Literacy- Compensatory Strategies and Resources of Older Latinos with Diabetes

描述(由申请人提供)：我们提出了一个创新的项目，将确定和审查低识字和低健康素养的拉丁裔糖尿病患者在面临与识字要求高的医疗保健相关任务时所使用的补偿策略和资源。通过比较患者的策略和资源，尽管他们的识字能力有限，但糖尿病控制良好，与那些控制不佳的患者相比，我们寻求识别和区分有效和无效的策略。此外，我们还将探索所使用的策略以及这些策略的有效性如何受到个人和医疗保健资源的影响。我们将把我们的研究限于患有2型糖尿病的老年拉丁裔患者，因为有巨大的机会改善识字率低和糖尿病的老年拉丁裔患者的健康。我们经验丰富的跨学科团队将对120名年龄较大、英语水平有限、精通西班牙语的糖尿病患者进行深入访谈，其中60人是文盲，其中60人具有一些但有限的健康素养技能(“低识字率”)。我们将从一家城市安全网医院招募所有参与者。这项研究将是关键的初步探索阶段，需要将干预-发展努力集中在补充、增强或利用成功战略的方法上。我们的研究团队将利用该项目的研究成果来(A)开展一项更大规模的调查，以定量评估可能影响策略和资源的使用和有效性的个人和医疗保健特征；以及(B)开发以患者为中心的干预措施并进行实证测试，以减少老年文盲和低文化程度的西班牙语糖尿病患者和其他类似慢性病患者的健康差距。公共卫生相关性：拟议的项目将深入了解识字率低和健康素养低的拉丁裔糖尿病患者使用的识字补偿战略和资源。这一见解将指导研究人员开发强大的以患者为中心的干预措施，极有可能减少拉美裔糖尿病患者中与识字相关的差异。

DESCRIPTION (provided by applicant): We propose an innovative project that will identify and examine the compensatory strategies and resources used by low literate and low health-literate Latino diabetes patients when faced with literacy-demanding healthcare-related tasks. By comparing strategies and resources of patients who, despite their limited literacy, have good diabetes control, to those who have poor control, we seek to identify and distinguish between effective and ineffective strategies. Moreover, we will explore how the strategies used, and the effectiveness of these strategies, are influenced by personal and healthcare resources. We will limit our study to older Latino patients who have type 2 diabetes because there is tremendous opportunity to improve the health of older Latinos with low literacy and diabetes. Our experienced interdisciplinary team will perform in-depth interviews with 120 older limited English proficient Spanish-speakers with diabetes, 60 of whom are illiterate and 60 of whom have some, but limited, health literacy skills ("low literate"). We will recruit all participants from an urban safety-net hospital. This study will be the critical initial exploratory phase needed to concentrate intervention-development efforts on approaches that complement, augment, or utilize successful strategies. Our research team will use this project's findings to (a) develop a larger survey to quantitatively assess for personal and health care characteristics that may influence the use and effectiveness of strategies and resources; and, (b) develop and empirically test patient-centered interventions to reduce health disparities for older illiterate and low-literate Spanish-speaking patients with diabetes and other comparable chronic illnesses. PUBLIC HEALTH RELEVANCE: The proposed project will provide insight into literacy-compensatory strategies and resources used by Latino diabetes patients with low literacy and low health literacy. This insight will guide researchers in developing powerful patient-centered interventions that have a high potential for decreasing literacy-associated disparities in diabetes outcomes among Latinos.