Low health literacy is common among adults and is related to adverse health outcomes. It also impacts health management and one’s ability to control his or her chronic illness. The current study examined the association of health literacy and diabetes management self-efficacy with employment among 126 individuals with diabetes. No relationship was found between health literacy and employment. Diabetes-management self-efficacy was not directly related to employment but it was indirectly linked to it through physical health and lack of interference of diabetes with activities of daily living. This research suggests that strategies to improve self-efficacy may contribute to improved health and employment outcomes. Implications for rehabilitation counseling practice and research are discussed.
AdkinsN. R.CorusC. (2009). Health literacy for improved health outcomes: Effective capital in the marketplace. Journal of Consumer Affairs, 43, 199–222. doi:10.1111/j.1745-6606.2009.01137.x
2.
AllegranteJ. P.MarksR. (2003). Self-efficacy in management of osteoarthritis. Rheumatic Disease Clinics of North America, 29, 747–768. doi:10.1016/S0889-857X(03)00060-7
3.
AllisonM. J.KellerC. (2004). Self-efficacy intervention effect on physical activity in older adults. Western Journal of Nursing Research, 26, 31–46. doi:10.1177/0193945903259350
4.
AltmaierE. G.RussellD.KaoC. F.LehmannT. R.WeinsteinJ. N. (1993). Role of self-efficacy in rehabilitation outcome among chronic low back pain patients. Journal of Counseling Psychology, 40, 335–339.
5.
ApterA. J.WangX.BogenD.BennettI. M.JenningsR. M.GarciaL.. . . Ten HaveT. (2009). Linking numeracy and asthma-related quality of life. Patient Education and Counseling, 75, 386–391. doi:10.1016/j.pec.2009.01.003
6.
ArozullahA. M.LeeS. D.KhanT.KurupS.RyanJ.BonnerM.. . . YarnoldP. R. (2006). The roles of low literacy and social support in predicting the preventability of hospital admission. Journal of General Internal Medicine, 21, 140–145. doi:10.1111/j.1525-1497.2005.00300.x
7.
BakerD. W. (2006). The meaning and the measure of health literacy. Journal of General Internal Medicine, 21, 878–883. doi:10.1111/j.1525-1497.2006.00540.x
8.
BakerD. W.ParkerR.WilliamsM.ClarkW. (1998). Health literacy and the risk of hospital admission. Journal of General Internal Medicine, 13, 791–798. doi:10.1046/j.1525-1497.1998.00242.x
9.
BanduraA. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215. doi:10.1037/0033-295X.84.2.191
10.
BerkmanN. D.DeWaltD. A.PignoneM. P.SheridanS. L.LohrK. N.LuxL.. . . BonitoA. J. (2004). Literacy and health outcomes (Evidence Report/Technology Assessment No. 87, Technical Report). Research Triangle Park: RTI International - University of North Carolina Evidence-Based Research Center.
11.
BishopM.ChapinM. H.MillerS. (2008). Quality of life assessment in the measurement of rehabilitation outcome. Journal of Rehabilitation, 74, 45–55.
12.
CarmonaR. H. (2006). Health literacy: A national priority. Journal of General Internal Medicine, 21, 803. doi:10.1111/j.1525-1497.2006.00569.x
13.
Centers for Disease Control and Prevention. (2011). National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Author.
14.
ChapinM. H.HolbertD. (2010). Employment at closure is associated with enhanced quality of life and subjective well-being for persons with spinal cord injuries. Rehabilitation Counseling Bulletin, 54, 6–14. doi:10.1177/0034355210367685
15.
CherringtonA.WallstonK. A.RothmanR. L. (2010). Exploring the relationship between diabetes self-efficacy, depressive symptoms, and glycemic control among men and women with type 2 diabetes. Journal of Behavioral Medicine, 33, 81–89. doi:10.1007/s10865-009-9233-4
16.
DeWaltD. A.BerkmanN. D.SheridanS.LohrK. N.PignoneM. P. (2004). Literacy and health outcomes: A systematic review of the literature. Journal of General Internal Medicine, 19, 1228–1239. doi:10.1111/j.1525-1497.2004.40153.x
17.
DeWaltD. A.BooneR. S.PignoneM. P. (2007). Literacy and its relationship with self-efficacy, trust, and participation in medical decision making. American Journal of Health Behavior, 31, S27–S35.
18.
DilorioC.FahertyB.ManteuffelB. (1992). Self-efficacy and social support in self-management of epilepsy. Western Journal of Nursing Research, 14, 292–307. doi:10.1177/019394599201400303
19.
DooleyD.CatalanoR.HoughR. (1992). Unemployment and alcohol disorder in 1910 and 1990: Drift versus social causation. Journal of Occupational and Organizational Psychology, 65, 277–290.
20.
DooleyD.CatalanoR.WilsonG. (1994). Depression and unemployment: Panel findings from the epidemiologic catchment area study. American Journal of Community Psychology, 22, 745–765. doi: 10.1007/BF02521557
21.
