DEVELOPMENT OF A HEALTH LITERACY TOOL TO SUPPORT CERTIFIED DIABETES EDUCATORS DURING VIRTUAL VISITS

Abstract

Using a Quality Improvement (QI) approach, this qualitative study intended to develop a health literacy assessment tool or to modify existing tools that can assess the health literacy of individuals diagnosed with diabetes during their virtual consultations with Certified Diabetes Educators (CDEs). Accurately assessing the health literacy levels of individual clients will ultimately enable CDEs to customize education for their clients that will better support the self-management of their diabetes. While self-management leads to improvement in clinical outcomes, this study is focused on helping CDEs to better understand the diabetes health literacy level of their clients. Due to accessibility issues for the elderly and other clients, the study focused on the telephone visit as a preferred type of virtual visit. Virtual consultations reduce barriers for the elderly and other clients, including those with disabilities, who find travelling difficult and cannot physically access a clinic. Accessing technology exposes inequity issues; the telephone is accessible to most people, whereas in-person consultations at a clinical facility or consultations using audio-visual technology are not. In this qualitative research study, existing health literacy tools were assessed and in virtual consultations between Certified Diabetes Educators (CDEs), a new diabetes health literacy tool was developed. Using an interpretive quality improvement approach, the participants' (CDEs) perspectives on the effectiveness and practicality of the existing diabetes health literacy tools were assessed. CDEs’ views on the tools' application in practice were assessed through a focus group session. Based upon feedback from CDEs, a new diabetes health literacy tool was developed, and finally, the participants assessed the new tool in their virtual practice. CDEs selected telephone visits along with newly developed health literacy tools for their initial assessments of clients' health literacy. The study was conducted over several phases, and the data was collected using focus groups and open-ended surveys. Overall, CDEs found that having a diabetes health literacy tool is beneficial in their practice setting and allowed them to better understand their clients’ needs; however, the tool needs to be further improved to adapt to the specific variety of conditions including type 1 and 2 diabetes and prediabetes.