Abstract P145: Health Literacy And Self-care Practices Among Rural Appalachian Adults

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Introduction: The prevalence of cardiovascular disease (CVD) and type 2 diabetes (T2DM) in Appalachian communities is among the highest in the nation. Health literacy, one’s ability to understand and use information to make health-related decisions, influences self-care practices which, in turn, shape chronic disease prevalence and outcomes. Hypothesis: Higher levels of health literacy are associated with optimal self-care practices among rural Appalachian adults with T2DM. Methods: Adults (N=356) diagnosed with T2DM were recruited from community sites across six rural Appalachian counties in Kentucky. Health literacy was measured using the New Vital Sign (NVS), with scores ranging 0-6. T2DM self-care was assessed using the Summary of Diabetes Self-Care Activities (SDSCA), with scores ranging 0-35. Linear mixed-effects models with random effects to account for clustering at the community level and household within site were fit to examine the association between level of health literacy and self-care practices. Results: The majority of the sample identified as female (65%), with a mean age of 64.2 years (SD: 10.6). The mean and median health literacy scores were 4.0 (SD: 2.0) and 5, respectively, indicating moderate health literacy. T2DM self-care scores ranged from 4-33 (Median= 17, Mean=17.1, SD: 6.3), indicating room for improvement concerning frequency of self-care practices. Specifically, average rates of self-care practices per week included following a generally healthy diet 3 days (SD: 2), exercising for 30 minutes 2 days (SD: 2), measuring blood sugar level 4 days (SD: 3), and practicing foot care 5 days (SD: 1). Health literacy was not associated with self-care practices when controlling for age, sex and financial status. Conclusions: Contrary to our hypothesis, results do not suggest a direct association between health literacy and T2DM self-care practices among Appalachian adults. Future studies should explore other personal or socio-cultural factors that may influence T2DM self-care among vulnerable populations experiencing numerous risk factors of cardiometabolic disease.