title: Literacy-appropriate educational materials and brief counseling improve diabetes self-management.
abstract: OBJECTIVE
  In this pilot study, we evaluated the impact of providing patients with a literacy-appropriate diabetes education guide accompanied by brief counseling designed for use in primary care.
  
  
  METHODS
  We provided the Living with Diabetes guide and brief behavior change counseling to 250 English and Spanish speaking patients with type 2 diabetes. Counseling sessions using collaborative goal setting occurred at baseline and by telephone at 2 and 4 weeks. We measured patients' activation, self-efficacy, diabetes distress, knowledge, and self-care at baseline and 3-month follow-up.
  
  
  RESULTS
  Statistically significant (p<or=0.001) and clinically important (effect sizes=0.29-0.42) improvements were observed in participants' activation, self-efficacy, diabetes-related distress, self-reported behaviors, and knowledge. Improvements were similar across literacy levels. Spanish speakers experienced both greater improvement in diabetes-related distress and less improvement in self-efficacy levels than English speakers.
  
  
  CONCLUSIONS
  A diabetes self-management support package combining literacy-appropriate patient education materials with brief counseling suitable for use in primary care resulted in important short-term health-related psychological and behavioral changes across literacy levels.
  
  
  CONCLUSIONS
  Coupling literacy-appropriate education materials with brief counseling in primary care settings may be an effective and efficient strategy for imparting skills necessary for diabetes self-management.
authors.affiliation: University of New Mexico, College of Nursing, Albuquerque, NM, USA.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Wallace
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Seligman
authors.forename: Terry C
authors.initials: TC
authors.lastname: Davis
authors.forename: Dean
authors.initials: D
authors.lastname: Schillinger
authors.forename: Connie L
authors.initials: CL
authors.lastname: Arnold
authors.forename: Betsy
authors.initials: B
authors.lastname: Bryant-Shilliday
authors.forename: Janet K
authors.initials: JK
authors.lastname: Freburger
authors.forename: Darren A
authors.initials: DA
authors.lastname: DeWalt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus; D037001:Directive Counseling; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D017145:Models, Educational; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care