Literacy and retention of information after a multimedia diabetes education program and teach-back

Few studies have examined the effectiveness of teaching strategies to improve patients' recall and retention of information. As a next step in implementing a literacy-appropriate, multimedia diabetes education program (MDEP), the present study reports the results of two experiments designed to answer (a) how much knowledge is retained 2 weeks after viewing the MDEP, (b) does knowledge retention differ across literacy levels, and (c) does adding a teach-back protocol after the MDEP improve knowledge retention at 2-weeks' follow-up? In Experiment 1, adult primary care patients (n = 113) watched the MDEP and answered knowledge-based questions about diabetes before and after viewing the MDEP. Two weeks later, participants completed the knowledge assessment a third time. Methods and procedures for Experiment 2 (n = 58) were exactly the same, except that if participants answered a question incorrectly after watching the MDEP, they received teach-back, wherein the information was reviewed and the question was asked again, up to two times. Two weeks later, Experiment 2 participants completed the knowledge assessment again. Literacy was measured using the S-TOFHLA. After 2 weeks, all participants, regardless of their literacy levels, forgot approximately half the new information they had learned from the MDEP. In regression models, adding a teach-back protocol did not improve knowledge retention among participants and literacy was not associated with knowledge retention at 2 weeks. Health education interventions must incorporate strategies that can improve retention of health information and actively engage patients in long-term learning.