The Effect of Diabetic Retinopathy-Specific Educational Services on Community Health Literacy

Abstract

Purpose : Deficits in community health literacy (CHL) impede individuals' capacity to comprehend and access health information. In this pilot cross-sectional observational study, we evaluated community understanding of diabetes mellitus and diabetic retinopathy (DR), hypothesizing that conducting health literacy discussions, utilizing the teach-back method, and distributing multilingual educational pamphlets would enhance CHL.

Methods : Approximately six-hundred community members participated in the educational services, of which forty-one agreed to participate in the study. Pre- and post-surveys assessed CHL, covering topics such as awareness of diabetes-associated ocular conditions (DAOC), understanding DR as the leading cause of blindness in U.S. adults, the importance of early detection in preventing associated blindness, and awareness of the recommended frequency of dilated eye exams for individuals over forty or diagnosed with diabetes. Responses were compared using a Wilcoxon signed-rank test, t-Test, reporting Hedges’ g (Cohen’s d correction), and p-values.

Results : Forty-one community members completed the pre- and post-surveys. Educational services improved CHL regarding DAOC, demonstrated by increased correct identification of DR (17.07%), glaucoma (19.51%), and cataracts (21.95%). There was a decrease in the selection of erroneous non-DAOC, including myopia (24.39%), hyperopia (12.20%), and macular degeneration (19.51%). A Wilcoxon signed-rank test indicated significant improvements in respondent selection of DAOC (r=0.65, p=1.07E-03) and significant reduction in the selection of non-DAOC (r=0.58, p=3.73E-03). CHL of DR as the primary cause of U.S. adult blindness significantly improved post-services by 49% (g=1.14, p=1.35E-07), as did awareness of early DR detection by 68% (g=1.85, p=1.20E-10). Further, there was a significant increase of 56% in CHL of recommended dilated eye exam frequency for individuals over 40 (g=1.40, p=5.82E-09) and for those diagnosed with diabetes by 32% (g=0.75, p=1.65E-03).

Conclusions : Our results are consistent with our hypothesis that facilitating community health education services markedly enhance CHL. Initial findings support further investigation and longitudinal analysis to comprehensively assess the long-term impact of the educational services.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Table 1. Statistical analysis of participant responses for pre- and post-educational services.