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Does Literacy Education Improve Symptoms of Depression and Self-efficacy in Individuals with Low Literacy and Depressive Symptoms? A Preliminary Investigation

Community Health Partners, Livingston, MT (LF, RH)
University of Arizona College of Medicine, Tucson, AZ (BDW, JHS)
Formerly Community Health Partners, Livingston, MT; currently, Mt. Desert School System, Northwest Harbor, ME (KH)

Correspondence: Corresponding author: Barry D. Weiss, MD, Department of Family and Community Medicine, University of Arizona College of Medicine, 1450 North Cherry, Tucson, AZ 85718 (E-mail: bdweiss{at}u.arizona.edu)

Background and Objectives: Individuals with low literacy and symptoms of depression have greater improvement of depression symptoms when their treatment includes education to enhance literacy skills. The reason why literacy enhancement helps depression symptoms is unknown, but we hypothesize that it might be due to improved self-efficacy. We studied whether providing literacy education to individuals with both depression symptoms and limited literacy might improve their self-efficacy.

Methods: We studied 39 individuals enrolled in an adult literacy program and who, on further testing with the Patient Health Questionnaire (PHQ-9) had symptoms of depression. While they participated in the literacy program, we monitored their self-efficacy using the General Self Efficacy (GSE) scale, and also monitored the severity of depression symptoms with the PHQ-9. Changes in GSE and PHQ-9 scores from baseline were assessed with the Wilcoxon Signed Ranks Test.

Results: Thirty-one (79.5%) subjects participated for 1 year. There was a significant increase in their self-efficacy (P = .019) and a significant decrease in depression symptoms (P < .002).

Conclusion: The results of this preliminary study suggest that among persons with low literacy and symptoms of depression, depression symptoms lessen as self-efficacy scores improve during participation in adult basic literacy education.