FUNCTIONAL HEALTH LITERACY, COMMUNICATION, AND DIABETES

描述（由申请人提供）：FHL是患者的指标？的能力 在考虑到识字的医疗保健环境中发挥作用 （阅读理解医疗保健说明）和算术能力（ 理解并按数字指令行事）。本研究的目标和 培训计划是为申请人提供必要的工具， 成为一名独立的调查员和健康领域的领导者 沟通，FHL和慢性病管理。根据他的训练 和经验，在初级保健内科，质量改进， 在服务不足的人群中进行研究，申请人建议制定 通过以下方式获得更多技能：1）与多学科导师互动 该团队包括健康传播，FHL，糖尿病， 和卫生服务研究; 2）教程和严格的课程设计， 扩大他的理论和方法的知识和技能;和3） 一系列有重点、有监督的研究项目。先前的研究 研究表明，低FHL在少数民族、老年人和 慢性病患者。尽管广泛的自我管理 对慢性病患者的需求，人们对慢性病患者的需求知之甚少。 FHL对慢性病患者健康结局的影响程度，或 关于加强对低FHL患者的护理的策略。研究 将利用GCRC资源检查是否 FHL问题与以下患者的临床结局较差相关： 2型糖尿病，并探讨健康沟通策略，以改善护理 低FHL的糖尿病患者。建议的具体目标 研究是：1）进行横断面研究，以检查 2型糖尿病患者FHL、自我管理和血糖控制之间的关系 糖尿病患者; 2）评估，作为资助的前瞻性研究的一部分， 自动电话疾病管理（ATDM），可接受性和 ATDM系统在2型糖尿病和低FHL患者中的可靠性; 和3）进行随机对照试验（有等待名单对照）， 评估定制的医生沟通培训对 2型糖尿病和低FHL患者的访视相关回忆。的 加州大学旧金山分校，其广泛的资源，为健康相关的研究，提供了一个 良好的环境，为申请人进行研究和培训。的 申请人？的赞助商和导师团队在相关领域拥有丰富的经验， 学科，并将是关键的申请人？发展作为一个 独立研究员，专注于改善弱势群体的健康 慢性病患者。

DESCRIPTION (provided by applicant): FHL is a measure of a patient?s ability to function in the healthcare setting that takes into account literacy (reading comprehension of healthcare instructions) and numeracy (ability to understand and act on numerical instructions). The goal of this research and training program is to provide the applicant with the tools necessary to become an independent investigator and a leader in the fields of health communication, FHL, and chronic disease management. Building on his training and experience in primary care internal medicine, quality improvement, and research among underserved populations, the applicant proposes to develop additional skills through: 1) interaction with a multidisciplinary mentorship team that includes national experts in health communication, FHL, diabetes, and health services research; 2) tutorials and rigorous coursework designed to expand his theoretical and methodological knowledge and skills; and 3) a series of focused, supervised research projects. Prior research has demonstrated that low FHL is prevalent among minorities, the elderly, and patients with chronic conditions. Despite the extensive self-management demands placed on patients with chronic diseases, little is known about the extent to which FHL impacts health outcomes among chronic disease patients, or about strategies to enhance care for those with low FHL. The research proposed in this application will utilize GCRC resources to examine whether FHL problems are associated with worse clinical outcomes among patients with Type 2 diabetes, and explore health communication strategies to improve care for diabetes patients with low FHL. The specific aims of the proposed research are to: 1) perform a cross-sectional study to examine the association between FHL, self-management, and glycemic control among Type 2 diabetes patients; 2) to evaluate, as part of a funded prospective study on automated telephone disease management (ATDM), the acceptability and reliability of an ATDM system among patients with Type 2 diabetes and low FHL; and 3) perform a randomized, controlled trial (with wait-list controls) to evaluate the impact of a tailored physician communication training on visit-related recall among patients with Type 2 diabetes and low FHL. The UCSF, with its extensive resources for health related research, provides an excellent environment for the applicant to pursue research and training. The applicant?s sponsor and mentorship team have vast experience in the relevant disciplines and will be critical to the applicant?s development as an independent researcher with a focus on improving the health of vulnerable patients with chronic diseases.