title: Health literacy and its influencing factors in Iranian diabetic patients.
abstract: BACKGROUND
  Health literacy is the ability to obtain, read, understand and use healthcare information to make appropriate health decisions and follow instructions for treatment. The aim of this study was to identify the effect of various factors on health literacy in patients with diabetes.
  
  
  METHODS
  407 patients with diabetes older than 15 years of age were identified from the Diabetes Clinic affiliated to the Institute of Endocrinology and Metabolism (IEM) of Iran University of Medical Sciences. We assessed patients' health literacy using the Persian version of Test of Functional Health Literacy in Adults (TOFHLA) questionnaire.
  
  
  RESULTS
  Mean age of the patients was 55.8 ± 11.3 years, and 61.7% the participants were female.. Overall, 18.2% of the patients had adequate health literacy skills, 11.8% had marginal and 70.0% inadequate health literacy skills. Male participants performed better than females (p< 0.01) and older patients had lower health literacy score than younger patients (p< 0.001). Furthermore, patients with higher educational and occupational levels had higher functional health literacy score than those with lower levels (p< 0.001).
  
  
  CONCLUSIONS
  Health literacy score in Iranian patients with diabetes seems inadequate. Therefrom effective interventions should be designed and implemented for this group of patients to improve diabetes outcomes.
authors.affiliation: MSc. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. mimina_13@yahoo.com.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Mohammadi
authors.affiliation: MD, MPH, PhD candidate of Epidemiology, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences & Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. tehranib@gmail.com.
authors.forename: Arash
authors.initials: A
authors.lastname: Tehrani Banihashemi
authors.affiliation: MD, Gynecology and Obstetrics specialist, Dezful University of Medical Sciences, Khuzestan, Iran. asgharifard@razi.tums.ac.ir.
authors.forename: Homa
authors.initials: H
authors.lastname: Asgharifard
authors.affiliation: MD, Faculty of Medicine, Emergency Department, Alborz University of Medical Sciences, Karaj, Iran. dr_mehran_b@yahoo.com.
authors.forename: Mehran
authors.initials: M
authors.lastname: Bahramian
authors.affiliation: MD, PhD, Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. baradaran.hr@iums.ac.ir.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Baradaran
authors.affiliation: MD, Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. mekhamseh@gmail.com.
authors.forename: Mohammad E
authors.initials: ME
authors.lastname: Khamseh
keywords: Diabetes; Health literacy; Influencing Factors