OBJECTIVE We used a mixed-methods approach to explore the relationships between participants’ perceptions of family members’ diabetes self-care knowledge, diabetes-specific supportive and nonsupportive behaviors, medication adherence glycemic control (A1C). RESEARCH DESIGN AND METHODS Adults with type 2 participated in focus group sessions that discussed barriers facilitators management (n = 45) and/or completed surveys 61) collect demographic information, measures adherence, behaviors. Most...

Objective-To examine the mechanisms linking health literacy to physical activity and selfreported health.Methods-From 2005-2007, patients (N=330) with hypertension were recruited from safety net clinics.Path analytic models tested pathways self-reported health.Results-There significant paths knowledge (r=0.22,P<0.001), self-efficacy (r=0.13,P<0.01), (r=0.17,P<0.01), status (r=0.17,P<0.01).Conclusions-Health education interventions should be sensitive aim enhance patient promote self-care...

Patient portal use has been associated with favorable outcomes, but we know less about how patients and benefit from specific patient features.Using mixed-methods, explored adults type 2 diabetes (T2DM) secure messaging (SM) within a portal.Adults T2DM who had used participated in focus group completed survey (n=39) or only (n=15). We performed thematic analysis of transcripts to identify the benefits barriers using SM portal. also examined association between various features patients'...

Although low health literacy and suboptimal medication adherence are more prevalent in racial/ethnic minority groups than Whites, little is known about the relationship between these factors adults with diabetes, whether or numeracy might explain disparities diabetes adherence. Previous work HIV suggests mediates racial differences to antiretroviral treatment, but no study date has explored as a mediator of race/ethnicity This tested and/or were related adherence, either factor explained...

The mechanisms underlying the relationship between health literacy, numeracy, and glycemic control are unclear. We explored role of diabetes self-efficacy in predicted pathway linking literacy numeracy to (A1C). Adults with type 1 or 2 mellitus (N = 383) were enrolled a cross-sectional study at primary care clinics three medical centers. Data collected included demographic information, general A1C. Path models estimated relations among as predictors Health (r 0.14, p < .01) 0.17, .001) each...

To compare performance of the newest vital sign (NVS) with existing literacy measures.We administered NVS and REALM to 129 patients, S-TOFHLA 119 patients all in public clinics.The demonstrated high sensitivity for detecting limited moderate specificity (area under receiver operating characteristic [AUROC] curve 0.71-0.73). The was less effective than predicting health outcomes.The is able identify skills, but may misclassify those adequate according S-TOFHLA. scores were not associated outcomes.

The Internet can be leveraged to provide disease management support, including medication adherence promotion that, when tailored, effectively improve medications. growing adoption of patient portals represents an opportunity support and more broadly, but virtually no data exist about the real potential impact existing on these outcomes.We sought (1) understand who uses portal reasons for use nonuse, (2) how users are using a manage their medications, (3) explore participants' ideas...

The relationship between limited health literacy and poor may be due, in part, to communication quality within care delivery organizations. We explored the status receiving patient-centered clinics hospitals serving communication-vulnerable patient populations. Thirteen organizations nationwide distributed a survey 5929 patients. All patients completed seven items assessing communication. One third also three literacy. majority of had self-reported challenges, reporting problems learning...

Although limited health literacy is a barrier to disease management and has been associated with poor glycemic control, the mechanisms underlying relationships between diabetes outcomes are unknown. We examined literacy, determinants of self-care, control in adults type 2 diabetes.Patients were recruited from an outpatient primary care clinic. collected information on demographics, knowledge, fatalism, social support, hemoglobin A1c values extracted medical record. Structural equation models...

Family members’ helpful and harmful actions affect adherence to self-care glycemic control among adults with type 2 diabetes (T2D) low socioeconomic status. Few family interventions for T2D address or use text messages reach members. Through user-centered design iterative usability/feasibility testing, we developed a mHealth intervention disadvantaged called FAMS. FAMS delivers phone coaching set goals improve patient participant’s (PP) ability identify that support/impede self-care. PPs...

Food insecurity is the 'limited or uncertain availability of nutritionally adequate and safe foods'. Our objective was to examine association between food insecurity, diabetes self-care glycaemic control.We conducted a cross-sectional analysis baseline data from adult patients with Type 2 who were enrolled in randomized trial evaluating health literacy-focused intervention safety net primary care clinics middle Tennessee. assessed three items U.S. Household Security Survey. Diabetes...

Suboptimal adherence to diabetes medications is prevalent and associated with unfavorable health outcomes, but it remains unclear what intervention content necessary effectively promote medication in diabetes. In other disease contexts, the Information-Motivation-Behavioral skills (IMB) model has explained promoted thus may have utility explaining promoting medications. We tested IMB model's hypotheses a sample of adults type 2 diabetes.Participants (N = 314) completed an...

Abstract Objective Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined relationship between patient and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 (T2DM). Materials Methods Eighty patients T2DM participated a 3-month called MEssaging Diabetes that leveraged mobile communications platform. Participants received daily...