• Devika Krishnakumar, Danielle Hessler Jones, and Michael B Potter.
• From the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA (DK); Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA (DHS, MBP). devikakk07@gmail.com.
• J Am Board Fam Med. 2024 Mar 1; 37 (2): 303308303-308.

IntroductionPrevious research has found an association between low health literacy and poor clinical outcomes in type 2 Diabetes Mellitus (T2DM) patients. We sought to determine if this association can be mitigated by a self-management support (SMS) program provided by trained health workers using a technology assisted menu driven program, called Connection to Health (CTH).MethodsThis study is a secondary analysis from a randomized trial of 2 similar versions of CTH implemented in 12 Northern California community health centers. As part of this, each participant completed a single validated question to assess health literacy. We used unadjusted and adjusted linear regression analyses to determine the extent to which baseline health literacy was predictive of prepost changes in hemoglobin A1c (HbA1c).ResultsOf 365 participants for whom prepost HbA1c data were available, HbA1c concentrations declined by an average of 0.76% (from 9.9% to 9.2%, 95% CI (0.53%-1.0%). Almost 114 (31.2%) of the participants had low health literacy, but there was no significant association between health literacy and the reduction in HbA1c concentrations in either the unadjusted or adjusted models, nor did baseline health literacy predict prepost changes in body mass index, medication adherence, exercise, or diet.DiscussionThe study found that implementing the CTH program in 2 versions via a randomized clinical trial improved HbA1c concentrations without increasing disparities between participants with high and low health literacy. This suggests CTH-like programs can enhance diabetes outcomes in community health centers without exacerbating inequities for those with low health literacy.© Copyright 2024 by the American Board of Family Medicine.

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