FUNCTIONAL HEALTH LITERACY, COMMUNICATION, AND DIABETES

描述(申请人提供)：FHL是衡量一个患者-S能力的指标 在考虑识字的医疗保健环境中发挥作用 (对医疗保健说明的阅读理解)和算术(能力 理解数字指令并按其执行)。这项研究的目标是 培训计划是为申请者提供必要的工具 成为健康领域的独立调查者和领导者 传播、FHL和慢性病管理。以他的训练为基础 和初级保健内科的经验，质量改进，以及 在服务不足的人群中进行研究，申请人建议开发 通过以下方式获得其他技能：1)与多学科导师进行互动 该团队包括健康传播、FHL、糖尿病、 和卫生服务研究；2)设计的教程和严格的课程 扩展其理论和方法知识和技能；以及3)a) 一系列有重点、有监督的研究项目。先前的研究已经 表明低FHL在少数族裔、老年人和 患有慢性病的患者。尽管广泛的自我管理 对慢性病患者的要求，人们对 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。这项研究 将利用GCRC资源检查是否 FHL问题与以下患者的临床预后较差有关 2型糖尿病，并探索改善护理的健康沟通策略 适用于FHL低的糖尿病患者。建议的具体目标 研究是为了：1)进行横断面研究，以检查 2型患者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 自动化电话疾病管理(ATDM)、可接受性和 ATDM系统在2型糖尿病低FHL患者中的可靠性； 和3)进行随机对照试验(使用等待名单对照)以 评估定制医生沟通培训对以下方面的影响 2型糖尿病和低FHL患者的访视相关回忆。这个 加州大学旧金山分校，凭借其广泛的健康相关研究资源，提供了 为申请者提供进行研究和培训的良好环境。这个 申请者？S赞助商和导师团队在相关领域拥有丰富的经验 学科和将对申请者至关重要？S作为一名 独立研究人员，专注于改善弱势群体的健康 患有慢性病的患者。

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.