Examining Health Literacy and Appropriateness of Commercially Developed Patient Education Materials for Adults Living With Diabetes on the U.S./Mexico Border

Abstract

Effective patient education is critical to an individual’s treatment plan when living with diabetes, a debilitating disease requiring extensive knowledge and skills to effectively manage and prevent future morbidity. This descriptive, cross-sectional study assessed the appropriateness of commercially developed patient education materials for rural adults with diabetes. Using electronic health record data from patients (n = 132) with documented health literacy levels (HLL), their HLL scores were reviewed for suitability of educational materials provided by a single rural-border hospital. HLL was measured using the Newest Vital Sign, while educational materials were assessed by two independent reviewers using the Patient Education Materials Assessment Tool for Printable Materials to measure understandability and actionability, and the Simple Measure of Gobbledygook to measure the readability level of documents in both English and Spanish. The mean HLL for Spanish speakers (n = 77) was 2.01 (±1.56), while the mean HLL for English speakers (n = 55) was 2.09 (±1.46), indicating a high likelihood of low health literacy. The materials were evaluated with the English materials achieving an understandability score of 83.33% and an actionability score of 60.00%. By contrast, the Spanish materials scored lower, 61.54% and 20.00%, respectively. In addition, the readability of the materials measured a 9.0 grade level for English materials and a slightly higher 10.8 for Spanish materials. These findings highlight a significant discrepancy between the HLL and the appropriateness of educational materials for the sample population. Although commercially available educational products may provide a budget-concise solution to patient education, particularly in low-resourced organizations, they fail to address the health education needs of the individuals who receive them. Despite the project’s limited sample size and single geographical location, it underscores the importance for healthcare organizations to address the health education needs of their communities.