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Cited by 80Health Literacy and Information AccessibilityDiabetes Management and EducationMedia Influence and Health

Improving Diabetes Health Literacy by Animation

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Calderón, José L., Shaheen, Magda, Hays, Ron D., Fleming, Erik S., Norris, Keith C., Baker, Richard S.·2014·The Diabetes Educator
DOI 10.1177/0145721714527518PMC PMC6309339
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Abstract

Purpose and Scope: To produce a Spanish/English animated video about diabetes; to qualitatively assess cultural and linguistic appropriateness; and to test effectiveness at improving diabetes health literacy among Latino/Hispanics. Methods: Participatory research and animation production methods guided development of the video. Cultural appropriateness was assessed through focused discussion group methods. A prospective randomized controlled trial tested the effectiveness of the Spanish version at improving diabetes health literacy, compared to “easy to read” diabetes information from the National Institute of Diabetes and Digestive and Kidney Diseases. Functional health literacy was measured by the Short Test of Functional Health Literacy in Adults. Diabetes health literacy was measured by the Diabetes Health Literacy Survey (DHLS). Results: No significant differences were recorded between experimental (n = 118) and control groups (n = 122) at baseline on demographic characteristics, Short Test of Functional Health Literacy in Adults score, or DHLS score. Fifty-eight percent of the study participants had inadequate functional health literacy. Mean DHLS score for all participants and those having adequate functional health literacy were 0.55 and 0.54, respectively (inadequate diabetes health literacy). When adjusting for baseline DHLS score, sex, age, and insurance status, DHLS scores improved significantly more in the experimental group than the control group (adjusted mean = 55% vs 53%, F = 4.7, df = 1, P = .03). Interaction between experimental group and health literacy level was significant ( F = 6.37, df = 2, P = .002), but the experimental effect was significant only for participants with inadequate health literacy ( P = .009). Conclusions: The positive effect on DHLS scores suggests that animation has great potential for improving diabetes health literacy among Latinos having limited functional health literacy. A study is needed that targets participants with inadequate health literacy and that uses the English and Spanish versions of the video.

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  • Animation, text or social media promotion, or apps help patients acquire health information more effectively.

    “For example, animation [357,358], text or social media promotion [359,360,361], or apps [362,363] help patients acquire health information more effectively [364].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [358]

    The Abstract Results report that an animated diabetes video improved diabetes health-literacy scores more than easy-to-read text, but the effect was significant only among participants with inadequate functional health literacy. The paper does not establish that social media promotion or apps help patients acquire information more effectively, so it supports only the animation portion of the cited claim. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Calderón, J. L., Shaheen, M., Hays, R. D., Fleming, E. S., Norris, K. C., & Baker, R. S.
Affiliations
University of California, Los Angeles (US)
ORCID
Venue
The Diabetes Educator
Publisher
SAGE Publications
Published
2014-03-27
Volume
40
Issue
3
Pages
361-372
ISSN
  • 0145-7217 (ISSN-L)
  • 1554-6063
DOI
10.1177/0145721714527518
PMC
PMC6309339
OpenAlex
W2100056783
Cited by
80
References
3
Citations by year
2026: 6 · 2025: 5 · 2024: 12 · 2023: 15 · 2022: 13 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 3 · 2017: 1 · 2016: 6 · 2015: 1 · 2014: 1
FWCI
5.43
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The Science of Diabetes Self-Management and Care (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (4p20md000182-15, UL1TR000124, UL1TR001881)
  • Agency for Healthcare Research and Quality (U18HS016980, R24 HS014022)
  • National Institute on Aging (P30AG021684)
  • National Center for Research Resources (P20RR011145)
  • National Center for Advancing Translational Sciences
  • National Institute on Minority Health and Health Disparities (U54MD008149, S21MD000103, P20-MD000182, P20MD000516)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
Keywords
animation, animated educational videos, Spanish-language health education, functional health literacy, cultural appropriateness, linguistic appropriateness, diabetes self-management education
MeSH terms
Adolescent, Adult, Cartoons as Topic, Diabetes Mellitus, Female, Hispanic or Latino, Humans, Male, Middle Aged, Patient Education as Topic, Prospective Studies, Video Recording, Focus Groups, Qualitative Research, Community-Based Participatory Research, Young Adult, Health Literacy

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