ArticlePatient preference and adherence2014
Interaction between functional health literacy, patient activation, and glycemic control.
Article in Patient preference and adherence, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Unravelling the role of health literacy among individuals with multimorbidity: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis.Journal of general internal medicine · 2019Pooled it
- Relationship between patient activation, experienced stigma, and internalised weight stigma in people with type 2 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2026Observational
- The Mediating Role of Treatment Adherence in the Relationship Between Health Literacy and Health Maintenance Efficacy Among Adults with Type 1 Diabetes.Patient preference and adherence · 2026Article
- Physician self-reported factors driving clinical decision-making in management of patients with T2D and ASCVD/high risk of ASCVD across the middle East and Africa: a cross-sectional study.Frontiers in pharmacology · 2025Article
- Health Literacy and Patient Activation in the Pediatric to Adult Transition in Systemic Lupus Erythematosus: Patient and Health Care Team Perspectives.ACR open rheumatology · 2022Article
- Article
- Patient Activation and Glycemic Control Among Filipino Americans.Health equity · 2021Article
- Development of a Clinically Feasible Process for Identifying Individual Health Priorities.Journal of the American Geriatrics Society · 2018Article
- Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association.Circulation · 2018Review
- Effect of Diabetes Online Community Engagement on Health Indicators: Cross-Sectional Study.JMIR diabetes · 2018Article
- Higher health literacy is associated with better glycemic control in adults with type 1 diabetes: a cohort study among 1399 Danes.BMJ open diabetes research & care · 2017Article
- Factors associated with diet barriers in patients with poorly controlled type 2 diabetes.Patient preference and adherence · 2016Article
- Health Literacy and Education as Mediators of Racial Disparities in Patient Activation Within an Elderly Patient Cohort.Journal of health care for the poor and underserved · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFunctional health literacy (FHL) and patient activation can impact diabetes control through enhanced diabetes self-management. Less is known about the combined effect of these characteristics on diabetes outcomes. Using brief, validated measures, we examined the interaction between FHL and patient activation in predicting glycosylated hemoglobin (HbA1c) control among a cohort of multimorbid diabetic patients.
methodsWe administered a survey via mail to 387 diabetic patients with coexisting hypertension and ischemic heart disease who received outpatient care at one regional VA medical center between November 2010 and December 2010. We identified patients with the study conditions using the International Classification of Diseases-Ninth Revision-Clinical Modification (ICD-9-CM) diagnoses codes and Current Procedure Terminology (CPT) procedures codes. Surveys were returned by 195 (50.4%) patients. We determined patient activation levels based on participant responses to the 13-item Patient Activation Measure and FHL levels using the single-item screening question, "How confident are you filling out medical forms by yourself?" We reviewed patient medical records to assess glycemic control. We used multiple logistic regression to examine whether activation and FHL were individually or jointly related to HbA1c control.
resultsNeither patient activation nor FHL was independently related to glycemic control in the unadjusted main effects model; however, the interaction between the two was significantly associated with glycemic control (odds ratio 1.05 [95% confidence interval 1.01-1.09], P=0.02). Controlling for age, illness burden, and number of primary care visits, the combined effect of these measures on glycemic control remained significant (odds ratio 1.05 [95% confidence interval 1.01-1.09], P=0.02).
conclusionThe interaction between FHL and patient activation is associated with HbA1c control beyond the independent effects of these parameters alone. A personalized approach to diabetes management incorporating these characteristics may increase patient-centered care and improve outcomes for patients with diabetes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.