Effects of Educational Health Literacy Development Program on Health Literacy, Health Behaviors, and Clinical Outcomes in Type 2 Diabetes Mellitus Patients in Thailand: a Mixed-Method Study

Abstract

Diabetes mellitus has been the fifth-leading leading cause of death worldwide. This mixed-methods study aimed to investigate the impacts of an educational health literacy development program (EEHLDP) on health literacy, health behaviors, and diabetic clinical outcomes in patients with type 2 diabetes mellitus (T2DM). The quantitative sample comprised 30 control (regular monitoring and follow-ups) and 30 experimental T2DM patients who received the 5-month health literacy development program (encouragement for proactive health behaviors via home visits and telehealth). The qualitative experimental model included 17 patients. The research outcomes were health literacy, fasting blood sugar (FBS) level, and hemoglobin A1c (HbA1c). Results showed that the post-trial health literacy level in the quantitative experimental group was significantly higher than that of the control group (p<0.01). In addition, fasting blood sugar was significantly reduced, but the HbA1c was stable. A qualitative experimental group understood basic technical terms used in diabetes and laboratory results. Moreover, they also were able to decide to choose appropriate health behaviors. Based on findings from this study, it was concluded that the EHLDP could help reduce fasting blood sugar levels and accumulated HbA1c. Therefore, this program should be further disseminated to a larger group of T2DM patients in the community.