Health Literacy and Self-Management in Heart Failure

描述(由申请人提供)：健康素养技能不足是很常见的，并与不良的健康结果有关。心力衰竭是发病率和死亡率的重要原因。注重培养自我管理技能的心力衰竭疾病管理计划可以降低住院率。我们的试点随机试验表明，识字不足的患者可能比识字充分的患者从此类计划中获得更大的好处。我们的目标是在一项多点随机试验中，检查提高心力衰竭自我管理技能的识字敏感干预是否可以改善所有患者的健康结果，特别是那些识字不足的患者。我们将对600名心力衰竭患者进行多地点随机试验，以确定在患者达到行为目标(Teach To Goal)之前传授基本自我护理技能的识字敏感、多时段干预是否优于由单一教育时段组成的简短教育干预(BEI)，以确定12个月后住院或死亡的发生率以及与心力衰竭相关的生活质量的结果。我们还将检查患者获得适当的心力衰竭相关自我护理知识和行为的比例的差异，并将分别检查TTG对文化程度足够和不充分的患者的影响。

DESCRIPTION (provided by applicant): Inadequate health literacy skills are common and associated with poor health outcomes. Heart failure is an important cause of morbidity and mortality. Heart failure disease management programs that focus on building self-management skills can reduce rates of hospitalization. Our pilot randomized trial suggests that patients with inadequate literacy may derive greater benefit from such programs than patients with adequate literacy. We aim to examine, in a multi-site randomized trial, whether a literacy-sensitive intervention to improve heart failure self-management skills can improve health outcomes for all patients, and particularly those with inadequate literacy. We will conduct a multi-site randomized trial of 600 patients with heart failure to determine whether a literacy-sensitive, multi-session intervention that teaches essential self-care skills until patients reach behavioral goals (Teach to Goal) is superior to a Brief Educational Intervention (BEI) consisting of a single educational session, for the outcomes of incidence of hospitalization or death and heart failure-related quality of life over 12 months. We will also examine differences in the proportion of patients achieving appropriate HF-related self-care knowledge and behaviors, and will examine the effect of TTG for patients with adequate and inadequate literacy separately.