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常见的，并与不良的健康结果。心力衰竭是发病率和死亡率的重要原因。心力衰竭疾病管理计划侧重于建立自我管理技能，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足的患者从这些计划中获得更大的好处。我们的目标是在一项多中心随机试验中研究，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中心随机试验，以确定在患者达到行为目标之前，（教目标）是上级的一个简短的教育干预（BEI）组成的一个单一的教育会议，12个月内住院或死亡的发生率和心力衰竭相关生活质量的结局。我们还将研究获得适当的HF相关自我护理知识和行为的患者比例的差异，并将分别研究TTG对识字充足和识字不足的患者的影响。

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.