Health Literacy and Pregnancy Preparedness in Pregestational Diabetes

Health Literacy and Pregnancy Preparedness in Pregestational Diabetes Loraine K. Endres , MD 1 , Lisa K. Sharp , PHD 2 , Elaine Haney , BS, MS 3 and Sharon L. Dooley , MD, MPH 1 1 Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 2 Department of Family Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 3 Evanston Hospital, Northwestern University Feinberg School of Medicine, Evanston, Illinois Address correspondence and reprint requests to Loraine K. Endres, MD, University of Illinois, Department of Obstetrics and Gynecology, 820 S. Wood St., MC 808, Chicago, IL 60612. E-mail: lendres{at}uic.edu Abstract OBJECTIVE —We investigated the association between functional health literacy and markers of pregnancy preparedness in women with pregestational diabetes. RESEARCH DESIGN AND METHODS —English- and Spanish-speaking pregnant women with pregestational diabetes were recruited. Women completed the Test of Functional Health Literacy in Adults (TOFHLA) short form and a questionnaire. A TOFHLA score of ≤30 was defined as low functional health literacy. RESULTS —Of 74 women participating in the study, 16 (22%) were classified as having low functional health literacy. Compared with women with adequate health literacy, those with low health literacy were significantly more likely to have an unplanned pregnancy ( P = 0.02) and significantly less likely to have either discussed pregnancy ahead of time with an endocrinologist or obstetrician ( P = 0.01) or taken folic acid ( P = 0.001). CONCLUSIONS —The results of this study suggest that low functional health literacy among women with pregestational diabetes is associated with several factors that may adversely impact birth outcomes. TOFHLA, Test of Functional Health Literacy in Adults Footnotes A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted October 15, 2003. Received June 9, 2003. DIABETES CARE