DooleyD.FieldingJ.LeviL. (1996). Health and unemployment. Annual Review of Public Health, 17, 449–465. doi:10.1146/annurev.pu.17.050196.002313
22.
EgedeL. E. (2007). Major depression in individuals with chronic medical disorders: Prevalence, correlates and association with health resource utilization, lost productivity and functional disability. General Hospital Psychiatry, 29, 409–416. doi:10.1016/j.genhosppsych.2007.06.002
23.
EricksonW.LeeC.von SchraderS. (2012). 2010 Disability status report: United States. Ithaca, NY: Cornell University Employment and Disability Institute.
24.
HamptonN. Z. (2000). Self-efficacy and quality of life in people with spinal cord injuries in China. Rehabilitation Counseling Bulletin, 43, 66–74. doi:10.1177/003435520004300202
25.
HamptonN. Z. (2004). Subjective well-being among people with spinal cord injuries: The role of self-efficacy, perceived social support, and perceived health. Rehabilitation Counseling Bulletin, 48, 31–37. doi:10.1177/00343552040480010401
26.
HerquelotE.GuéguenA.BonenfantS.Dray-SpiraR. (2011). Impact of diabetes on work cessation: Data from the GAZEL cohort study. Diabetes Care, 34, 1344–1349. doi:10.2337/dc10-2225
27.
JohnsonM. O.ChesneyM. A.GoldsteinR. B.RemienR. H.CatzS.Gore-FeltonC.. . . MorinS. F. (2006). Positive provider interactions, adherence self-efficacy, and adherence to antiretroviral medications among HIV-infected adults: A mediation model. AIDS Patient Care and STDs, 20, 258–268. doi:10.1089/apc.2006.20.258
28.
KalichmanS.RompaD. (2000). Emotional reactions to health status changes and emotional well-being among HIV-positive persons with limited reading literacy. Journal of Clinical Psychology in Medical Settings, 7, 203–211. doi:10.1023/A:1009528429865
29.
KirschI. S.JungeblutA.JenkinsL.KolstadA. (2002). Adult literacy in America: A first look at the results of the National Adult Literacy Survey (NALS) (Technical Report). Washington, DC: National Center for Education Statistics, U.S. Department of Education.
30.
KrautA.WalldR.TateR.MustardC. (2001). Impact of diabetes on employment and income in Manitoba, Canada. Diabetes Care, 24, 64–68. doi:10.2337/diacare.24.1.64
31.
KripalaniS.Paasche-OrlowM. K.ParkerR. M.SahaS. (2006). Advancing the field of health literacy. Journal of General Internal Medicine, 21, 804–805. doi:10.1111/j.1525-1497.2006.00568.x
32.
KutnerM.GreenbergE.JinY.PaulsenC. (2006). The health literacy of America’s adults: Results from the 2003 national assessment of adult literacy (NCES 2006–483). U.S. Department of Education. Washington, DC: National Center for Education Statistics.
33.
LincolnA.Paasche-OrlowM. K.ChengD. M.Lloyd-TravagliniC.CarusoC.SaitzR.SametJ. H. (2006). Impact of health literacy on depressive symptoms and mental health-related: Quality of life among adults with addiction. Journal of General Internal Medicine, 21, 818–822. doi:10.1111/j.1525-1497.2006.00533.x
34.
MancusoC. A.RinconM. (2006). Impact of health literacy on longitudinal asthma outcomes. Journal of General Internal Medicine, 21, 813–817. doi:10.1111/j.1525-1497.2006.00528.x
35.
MarksR.AllegranteJ. P.LorigK. (2005). A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: Implications for health education practice (part II). Health Promotion Practice, 6, 148–156. doi:10.1177/1524839904266792
36.
MarroneJ.GolowkaE. (1999). If work makes people with mental illness sick, what do unemployment, poverty, and social isolation cause?Psychiatric Rehabilitation Journal, 23, 187–193.
37.
McEwenL. N.KimC.EttnerS. L.HermanW. H.KarterA. J.BecklesG. L.BrownA. F. (2011). Competing demands for time and self-care behaviors, processes of care, and intermediate outcomes among people with diabetes: Translating research into action for diabetes (TRIAD). Diabetes Care, 34, 1180–1182. doi:10.2337/dc10-2038
38.
NakaharaR.YoshiuchiK.KumanoH.HaraY.SuematsuH.KubokiT. (2006). Prospective study on influence of psychosocial factors on glycemic control in Japanese patients with type 2 diabetes. Psychosomatics, 47, 240–246. doi:10.1176/appi.psy.47.3.240
39.
OsbornC. Y.CavanaughK.WallstonK. A.RothmanR. L. (2010). Self-efficacy links health literacy and numeracy to glycemic control. Journal of Health Communication, 15(Suppl. 2), 146–158. doi:10.1080/10810730.2010.499980
40.
