LOW-LITERACY - A PROBLEM IN DIABETES EDUCATION

Eighty-five diabetic patients who were proficient in English were stud ied to assess the impact of educational material of varying literacy l evels on patient comprehension. Two samples of available diabetes foot care material of Grade 11 and 9 readability (measured by SMOG formula ) and purposely written in-house material of Grade 6 readability were used. Patients were randomized to read information of either Grade 6 a nd Grade 11 or Grade 6 and Grade 9 readability. Socio-demographic data and reading habits were collected to allow for identification of lite racy markers. The mean CLOZE score (a measure of comprehension) was be tter in patients who read the Grade 6 information than for both the Gr ade 11 and Grade 9 information (59.5 +/- 11.8, 46.8 +/- 22.0, 45.8 +/- 22.2 respectively, p < 0.001). When evaluated in terms of percent of patients that could independently understand the material, Grade 6 inf ormation outperformed the Grade 11 and Grade 9 information (60 %, 19 % , 21 %, respectively, p < 0.001). For the Grade 11 and Grade 9 informa tion, poorer comprehension was associated with a non-English speaking background, early school leaving age, infrequent reading habits, and p reference for tabloids (p < 0.02). Comprehension when patients read th e Grade 6 information was no longer dependent on two of the four ident ified literacy markers. We conclude that reducing literacy demands of health literature improves patients' comprehension. Attention to socio -demographic data and reading habits can assist educators in assessing patients' literacy status and ensuring patients are given literature of compatible readability.