Teach to goal: Theory and design principles of an intervention to improve heart failure self-management skills of patients with low health literacy

David W. Baker*, Darren A. Dewalt, Dean Schillinger, Victoria Hawk, Bernice Ruo, Kirsten Bibbins-Domingo, Morris Weinberger, Aurelia MacAbasco-O'Connell, Michael Pignone

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

Self-management is vital for achieving optimal health outcomes for patients with heart failure (HF). We sought to develop an intervention to improve self-management skills and behaviors for patients with HF, especially those with low health literacy. Individuals with low health literacy have difficulty reading and understanding written information and comprehending numerical information and performing calculations, and they tend to have worse baseline knowledge, short-term memory, and working memory compared with individuals with higher health literacy. This paper describes theoretical models that suggest methods to improve the design of educational curricula and programs for low literate audiences, including cognitive load theory and learning mastery theory. We also outline the practical guiding principles for designing our intervention, which includes a multisession educational strategy that teaches patients self-care skills until they reach behavioral goals (Teach to Goal). Our intervention strategy is being tested in a randomized controlled trial to determine if it is superior to a single-session brief educational intervention for reducing hospitalization and death. If this trial shows that the Teach to Goal approach is superior, it would support the value of incorporating these design principles into educational interventions for other diseases.

Original languageEnglish (US)
Pages (from-to)73-88
Number of pages16
JournalJournal of Health Communication
Volume16
Issue numberSUPPL. 3
DOIs
StatePublished - 2011

ASJC Scopus subject areas

  • Health(social science)
  • Communication
  • Public Health, Environmental and Occupational Health
  • Library and Information Sciences

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