Dean Schillinger|Lauren R. Barton|Andrew J. Karter|Frances Wang|Nancy E. Adler
Does Literacy Mediate the Relationship between Education and Health Outcomes? A Study of a Low-Income Population with Diabetes
University of California, San Francisco|SRI International|Menlo School|Kaiser Permanente|University of California, San Francisco|University of California, San Francisco
objectives sought determine whether literacy mediates relationship education glycemic control among diabetes patients methods measured educational attainment literacy using short test functional health literacy adults stofhla glycemic control hba1c 395 diabetes patients us public hospital performed path analysis compare two competing models explain glycemic control direct effects model estimated education related hba1c mediational model estimated strength direct relationship additional pathway education literacy hba1c added results model direct effect education hba1c model literacy mediator supported good fit observed data mediational model however significant improvement additional path literacy hba1c reducing discrepancy observed data plt001 including path direct relationship education hba1c fell nonsignificant threshold conclusions lowincome population diabetes literacy mediated relationship education glycemic control finding important implications education health policy