Over 81% of the participants in this study were African American with
56.3% of the women demonstrating high health literacy as determined by the REALM.
Glycemic control, measured by glucose self-report, demonstrated that women with high
health literacy recorded more glucose readings (p = .02) than women with low health
literacy scores. Mothers with high health literacy experienced more spontaneous labor at
term (p = .10), a higher cesarean section rate and more normal weight infants than the
mothers with low health literacy. While not statistically significant, women with low
health literacy experienced more adverse birth outcomes. Women with pregestational
diabetes trended toward higher health literacy than did women with gestational diabetes
on all three instruments. In fact, those with gestational diabetes initiated prenatal care
later than those with pregestational diabetes. The 3 questions from the S-TOFHLA did
not show high enough correlation to the REALM (r = -.25) and thus were not considered
as an effective as a screening tool for health literacy in this study.