Creating a Comprehensive Diabetes Self-Management Resource For the Metro-Atlanta Area: Diabetes Self-Management Workbook, Diabetes Association of Atlanta Open Access

George, Katherine Ruth

Permanent URL: https://etd.library.emory.edu/concern/etds/bc386k177?locale=en
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Abstract


Health literacy is a person's ability to function in the healthcare system, and includes the
ability to understand and process health information. The principles of universal
precautions and plain language are two key responses in the effort to address health
literacy issues. Using these two principles, I created a workbook for use in the Diabetes
Self-Management Education (DSME) classes offered by the Diabetes Association of
Atlanta (DAA).
More than 300,000 people in the 13 metro-Atlanta counties served
diagnosed with diabetes, a chronic condition for which most of the burden of
management falls on the patient. Diabetes also puts one at a higher risk for a variety of
other chronic conditions. Because diabetes is a chronic condition mostly managed by
the patient, it is the ideal perspective from which to address the issue of health literacy
and its effect on health outcomes.
DSME focuses on equipping people with the knowledge and skills that would help
participants manage their diabetes for the best possible health outcomes. However, this
self-management ideal is often hindered by low levels of health literacy among people
with diabetes. An estimated 55% of patients with diabetes have marginal or inadequate
levels of health literacy.
DAA holds monthly DSME workshops across the metro-Atlanta region. The current
workbook (version 1.9) was designed in the late 1990s and is severely outdated. Using a
survey developed for DAA, I conducted a pre-project assessment of the current
workbook used in DAA's DSME classes. I developed a new workbook based on
feedback from the pre-project assessment and research on the latest recommendations
for diabetes self-management, with an especial emphasis on a low-literacy audience.
Then I assessed the clarity, relevance, and utility of the new workbook using the
principles of pre-testing.

Table of Contents

2

Table of Contents
Introduction ..........................................................................................................................3
Background ...........................................................................................................................3
Health Literacy ......................................................................................................................3
Scope of the Problem ..............................................................................................................4
Plain Language .......................................................................................................................5
Universal Precautions ..............................................................................................................6
Health Literacy and Diabetes ....................................................................................................6
Diabetes Self-Management Education .........................................................................................7
Organization Description ..........................................................................................................8
Methods ..............................................................................................................................10
Formative Research ...............................................................................................................10
Writing ................................................................................................................................11
Testing ................................................................................................................................13
Methods ..............................................................................................................................13
Results ................................................................................................................................16
Strengths and Limitations ........................................................................................................17
Public Health Implications ........................................................................................................19
Personal Implications ..............................................................................................................20
References ...........................................................................................................................22
Figures
Figure 1: Sample Workbook Pages ..............................................................................................9
Figure 2: "Balance Icon" ..........................................................................................................15

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