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The Feasibility of Health Trainer Improved Patient Self-Management in Patients with Low Health Literacy and Poorly Controlled Diabetes: A Pilot Randomised Controlled Trial

Lookup NU author(s): Professor Gill Rowlands



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Type 2 diabetes mellitus is most prevalent in deprived communities and patients with low health literacy have worse glycaemic control and higher rates of diabetic complications. However, recruitment from this patient population into intervention trials is highly challenging. We conducted a study to explore the feasibility of recruitment and to assess the effect of a lay health trainer intervention, in patients with low health literacy and poorly controlled diabetes from a socioeconomically disadvantaged population, compared with usual care. Methods. A pilot RCT comparing the LHT intervention with usual care. Patients with HbA1c > 7.5 (58mmol/mol) were recruited. Baseline and 7-month outcome data were entered directly onto a laptop to reduce patient burden. Results. 76 patients were recruited; 60.5% had low health literacy and 75% were from the most deprived areas of England. Participants in the LHT arm had significantly improved mental health (𝑝 = 0.049) and illness perception (𝑝 = 0.040). The intervention was associated with lower resource use, better patient self-care management, and better QALY profile at 7-month follow-up. Conclusion. This study describes successful recruitment strategies for hard-to-reach populations. Further research is warranted for this cost-effective, relatively low-cost intervention for a population currently suffering a disproportionate burden of diabetes, to demonstrate its sustained impact on treatment effects, health, and health inequalities.

Publication metadata

Author(s): Protheroe J, Rathod T, Bartlam B, Rowlands G, Richardson G, Reeves D

Publication type: Article

Publication status: Published

Journal: Journal of Diabetes Research

Year: 2016

Volume: 2016

Print publication date: 24/10/2016

Online publication date: 24/10/2016

Acceptance date: 28/09/2016

Date deposited: 01/11/2016

ISSN (print): 2314-6745

ISSN (electronic): 1687-5303

Publisher: Hindawi Publishing Corporation


DOI: 10.1155/2016/6903245


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Funder referenceFunder name
PB-PG-0110-20033National Institute for Health Research (NIHR) under Research for Patient Benefit Programme