Improving Care for Patients With Diabetes and Poor Numeracy Skills

Vanderbilt University

Status: Completed

Conditions: Diabetes

Treatments: Behavioral: Control Group; Behavioral: Literacy/Numeracy oriented educational intervention

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT00311922

IRB# 060128

DK20593 P&F 6 NIH/NIDDK

Details and patient eligibility

About

The aim of this research will be to perform a randomized controlled trial (RCT) of a new diabetes educational intervention that teaches self-management skills that compensate for poor numeracy skills among a sample of patients with diabetes and low numeracy.

Full description

Results of the National Adult Literacy Survey (NALS) suggest that over 90 million adult Americans have poor quantitative skills. Numeracy, the ability to understand and use numbers and math skills in daily life, may be particularly important to patients with diabetes because caring for diabetes often requires self-management skills that rely on the daily application of math skills, such as counting carbohydrates, interpreting blood glucose monitoring, applying sliding scale insulin regimens, and calculating insulin to carbohydrate ratios. Presumably diabetes patients with poor numeracy have more difficulty with self-management and are at risk for poorer clinical outcomes, but to date, there are no published studies that rigorously examine the role of numeracy in diabetes. We have recently completed the initial development of a new scale to measure numeracy in patients with diabetes: the Diabetes Numeracy Test (DNT).

The aim of this research will be to perform a randomized controlled trial (RCT) of a new diabetes educational intervention that teaches self-management skills that compensate for poor numeracy skills among a sample of patients with diabetes and low numeracy. We hypothesize that a group of patients with poor numeracy who are taught self-management skills that accommodate their poor numeracy will have: (1) improved treatment satisfaction and perceived self-efficacy, (2) improved performance in self-management tasks, and (3) improved glycemic control compared to a control group that receives usual education.

Enrollment: 106 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Clinical diagnosis of Type 1 or 2 Diabetes;
2. most recent A1C greater than or equal to 7.0%;
3. Referred to the Diabetes Improvement Program for diabetes care;
4. Age 18-80;
5. English Speaking.

Exclusion criteria

1. Patients with corrected visual Acuity >20/50 using a Rosenbaum Pocket Vision Screener, or
2. Patients with a diagnosis of significant dementia, psychosis, or blindness.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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106 participants in 2 patient groups

Control

Active Comparator group

Description:

Active Control Arm receives Comprehensive Diabetes Education

Treatment:

Behavioral: Control Group

Intervention Arm

Experimental group

Description:

Receives comprehensive education that is literacy/numeracy sensitive

Treatment:

Behavioral: Literacy/Numeracy oriented educational intervention