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Impact of health literacy on outcomes and effectiveness of an educational intervention in patients with chronic diseases [with consumer summary]
Eckman MH, Wise R, Leonard AC, Dixon E, Burrows C, Khan F, Warm E
Patient Education and Counseling 2012 May;87(2):143-151
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: No; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Study impact of health literacy on educational intervention for patients "Living with Coronary Artery Disease". METHODS: 187 patients were randomized to: VHS/DVD plus printed booklet; or booklet alone prior to scheduled visit. Main outcome measures included CAD knowledge assessment, clinical outcomes (weigh and blood pressure) and health behaviors (diet, exercise, and smoking); while functional health literacy was assessed as a possible predictor variable. RESULTS: Knowledge scores and health behaviors improved following both interventions. Those receiving the booklet and video also had a significant improvement in exercise, and weight loss. There was a trend (p = 0.07) towards greater improvement in test scores among those receiving the booklet plus video. Patients with lower health literacy benefited as much as higher literacy patients. CONCLUSIONS: Incorporation of an educational program into clinical visits for patients with chronic disease improved disease-specific knowledge and prompted patients to become activated and involved in their care, improving health behaviors and outcomes. Lower health literacy was not a barrier to this beneficial effect. PRACTICE IMPLICATIONS: Patients with lower health literacy may also benefit from educational, shared decision-making interventions.
With permission from Excerpta Medica Inc.

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