ParkerR.BakerD.WilliamsM.NurssJ. (1995). The test of functional health literacy in adults: A new instrument for measuring patients literacy skills. Journal of General Internal Medicine, 10, 537–541. doi:10.1007/BF02640361
41.
PleasantA.McKinneyJ. (2011). Coming to consensus on health literacy measurement: An online discussion and consensus-gauging process. Nursing Outlook, 59, 95–106. doi:10.1016/j.outlook.2010.12.006
42.
PleasantA.McKinneyJ.RikardR. V. (2011). Health literacy measurement: A proposed research agenda. Journal of Health Communication, 16, 11–21. doi:10.1080/10810730.2011.604392
43.
PowellC. K.HillE. G.ClancyD. E. (2007). The relationship between health literacy and diabetes knowledge and readiness to take health actions. The Diabetes Educator, 33, 144–151.
44.
RyanC. L.SiebensJ. (2012). Educational attainment in the United States: 2009. Current Population Reports (Technical Report). Washington, DC: U.S. Census Bureau, U.S. Department of Commerce Economics and Statistics Administration.
45.
SarkarU.FisherL.SchillingerD. (2006). Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy?Diabetes Care, 29, 823–829. doi:10.2337/diacare.29.04.06.dc05-1615
46.
SchillingerD.GrumbachK.PietteJ.WangF.OsmondD.DaherC.. . . BindmanA. B. (2002). Association of health literacy with diabetes outcomes. The Journal of the American Medical Association, 288, 475–482. doi:10.1001/jama.288.4.475
47.
SmarrK.ParkerJ.WrightG.Stucky-RoppR.BuckelewS.HoffmanR.. . . HewettJ. E. (1997). The importance of enhancing self-efficacy in rheumatoid arthritis. Arthritis Care & Research, 10, 18–26.
48.
StoopsN. (2004). Current population reports: Educational attainment in the United States: 2003 (Technical Report). Washington, DC: U.S. Census Bureau, U.S. Department of Commerce Economics and Statistics Administration.
49.
SudoreR. L.YaffeK.SatterfieldS.HarrisT. B.MehtaK. M.SimonsickE. M.. . . SchillingerD. (2006). Limited literacy and mortality in the elderly: The health, aging, and body composition study. Journal of General Internal Medicine, 21, 806–812. doi:10.1111/j.1525-1497.2006.00539.x
50.
TunceliK.BradleyC. J.NerenzD.WilliamsL. K.PladevallM.Elston LafataJ. (2005). The impact of diabetes on employment and work productivity. Diabetes Care, 28, 2662–2667. doi:10.2337/diacare.28.11.2662
51.
van der BiljJ.van Poelgeest-EeltinkA.Shortridge-BaggettL. (1999). The psychometric properties of the Diabetes Management Self-Efficacy Scale for patients with type 2 diabetes mellitus. Journal of Advanced Nursing, 30, 352–359. doi: 10.1046/j.1365-2648.1999.01077.x
52.
von WagnerC.SemmlerC.GoodA.WardleJ. (2009). Health literacy and self-efficacy for participating in colorectal cancer screening: The role of information processing. Patient Education and Counseling, 75, 352–357. doi:10.1016/j.pec.2009.03.015
53.
WahlA. K.RustøenT.HanestadB. R.GjengedalE.MoumT. (2005). Self-efficacy, pulmonary function, perceived health and global quality of life of cystic fibrosis patients. Social Indicators Research, 72, 239–261. doi:10.1007/s11205-004-5580-2 g
54.
WallaceA. S.SeligmanH. K.DavisT. C.SchillingerD.ArnoldC. L.Bryant-ShillidayB.DeWaltD. A. (2009). Literacy-appropriate educational materials and brief counseling improve diabetes self-management. Patient Education and Counseling, 75, 328–333. doi:10.1016/j.pec.2008.12.017
55.
WallstonK. A.RothmanR. L.CherringtonA. (2007). Psychometric properties of the Perceived Diabetes Self-Management Scale (PDSMS). Journal of Behavioral Medicine, 30, 395–401. doi:10.1007/s10865-007-9110-y
56.
WeissB. D.FrancisL.SenfJ. H.HeistK.HargravesR. (2006). Literacy education as treatment for depression in patients with limited literacy and depression: A randomized controlled trial. Journal of General Internal Medicine, 21, 823–828. doi:10.1111/j.1525-1497.2006.00531.x
57.
WilliamsM.BakerD.ParkerR.NurssJ. (1998). Relationship of functional health literacy to patients’ knowledge of their chronic disease—A study of patients with hypertension and diabetes. Archives of Internal Medicine, 158, 166–172. doi:10.1001/archinte.158.2.166
58.
WolfM.GazmararianJ.BakerD. (2005). Health literacy and functional health status among older adults. Archives of Internal Medicine, 165, 1946–1952. doi:10.1001/archinte.165.17.1946
59.
World Health Organization. (1998). World health organization quality of life brief: User manual (Technical Report). Geneva, Switzerland: Author.
