semi-structured interviews were used to examine gender differences on health literacy, diabetes knowledge, health-promoting behaviors, diabetes, eating and exercise self-efficacy (SE), and T2DM SM practices among a cohort of limited English language–proficient Latinx immigrants. Statistical and qualitative analysis procedures were performed comparing males and females. Results: Thirty persons participated. Males tended to be older, have higher educational achievement, and more financial security than females. Physiologic measures tended worse among female participants. Health literacy and exercise SE scores were similar, but females scored lower on Eating and Diabetes SE. Forty-seven percent ( n= 9) of the women reported a history of gestational diabetes mellitus and a majority of men ( n = 7) cited difficulty with excessive alcohol. Consumption: Males appeared to receive more SM support compared to females. Females more frequently noted how family obligations and a lack of support impeded their SM. Work environments negatively influenced SM practices. Conclusion: Men and women have unique SM challenges and as such require individualized strategies and support to improve T2DM management.

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Type 2 diabetes self-management schemas across diverse health literacy levels: a qualitative investigation

Psychology and Health ◽

10.1080/08870446.2021.1909023 ◽

2021 ◽

pp. 1-21

Author(s):

Julie Ayre ◽

Carissa Bonner ◽

Danielle M. Muscat ◽

Sian Bramwell ◽

Sharon McClelland ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Self Management ◽

Qualitative Investigation

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Low health literacy is associated with higher risk of type 2 diabetes: a cross-sectional study in Germany

BMC Public Health ◽

10.1186/s12889-021-10508-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniel Tajdar ◽

Dagmar Lühmann ◽

Regina Fertmann ◽

Tim Steinberg ◽

Hendrik van den Bussche ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Statistical Models ◽

Cross Sectional Study ◽

Diabetes Risk ◽

Sectional Study ◽

Cross Sectional ◽

Low Health Literacy ◽

The Individual

Abstract Background Low health literacy is believed to be associated with behaviours that increase the risk of type 2 diabetes. But there is limited knowledge on the relation between health literacy (HL) and diabetes risk, and whether improving HL could be a potential prevention strategy. Therefore, the main purpose of this study was to examine the link between HL and diabetes risk among non-diabetic adults. Methods We used data from the Hamburg Diabetes Prevention Survey, a population-based cross-sectional study in Germany. One thousand, two hundred and fifty-five non-diabetic subjects aged 18–60 years were eligible. The German Diabetes Risk Score (GDRS, ranging 0 to 123 points) was used to determine the individual risk of type 2 diabetes. The short version of the European Health Literacy Questionnaire (HLS-EU-Q16, ranging 0 to 16 points) was applied to assess the individual self-reported HL. Subjects were asked to self-estimate their diabetes risk, which was then compared with the calculated GDRS. Descriptive statistics were calculated to investigate group differences in the GDRS and self-estimated diabetes risk. Linear as well as logistic regression models were performed to analyse potential influencing variables of the GDRS as well as incorrect self-estimated diabetes risk. In three nested statistical models for each outcome, these analyses were adjusted for age, gender, educational level and the presence of chronic conditions. Results According to the criteria of the GDRS, 996 (79.4%) subjects showed “low risk”, 176 (14.0%) “still low risk”, 53 (4.2%) “elevated risk”, and 30 (2.4%) “high to very high risk” to develop type 2 diabetes within the next 5 years. In the statistical models including all control variables, subjects with “inadequate HL” scored 2.38 points higher on the GDRS (95% CI 0.378 to 4.336; P = 0.020) and had a 2.04 greater chance to estimate their diabetes risk incorrectly (OR 2.04; 95% CI 1.33 to 3.14; P = 0.001) compared to those with “sufficient HL”. Conclusion The risk of type 2 diabetes is increased in people with inadequate self-reported HL. People with high diabetes risk and inadequate HL might be provided with educational programs to improve diabetes knowledge and reduce behavioural risk factors.

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