title: [Diabetes-specific health literacy: what do Turkish immigrants with diabetes mellitus 2 know about their disease?].
abstract: OBJECTIVE
  Only few findings are available for the large group of type 2 diabetics whose origin is not German. This article investigates 1) the degree of diabetes-knowledge among diabetics of Turkish origin, and 2) factors that influence this knowledge and the competencies with handling the disease.
  
  
  METHODS
  In cooperation with 15 medical practices 294 diabetics of Turkish origin were interviewed in person by Turkish-speaking interviewers. There is no established concept for this population to measure their health literacy, therefore we adopted some questions from other tests and added our own items. Besides diabetes knowledge tests with closed and open questions the interviewees had to undertake a reading test and a screening test on German language skills. Socio-demographics and the attendance at diabetes trainings were gathered as well, and analysed in principal component analyses and multiple regressions.
  
  
  RESULTS
  On average, the respondents had lived in Germany for 32 years, but 40% of them do not speak German. 25% never went to school and 21% cannot read or write (Turkish). Even though 60% took part in a diabetes training course, it appears that knowledge about the disease is scarce: only 15% could sufficiently explain their diabetes disease with their own words. A dimensional analysis helps to differentiate "theoretical" and "behavioural relevant" knowledge about diabetes. Theoretical knowledge is strongly associated with education, German language skills and attending a training course, whereas competencies that are relevant to the behaviour only are associated with participation in diabetes training courses. The educational effects remain on a rather low level and cannot compensate the fact that theoretical knowledge about diabetes depends on education. Hence, the overall (too) low level of knowledge on health and diabetes is only marginally improved.
  
  
  CONCLUSIONS
  Education, attending a diabetes training course and language skills are the main factors for explaining poor knowledge about diabetes. A tailor-made training course--considering people's educational background--for the large group of people of Turkish origin could lead to improvements. Moreover, the neglected potential of self-help groups should be developed, as only one person of the reviewed population reported to search for support here.
authors.affiliation: Institut für Medizinische Soziologie, Sozialmedizin und Gesundheitsökonomie (IMSG), Universitätsklinikum Hamburg Eppendorf.
authors.forename: C
authors.initials: C
authors.lastname: Kofahl
authors.affiliation: Institut für Medizinische Soziologie, Sozialmedizin und Gesundheitsökonomie (IMSG), Universitätsklinikum Hamburg Eppendorf.
authors.forename: O
authors.initials: O
authors.lastname: von dem Knesebeck
authors.affiliation: Institut für Medizinische Soziologie, Sozialmedizin und Gesundheitsökonomie (IMSG), Universitätsklinikum Hamburg Eppendorf.
authors.forename: J
authors.initials: J
authors.lastname: Hollmann
authors.affiliation: Institut für Medizinische Soziologie, Sozialmedizin und Gesundheitsökonomie (IMSG), Universitätsklinikum Hamburg Eppendorf.
authors.forename: E
authors.initials: E
authors.lastname: Mnich
mesh_terms: D017677:Age Distribution; D001294:Attitude to Health; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015995:Prevalence; D017678:Sex Distribution; D014421:Turkey / Q000208:ethnology