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Patient Educ Couns. 2015 Feb;98(2):144-9. doi: 10.1016/j.pec.2014.10.019. Epub 2014 Oct 28.

Health communication, self-care, and treatment satisfaction among low-income diabetes patients in a public health setting.

Author information

1
Division of Community Internal Medicine, Mayo Clinic, Jacksonville, USA; Department of Family Medicine, Mayo Clinic, Jacksonville, USA. Electronic address: white.richard@mayo.edu.
2
Department of Biostatistics, Vanderbilt University, Nashville, USA.
3
School of Nursing, Vanderbilt University Medical Center, Nashville, USA.
4
Department of Medicine, Vanderbilt University Medical Center, Nashville, USA; Institute for Medicine and Public Health, Vanderbilt University, Nashville, USA.
5
Institute for Medicine and Public Health, Vanderbilt University, Nashville, USA.

Abstract

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.

KEYWORDS:

Diabetes; Health communication; Primary care; Provider education; Public health

PMID:
25468393
PMCID:
PMC4282939
DOI:
10.1016/j.pec.2014.10.019
[Indexed for MEDLINE]
Free PMC Article

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