Building Competency in Diabetes Education THE ESSENTIALS

SELF-MANAGEMENT EDUCATION & SUPPORT: PROGRAM DEVELOPMENT| 11-45

The good news is that there is an increasing trend towards higher literacy levels in Canada. However, this can be misleading. The ability to read has three components: 1. Reasoning ability 2. Mastery of the language 3. Familiarity with the alphabetic code (65) As knowledge expands so does the language needed to describe it. An example of this is ‘computer literacy’ where an entirely new vocabulary has been developed. If one does not keep up with the new knowledge, they can quickly become ‘illiterate’. Another compounding factor is that we must possess sufficient prior knowledge in order to begin to understand the new vocabulary. If one is ‘illiterate’ by the original standards, and they do not possess the essential basics, any new vocabulary increases their disparity. With our fast-paced world and the increasing use of technology, be it via the web, chat rooms, digital, text etc., we must be more diligent in recognizing low literacy and its impact on our educational programming (65). Health literacy Low literacy is of particular relevance when we consider its effect on information given and received in our health-care settings. Health literacy is defined as “the ability to obtain, interpret and understand basic health information and services and the competence to use this information to enhance one’s health status” (67). Diabetes self-management requires many complex skills involving the understanding of information and the ability to act on this information to make behaviour changes. This means that the patient with diabetes and low

health literacy may have difficulty: • Reading prescription labels. • Comprehending directions for meter use. • Filling out applications. • Reading appointment cards. • Understanding health literature. • Following instructions for insulin pen use.

To add a further barrier to their ability to engage in diabetes care is the realization that many patients with low literacy also have difficulty with numeracy defined as “the ability to use numbers in daily life” (68). There are many tasks involved in diabetes management which