title: Literacy and its relationship with self-efficacy, trust, and participation in medical decision making.
abstract: OBJECTIVE
  To examine the relationship between literacy and trust, self-efficacy, and participation in medical decision making in adults with diabetes.
  
  
  METHODS
  A cross-sectional survey and chart review was performed. Patients' literacy was categorized as low if measured < or = 6th grade level.
  
  
  RESULTS
  Two hundred sixty-eight patients participated; 53 had low literacy. No relationship was found between literacy and trust or self-efficacy. Patients with low literacy had less desire to participate in medical decision making (P<0.001) and less diabetes-related knowledge (P<0.001). Literacy was not associated with diabetes outcomes.
  
  
  CONCLUSIONS
  Low literacy is associated with less desire to participate in medical decision making, but not associated with trust or self-efficacy.
authors.affiliation: School of Medicine, Division of General Internal Medicine, University of North Carolina, Chapel Hill, NC 27599, USA. dewaltd@med.unc.edu
authors.forename: Darren A
authors.initials: DA
authors.lastname: DeWalt
authors.forename: Regina S
authors.initials: RS
authors.lastname: Boone
authors.forename: Michael P
authors.initials: MP
authors.lastname: Pignone
mesh_terms: D003430:Cross-Sectional Studies; D003657:Decision Making; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D035502:Trust