DSMES Health Literacy Tool: Tips Before and After a DSMES Session

What to know

These tips can help you prepare for a DSMES session with a participant and reflect afterward on what went well and what you could improve.

Educator looking at her laptop as she prepares for a DSMES session

Pre-session mindset check-in

Take a moment before a DSMES session to get in the right mindset. Focus on how you’ll help the person with diabetes find, understand, and use information and services to make good health decisions—no matter what their barriers might be.

  • Empathy: I’ll approach this session with empathy, remembering my role as a facilitator rather than a lecturer.
  • Organic conversation: I’ll let the participant lead the session flow. I’ll start conversations by asking what they want to talk about or learn. I’ll ask open-ended questions that encourage more than “yes” or “no” answers and that move the dialogue forward.
  • Language fluency: I’ll keep in mind that limitations in English proficiency are not a reflection of someone’s intelligence. I’ll have language assistance such as interpreters ready as needed.
  • Culture: I understand that the perception of health, wellness, medical treatment, health education, food, and nutrition are different from culture to culture.
  • Customized care: I know that everyone learns differently, and I have educational tools on hand in a variety of formats to fit the needs of this person (e.g., photos, illustrations, plain language descriptions, stories, and analogies).
  • Body language: I’m aware of my body language and will nonverbally communicate that I am present, not distracted, have time for this person, and want to be here.
  • Plain language: I’ll use everyday language and avoid jargon.
  • Teach-back: I’ll confirm the person understands by using the teach-back method. This gives the person a chance to tell me in their own words what they learned and what the next steps are. I can also encourage the person to share what we talked about with a family member or friend after the session.

Post-session reflection

After a session with someone who has limited health literacy or limited English skills, reflect on what went well and what you could improve. This also can help you prepare for your next session. Ask yourself the following questions and think about whether your goals for supporting the participant were met.

  • Time: Did I have enough time in this session to ensure the participant received and understood the information they needed?
  • Environment: Did the physical environment of the session feel welcoming and easy to navigate, support effective communication, and use signs with culturally appropriate symbols to help people find their way?
  • Conversation: Did I ask open-ended questions and ask the participant to explain things back to me to ensure understanding?
  • Reaction: How did the participant seem when they left, based on body language? Did they seem confused or like they were pretending to understand? Did they seem self-confident and prepared?
  • Follow-up: Did I provide follow-up health information that is easy to understand and fits the needs of this participant (e.g., printed information, web referrals, emailed content and text messages available in the participant’s preferred language)?
  • Feedback: Did I seek out feedback from the participant about the session to consider for future sessions? Did I ask what remaining unanswered questions or follow-up was needed?