While grounded theory is often cited in the qualitative literature as the methodology, there are few good examples of publications that follow the principles of grounded theory and result in an actual theory. The purpose of this paper is to demonstrate how the Corbin and Strauss (2015) method of grounded theory was used in a study looking at how patients with cardiovascular disease and diabetes develop health literacy skills that are used to manage their condition. The key principles of grounded theory include theoretical sampling, constant comparison, open, axial, and selective coding, the use of memoing, and theoretical saturation. Data collection in this study was in the form of semi-structured interviews of 16 patients with cardiovascular disease and diabetes, and 19 healthcare professionals that care for or educate these patients. Patients were recruited from a primary care medical practice, a cardiology medical practice, patient focused programs provided by the American Heart Association, and social media. Healthcare professionals were recruited from the medical practices, the American Heart Association, and social media. Each interview was recorded, transcribed, and coded. Insights from these interviews led to the development of the health literacy instructional mode, which explores the use of digital tools, instructional approaches, social support, and self-directed learning in the development of health literacy skills, and is an example of the use of grounded theory in cardiovascular research.


Health Literacy, Grounded Theory, Cardiovascular, Diabetes, Qualitative Research

Author Bio(s)

Patrick Dunn, Ph.D. is on the Patient and Healthcare Innovation team at the American Heart Association. He has worked as a clinical exercise physiologist, educator, and program director in cardiac rehabilitation for over 30 years, and is Contributing Faculty in Walden University College of Health Sciences. Correspondence regarding this article can be addressed directly to: pat@yourheartscore.com.

Vasileios Margaritis, Ph.D. is a professor of Public Health at Walden University. Correspondence regarding this article can also be addressed directly to: vasileios.margaritis@waldenu.edu.

Cheryl Anderson, Ph.D. is a professor in the School of Health Sciences at Walden University. Correspondence regarding this article can also be addressed directly to: cheryl.anderson@waldenu.edu.


To our colleagues at the American Heart Association and Walden University, and all of the patients and healthcare professionals that participated in the study.

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