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38. Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

Author

Al Sayah, Fatima, Williams, Beverly, and Johnson, Jeffrey A.

Abstract

Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review was conducted to identify the instruments. Nutbeam's domains of health literacy and a diabetes health literacy skill set were used to evaluate the measurement scope of the identified instruments and to evaluate their applicability in people with diabetes. Results: Fifty-six studies were included, from which one diabetes-specific (LAD) and eight generic measures of health literacy (REALM, REALM-R, TOFHLA, s-TOFHLA, NVS, 3-brief SQ, 3-level HL Scale, SILS) and one diabetes-specific (DNT) and two generic measures of numeracy (SNS, WRAT) were identified. These instruments were categorized into direct measures, that is, instruments that assess the performance of individuals on health literacy skills and indirect measures that rely on self-report of these skills. The most commonly used instruments measure selective domains of health literacy, focus mainly on reading and writing skills, and do not address other important skills such as verbal communication, health care system navigation, health-related decision making, and numeracy. The structure, mode, and length of administration and measurement properties were found to affect the applicability of these instruments in clinical and research settings. Indirect self- or clinician-administered measures are the most useful in both clinical and research settings. Conclusion: This review provides an evaluation of available health literacy measures and guidance to practitioners and researchers for selecting the appropriate measures for use in clinical settings and research applications. (Contains 2 tables and 1 figure.)

Published
2013
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49. Activity Levels and Healthcare Utilization: Associations in Individuals with Type 2 Diabetes

Author

Johnson, Steven (Faculty of Health Disciplines, Athabasca University)), Al Sayah, Fatima (Public School of Health, University of Alberta), Vallance, Jeff (Faculty of Health Disciplines, Athabasca University), Luckhurst, Ian, Johnson, Steven (Faculty of Health Disciplines, Athabasca University)), Al Sayah, Fatima (Public School of Health, University of Alberta), Vallance, Jeff (Faculty of Health Disciplines, Athabasca University), and Luckhurst, Ian

Abstract

Background: This study’s objective was to examine cross-sectional associations of device-measured physical activity with healthcare utilization among adults with Type 2 Diabetes. Methods: Healthcare utilization data included number of physician claims, type of physician service, number of emergency department visits, number of ambulatory care visits, and number of hospitalizations. Device-based physical activity and sedentary time were assessed using the ActiGraph® GT3X+ accelerometer. Results: For moderate vigorous physical activity and sedentary time, no statistically significant associations were found with healthcare utilization. For daily steps, ANOVA suggested higher step counts were associated with fewer physician claims and emergency department visits. Conclusion: Device-based MVPA and sedentary time were not associated with healthcare utilization. Daily steps was found to be significantly associated with physician claims and emergency department visits. Increasing walking may help reduce healthcare utilization in adults with T2D., 2021-June

Published
2021

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