Impact of health literacy on outcomes and effectiveness of an educational intervention in patients with chronic diseases

ObjectiveStudy impact of health literacy on educational intervention for patients “Living with Coronary Artery Disease.”Methods187 patients were randomized to: VHS/DVD plus printed booklet; or booklet alone prior to scheduled visit. Main outcome measures included CAD knowledge assessment, clinical outcomes (weigh and blood pressure) and health behaviors (diet, exercise, and smoking); while functional health literacy was assessed as a possible predictor variable.ResultsKnowledge scores and health behaviors improved following both interventions. Those receiving the booklet and video also had a significant improvement in exercise, and weight loss. There was a trend (p = 0.07) towards greater improvement in test scores among those receiving the booklet plus video. Patients with lower health literacy benefited as much as higher literacy patients.ConclusionsIncorporation of an educational program into clinical visits for patients with chronic disease improved disease-specific knowledge and prompted patients to become activated and involved in their care, improving health behaviors and outcomes. Lower health literacy was not a barrier to this beneficial effect.Practice implicationsPatients with lower health literacy may also benefit from educational, shared decision-making interventions.