A Case Study Examining Food Literacy in a Group of Adults With Type 2 Diabetes Mellitus Using the Eating and Food Literacy Behaviors Questionnaire for Diabetics (EFLBQ-D)

Objectives: Food literacy (FL), the ability to plan, manage, select, prepare, and eat healthy foods, is an important skill for those with chronic diseases such as Type 2 Diabetes Mellitus (T2DM). This study assessed FL in adults with T2DM who participated in a diabetes education program using the validated Eating and Food Literacy Behaviors Questionnaire for Diabetics (EFLBQ-D). The EFLBQ-D's factors include health and nutrition (F1), taste (F2), food preparation (F3), planning and decision making (F4), convenience (F5), counting carbs and reading labels (F6), and food selections for those with diabetes (F7). Methods: Patients of 2 clinics in southeastern Louisiana at least 18 years of age with a diagnosis of T2DM and first-time participation in a diabetes nutrition counseling and education program were recruited. Participants provided written informed consent prior to participating. Clinic registered nurses and dietitians taught a three-part class series, and participants completed the EFLBQ-D pre- and post-program upon attendance of all 3 classes. Statements were scored using a 4-point Likert scale (Never = 1, Seldom = 2, Often = 3, and Always = 4). Descriptive information was collected, and pre- and post-EFLBQ-D factors were compared using Wilcoxon Signed-Rank Tests. Results: Four females and 5 males completed the survey. Participants' ages ranged from 36 to 74 years. Most participants (78%) received Medicare or Medicaid. Subjects' pre-program Body Mass Index (BMI) ranged from 23.3 kg/m2 to 43.3 kg/m2, and hemoglobin A1C (HgbA1C) ranged from 6 to 12.9%. The F3 scores were higher after participating in the program (Mdn = 2.33) in comparison to the scores before attending (Mdn = 2.00, z = -2.05, P < 0.05, r = -0.68), and the F6 scores were higher between pre- (Mdn = 1.67) and post-measurements (Mdn = 3.00, z = -2.32, P < 0.05, r = -0.77). F5 scores were lower post-program (Mdn = 2.33) as compared to pre-program (Mdn = 3.00, z = -2.75, P < 0.01, r = -0.92). Conclusions: This collective case study suggests that FL may change as a result of participating in a diabetes education program. The findings from this study should be further tested with more participants. Funding Sources: This project was funded by Hatch Project #LAB94331.