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Advisors: Mona Sarfaty, MD., Rickie Brawer, MPH, PhD., Albert Crawford, PhD., Barry Ziring, MD., Family and Community Medicine, Thomas Jefferson University

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Previous studies have shown conflicting results regarding a relationship between functional health literacy, self-efficacy, and diabetic self-management. The mechanisms that may explain the relationship are unclear. The purpose of the study was to assess the relationship between functional health literacy (FHL), self-efficacy, and self-care activities for diabetes patients living in Philadelphia and attending a patient centered primary care practice. The study was cross-sectional. All patients with diabetes between August and October 2011 were invited to participate. After assessing FHL with an established tool, patients completed a survey instrument independently that asked questions regarding self-care activities, such as diet, physical activity, self-efficacy, and other FHL related questions, such as their reading ability related to health materials. Seventy-nine percent of patients agreed to participate. Fifty-eight percent had adequate FHL, and 42% had inadequate FHL. Similar proportions of patients in the adequate and inadequate groups responded that they needed help reading health related materials. Functional health literacy in the adequate and inadequate groups did not predict behaviors of self-care and self-efficacy. The numbers in the lowest literacy group were too few to draw reliable inferences. The majority (67%) preferred to know the risk for a health condition described in words as compared to describing the risk as numbers (30%). FHL scores were positively correlated with self-efficacy scores (r = 0.198, p = 0.046). Results also showed that self-efficacy was positively associated with healthy diet (r = 0.393, p < 0.0001) and physical activity (r = 0.222, p = 0.034). These findings suggest that self-efficacy may be an important mediator between FHL and health behaviors related to diet and physical activities. Future studies should investigate the association between diabetes self-efficacy and other variables. More work is needed to explore these relationships.