A number of self-management programs for type 2 diabetes have been developed and tested. Most have had great success in teaching patients to care for their condition. How can the results of these programs be transferred to different groups, including those with both diabetes and limited reading skills? An answer is found in a study by Carbone and coworkers who tested an interactive measure to assess learning preferences of Latinos with diabetes and limited literacy. The measure utilized interactive learning activities to represent four learning styles--visual (seeing), kinesthetic (doing), affective (feeling/sensing), and cognitive (thinking)--in targeting four diabetes self-management behaviors: (a) choosing healthy foods; (b) understanding portion sizes; (c) distinguishing foods to eat often/sometimes/rarely; and (d) limiting fat. The ability to read was determined by the Spanish Short Test of Functional Health Literacy in Adults. Individual interviews asked participants to identify learning activities that most reflected their own experience with diabetes. Participant observations provided additional data. Ten Spanish-speaking adults with type 2 diabetes and limited literacy participated in two randomly selected target behaviors and identified easiest and most difficult to understand learning activities. The scores on the literacy test ranged from 0 to 21 points, and identified eight participants with inadequate and two with marginal health literacy. It was determined that the easiest to understand tasks were doing and the most difficult to understand tasks were thinking.

VALUE OF STUDY TO READER: Overall, the results of the study are not that impressive. However, the results do offer ideas for future programs. For example, the findings are similar to those found in early investigations of the self-management of childhood asthma. Hands-on tasks, such as having the children wrap a string around a tube and tighten it, showed what happens in asthma when smooth muscle tightens around the airway. Other methods that involve patients doing activities have been proven useful across the spectrum of chronic diseases.

E.T. Carbone et al. Testing the feasibility of an interactive learning styles measure for U.S. Latino adults with type 2 diabetes and low literacy. International Quarterly of Community Health Education, 2005-2006;25:315-335.