Get Diabetes RITE (Retention, Integration, and Transfer to Everyday Self-Management)

The study objective is to integrate a theory-driven teaching strategy with a previously developed, low literacy multimedia diabetes education program (MDEP) designed for type 2 diabetic adults to promote patient learning and activation. 

Limited literacy, a risk factor for poorer chronic disease self-management, is common among vulnerable populations and may exacerbate diabetes-related disparities. Ideally, diabetes self-management education (DSME) should promote the retention, integration, and transfer of diabetes-related knowledge and skills to patients’ everyday lives. However, little is known about the most effective way to help patients retain, integrate, and transfer information to everyday actions as a specific curricular component in DSME. Knowledge transfer may be even more challenging in patients with lower literacy because: 1) patients with low literacy often have less background knowledge about diabetes; 2) background knowledge helps patients retain and integrate new information into long-term memory store; 3) learners who have difficulty integrating new information into long-term memory then have trouble transferring that information to support behaviors and overcome problems. Current teaching and counseling strategies have not adequately accounted for the challenges that low literacy patients may face in learning and applying related knowledge to every-day diabetes self-management.

Although evidence is available from cognitive and learning sciences to inform more robust teaching strategies, it has not been applied and tested in patient health education. Specifically, patient education should be designed to: 1) avoid content overload, 2) reinforce knowledge integration into long-term memory, and 3) promote learning transfer. This study’s objective is to develop and test the RITE approach (Retention and Integration of knowledge, to Transfer for Everyday self-management), a teaching strategy to help patients, across literacy levels, learn and transfer diabetes-self management concepts to daily-life.

The RITE approach will be used with newly-diagnosed type 2 diabetic patients after they view a multimedia diabetes education program and will include literacy-appropriate activities to promote retention, integration, and transfer, such as retrieval practice, inference questions, transfer questions and tasks, and implementation plans that reflect what patients will have to do in the real-world.

This will be one of the first studies to rigorously apply and evaluate well-known cognitive and learning sciences principles to chronic disease self-management education in patients with low literacy.

Principal Investigator: Namratha Kandula, MD, MPH
Co-Investigator: David W. Baker, MD, MPH

Funding Sources:
Northwestern Memorial Hospital Foundation
Northwestern University Division of General Internal Medicine and Geriatrics