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Health Literacy in Patients With Congestive Heart Failure

This study has been completed.
Connecticut Health Foundation
Information provided by (Responsible Party):
Dorothea Wild, MD, Griffin Hospital Identifier:
First received: July 26, 2007
Last updated: March 25, 2015
Last verified: March 2015

The primary aim of this project is to test the efficacy of an inpatient congestive heart failure (CHF) educational intervention compared with usual care among inpatients at Griffin Hospital, who are largely drawn from the population of the Naugatuck Valley in Connecticut.

The educational intervention will utilize:

  • written educational materials suitable for patients with low health literacy - alternatives to written materials (e.g., video- and audiotapes) that may more effectively communicate health information to elderly patients and those with low health literacy
  • a one-on-one educational session with a nurse patient educator. The educational session will use as its framework guidelines provided by the America Medical Association (AMA) to improve communication between healthcare providers and low health literacy patients. The investigators hypothesize that CHF patients who receive this educational intervention will have fewer hospital readmissions or deaths than the usual care group. The investigators further hypothesize that patients with low health literacy will derive more benefit from the intervention than patients with higher literacy.

The secondary aims of the project are to:

  • assess whether patients in the education and usual care groups differ on post-discharge CHF knowledge and on satisfaction with hospital care. Compared with usual care, the investigators hypothesize that CHF patients who receive the educational intervention will have better knowledge of CHF and will be more satisfied with the care they received in the hospital.

The potential impact of the proposed project may be to increase disease knowledge and health literacy, and improve adherence to CHF treatments. This, in turn, may contribute to improved medical outcomes and reduced hospital readmissions for CHF patients. In addition, if this preliminary study provides evidence of a promising educational intervention suitable for patients with low health literacy, th investigators will endeavor to test the intervention in ethnically diverse populations throughout Connecticut.

Condition Intervention
Congestive Heart Failure Behavioral: Health Literacy-Tailored Education

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized-Controlled Trial of a Health Literacy Tailored Educational Intervention for Hospitalized Congestive Heart Failure Patients

Resource links provided by NLM:

Further study details as provided by Dorothea Wild, MD, Griffin Hospital:

Primary Outcome Measures:
  • Re-hospitalization or Death [ Time Frame: 90 days ]
    Number of participants who are re-hospitalized or die within 90 days of discharge

Enrollment: 124
Study Start Date: March 2007
Study Completion Date: December 2012
Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: A
Usual Care - Education about CHF by Primary Nurse on discharge. No teach-back is used in this arm.
Experimental: B
Tailored Intervention for patients with low health literacy and nurse-directed teachback: Educational leaflet which has been developed for low-health literacy patients. Adminstered by dedicated Nurse-educator. Nurse-educator asks Patient for "teachback after Intervention". This means that the Patient repeats in his/her own words the Information received. Education ends once Patient has been able to repeat the Information back.
Behavioral: Health Literacy-Tailored Education
Intervention group receives a visit from a nurse educator who, using the teach back method of educating patients, provides counseling on their disease methods of controlling their disease. A video is also viewed to reinforce the materials.

  Show Detailed Description


Ages Eligible for Study:   50 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Eligible consecutive patients aged 50 years and over admitted with a primary diagnosis of CHF at Griffin Hospital will be invited to participate regardless of age, gender, race, or education level.
  • Because dietary and medication non-compliance affect patients with both systolic and diastolic heart failure, the investigators will include patients with both of these conditions, regardless of their ejection fraction.

Exclusion Criteria:

  • The investigators will exclude patients with clinical conditions and communication barriers that would limit their ability to participate in and/or benefit from this educational intervention.
  • The investigators will also exclude patients whose planned discharge is to another hospital or to a structured setting in which medical personnel are responsible for their care (e.g., a skilled nursing facility), thus limiting their ability to implement a largely self-directed self-care regimen upon leaving the hospital.
  • In addition, the investigators will exclude any patient who does not have a telephone and cannot, therefore, be contacted to obtain post-discharge follow-up data.

Specific exclusion criteria include:

  • A diagnosis of dementia or other severe mental disorder (e.g., acute delirium, psychosis)
  • Clinical instability or need for transfer to another hospital for acute intervention (e.g., experiencing cardiogenic shock, or needing valve surgery or acute coronary intervention)
  • Terminal illness or intubation
  • Moderate to severe uncorrected vision or hearing problems
  • Inability to speak English or to provide informed consent
  • Lack of access to a telephone
  • Planned discharge to a structured facility (e.g., skilled nursing facility, intermediate care facility)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00508716

United States, Connecticut
Griffin Hospital
Derby, Connecticut, United States, 06418
Sponsors and Collaborators
Griffin Hospital
Connecticut Health Foundation
Principal Investigator: NAVITHA WODDOR, MD MPH Griffin Hospital
  More Information

Responsible Party: Dorothea Wild, MD, Principal Investigator, Griffin Hospital Identifier: NCT00508716     History of Changes
Other Study ID Numbers: 2007-03
Study First Received: July 26, 2007
Results First Received: March 15, 2015
Last Updated: March 25, 2015

Keywords provided by Dorothea Wild, MD, Griffin Hospital:
Congestive Heart Failure
Health Literacy
Health Education
Congestive Heart Failure (inpatients)

Additional relevant MeSH terms:
Heart Failure
Heart Diseases
Cardiovascular Diseases processed this record on September 18, 2017