title: Using Teach-Back to Understand Participant Behavioral Self-Monitoring Skills Across Health Literacy Level and Behavioral Condition.
abstract: OBJECTIVE
  To assess differences, by health literacy status and behavioral condition, in participants' abilities to self-monitor behaviors accurately and recall key behavioral messages using data from a teach-back call.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Rural, southwestern Virginia.
  
  
  METHODS
  Adults (n = 301). The majority were female (81.1%), 31.9% had a high school education or less, 66.1% earned < $25,000/y, and 32.9% were low health literate.
  
  
  METHODS
  First class session of 2 community-based behavioral interventions: SIPsmartER (reduce sugar-sweetened beverage intake) or MoveMore (increase physical activity).
  
  
  METHODS
  Reported accuracy of behavioral diary completion, proportion of behavioral messages recalled during the first round of teach-back, and rounds of teach-back.
  
  
  METHODS
  Descriptive statistics and generalized linear model.
  
  
  RESULTS
  Low health literate participants were significantly less accurate in diary completion (P < .001), recalled fewer behavioral messages correctly (P < .001), and needed more rounds of teach-back (P < .001) than high health literate participants. Compared with SIPsmartER participants, MoveMore participants more accurately completed diaries (P = .001) but recalled a lower proportion of behavioral messages correctly (P < .001) and required more rounds of teach-back (P < .001).
  
  
  CONCLUSIONS
  Health literacy status and behavioral target affect the ability to self-monitor and recall key concepts. Researchers should consider using teach-back early in the intervention to assess and reinforce participants' ability to self-monitor.
authors.affiliation: Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA. Electronic address: kjporter@vt.edu.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Porter
authors.affiliation: William Allen White School of Journalism and Mass Communications, Virginia Tech, Blacksburg, VA.
authors.forename: Yvonnes
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA; Department of Family and Community Medicine, Virginia Tech Carillion School of Medicine, Blacksburg, VA.
authors.forename: Paul
authors.initials: P
authors.lastname: Estabrooks
authors.affiliation: Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Noel
authors.affiliation: Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
authors.forename: Angela
authors.initials: A
authors.lastname: Bailey
authors.affiliation: Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
authors.forename: Jamie
authors.initials: J
authors.lastname: Zoellner
mesh_terms: D000328:Adult; D001628:Beverages / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D014768:Virginia
keywords: beverages; health literacy; physical activity; self-report