A diabetes diagnosis can be challenging for any patient. But for patients with low health literacy, the diagnosis can be even more overwhelming. Low health literacy negatively affects an individual’s ability to make healthy choices about self-managing their condition, which makes it harder to achieve positive health outcomes.

The health literacy issue in the U.S.

Health literacy refers to an individual’s ability to access, process, and understand the information needed to make healthy decisions. According to the Office of Disease Prevention and Health Promotion, more than a third (77 million) of U.S. adults have only basic or below basic health literacy. In fact, only 12 percent of people demonstrate proficient health literacy.

Low health literacy can take many forms, but here are a few of the most common health literacy challenges:

  • Not being familiar with medical terms or how the human body works
  • Interpreting numbers or risks to make a health care decision
  • Being scared or confused by the diagnosis of a serious illness
  • Having a complex condition that requires complicated self-care

How does health literacy relate to diabetes?

Low health literacy is considered a potential barrier to improving health outcomes of people with diabetes and other chronic conditions.

There are countless studies exploring the relationship between low health literacy and health outcomes for people with diabetes. A systematic review of the topic found that low health literacy is associated with less diabetes-related knowledge and may be related to other important health outcomes. Another study concluded that higher health literacy levels are associated with lower HbA1c.

While health literacy is an issue for all types of people across the country, it is perhaps an even greater challenge for certain racial and ethnic groups. Of all the racial/ethnic groups, African Americans and Hispanics are over 50 percent more likely to have diabetes than non-Hispanic whites. Unfortunately, blacks and Hispanics also have the lowest health literacy among racial/ethnic groups, with 65% of black and Hispanic people being at a below basic level.

Other groups that commonly struggle with health literacy include adults with less than a high school diploma, the elderly, and people without insurance or on Medicaid or Medicare.

The Clinically Proven Strategy for Improving Diabetes Health Literacy

The CDC encourages people to receive Diabetes Self-Management Education and Support (DSMES) when they are first diagnosed, at yearly follow-up doctors’ visits, when health complications arise, and when changes in care occur. However, there are a few challenges with traditional SMES:

  • Tend to be taught in group-based formats that can’t assess the individual’s barriers and goals
  • Requires the patient to find the program themselves or follow up on a recommendation from a provider
  • Depending on the organization, may require a participation fee from the patient

Many people living with diabetes face barriers that negatively impact their ability to seek out help to self-manage their conditions. For these individuals, a self-initiated DSMES program may not be an effective or sustainable way to improve health outcomes.

Beyond education, many people with diabetes require personalized support to self-manage their conditions. They key to improving health outcomes for people with diabetes is a one-to-one approach that impacts widespread population behavior change.

The role of Certified Diabetes Educators in improving health literacy

At Cecelia Health, our approach has been clinically proven to improve diabetes health outcomes through scalable, personalized coaching.

We have found that by combining the individualized coaching of a  Certified Diabetes Educator (CDE) with proprietary technology, we can deliver a personalized coaching program that improves self-management and drives behavior change. Cecelia Health focuses on high-risk, poorly controlled populations who face unique barriers or would otherwise not seek help.

CDEs are health professionals who work one-on-one with patients to identify their personal barriers and teach strategies for overcoming them. CDEs educate, support, and advocate for people affected by diabetes, as well as promote self-management to achieve individualized behavior and treatment goals.

Because of the personal, one-on-one relationships patients build with CDEs, the patient’s individual health literacy barriers can be identified and addressed quickly. CDEs get to know each patient—not just their medical history, but who they are as a person. Through this trusted relationship, CDEs identify areas where their clients have low health literacy and work to help them understand their care.

Cecelia Health’s CDEs are trained to address a wide variety of health literacy issues, including:

  • Language barriers
  • Knowledge of how diabetes affects the body
  • Monitoring and interpreting blood glucose levels and other health metrics
  • Medication adherence issues—not understanding how to correctly self-administer
  • Knowledge of nutrition, reading food labels, and healthy meal choices

Through a combination of clinical coaching from CDEs and a technology-enabled platform for tracking health outcomes, Cecelia Health has successfully worked with health plans of all sizes to improve the health of their members with diabetes with direct, measurable impacts on Star, HEDIS, and Healthy Days measures.

Healthy People 2020 goals call for significant improvements in health literacy to advance the health of the population. For poorly controlled and high-risk populations with diabetes, the need for improved health literacy is of even greater importance. Only by truly understanding their condition can people with diabetes take an active role in managing their care.