title: The PRIDE (Partnership to Improve Diabetes Education) Toolkit: Development and Evaluation of Novel Literacy and Culturally Sensitive Diabetes Education Materials.
abstract: Patients with low literacy, low numeracy, and/or linguistic needs can experience challenges understanding diabetes information and applying concepts to their self-management. The authors designed a toolkit of education materials that are sensitive to patients' literacy and numeracy levels, language preferences, and cultural norms and that encourage shared goal setting to improve diabetes self-management and health outcomes. The Partnership to Improve Diabetes Education (PRIDE) toolkit was developed to facilitate diabetes self-management education and support.
  
  
  
  The PRIDE toolkit includes a comprehensive set of 30 interactive education modules in English and Spanish to support diabetes self-management activities. The toolkit builds upon the authors' previously validated Diabetes Literacy and Numeracy Education Toolkit (DLNET) by adding a focus on shared goal setting, addressing the needs of Spanish-speaking patients, and including a broader range of diabetes management topics. Each PRIDE module was evaluated using the Suitability Assessment of Materials (SAM) instrument to determine the material's cultural appropriateness and its sensitivity to the needs of patients with low literacy and low numeracy. Reading grade level was also assessed using the Automated Readability Index (ARI), Coleman-Liau, Flesch-Kincaid, Fry, and SMOG formulas.
  
  
  
  The average reading grade level of the materials was 5.3 (SD 1.0), with a mean SAM of 91.2 (SD 5.4). All of the 30 modules received a "superior" score (SAM >70%) when evaluated by 2 independent raters. The PRIDE toolkit modules can be used by all members of a multidisciplinary team to assist patients with low literacy and low numeracy in managing their diabetes.
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN (Ms Wolff)
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wolff
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA (Ms Chambers)
authors.forename: Laura
authors.initials: L
authors.lastname: Chambers
authors.affiliation: Department of Psychology, University of Illinois, Chicago, IL (Dr Bumol)
authors.forename: Stefan
authors.initials: S
authors.lastname: Bumol
authors.affiliation: Division of Community Internal Medicine, Mayo Clinic, Jacksonville, FL (Dr White)
authors.forename: Richard O
authors.initials: RO
authors.lastname: White
authors.affiliation: Vanderbilt Diabetes Center, Nashville, TN (Ms Gregory)
authors.forename: Becky Pratt
authors.initials: BP
authors.lastname: Gregory
authors.affiliation: Vanderbilt Diabetes Center, Nashville, TN (Ms Davis)
authors.forename: Dianne
authors.initials: D
authors.lastname: Davis
authors.affiliation: Departments of Medicine and Pediatrics, Vanderbilt University, Nashville, TN (Dr Rothman)
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
mesh_terms: D065246:Culturally Competent Care / Q000379:methods*; D003920:Diabetes Mellitus; D057220:Health Literacy / Q000379:methods*; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D010353:Patient Education as Topic / Q000379:methods*; D011932:Reading; D012648:Self Care / Q000379:methods* / Q000523:psychology