title: Health literacy, physician trust, and diabetes-related self-care activities in Hispanics with limited resources.
abstract: BACKGROUND
  Hispanics with diabetes often have deficits in health literacy (HL). We examined the association among HL, psychosocial factors, and diabetes-related self-care activities.
  
  
  METHODS
  Cross-sectional analysis of 149 patients. Data included patient demographics and validated measures of HL, physician trust, self-efficacy, acculturation, self-care behaviors, and A1c.
  
  
  RESULTS
  Participants (N=60) with limited HL were older and less educated, and had more years with diabetes compared with adequate HL participants (N=89). Limited HL participants reported greater trust in their physician, greater self-efficacy, and better diet, foot care, and medication adherence. Health literacy status was not associated with acculturation or A1c. In adjusted analyses, HL status remained associated with physician trust, and we observed a notable but nonsignificant trend between HL status and medication adherence.
  
  
  CONCLUSIONS
  Lower HL was associated with greater physician trust and better medication adherence. Further research is warranted to clarify the role of HL and physician trust in optimizing self-care for Hispanics.
authors.forename: Richard O
authors.initials: RO
authors.lastname: White
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.forename: Sunil
authors.initials: S
authors.lastname: Kripalani
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D057220:Health Literacy; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010817:Physician-Patient Relations; D012648:Self Care; D013714:Tennessee; D035502:Trust