Effects of health literacy improvement program on self-care behaviors and health outcomes in older adults with type 2 diabetes and hypertension comorbidities 10.55131/jphd/2022/200203

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Pimnada Kakahthum
Sunee Lagampan
Kwanjai Amnartsatsue


Health literacy is a necessary factor affecting self-care behaviors. This randomized control trial research aimed to study the effects of a health literacy improvement program on self-care behaviors and health outcomes in older adult patients with diabetes and hypertension comorbidities. Older adults at a private primary care unit, Bangkok, Thailand; aged 60-69 years, who had been diagnosed with diabetes and hypertension, were selected by simple random sampling into experimental and control groups, of 30 people each. The experimental group received eight weeks of a health literacy improvement program.  Group activities were held in three sessions at 4-week intervals. The control group received standard care only. Data were collected by using interview questionnaires at baseline, post-intervention, and follow-up. Research instrumentation included collected data on general characteristics and illness history.  Health literacy, self-care behavior, healthy eating, physical activity, stress management, and medication adherence scales were also included. In addition, blood pressure and HbA1C were examined at baseline and follow-up. Descriptive statistics, independent t-test, chi-square, Repeated Measures ANOVA, and Bonferroni post hoc test were used for data analysis.  After the intervention and follow-up, the experimental group had the following mean scores:  health literacy (ME.118.33±7.79, 123±4.90; MC 94.53±7.51; 94.17±5.86, p< .001), self-care behaviors in healthy eating (ME 49.10±3.14, 52.13±3.19; MC 43.70±2.83, 43.66±3.25, p< .001), physical activities (ME36.90±2.26, 38.53±2.56; MC 26.90±2.67,26.83±2.67, p<.001), stress management (ME26.83±1.89, 28.30±1.89; MC 21.33±2.00,21.60±2.09, p<.001), and medication adherence (ME34.60±2.47, 36.07±1.87; MC 27.40±2.64, 28.30±3.18, p< .001), all of which were significantly higher than the control group.  Furthermore, HbA1C (Diff_ME -0.46±0.50; Diff_MC.0.06±0.45, p< .05) and systolic blood pressure (Diff_ME -9.70±9.29; Diff_MC. -1.26± 12.89, p< .05) were significantly lower than the control group.


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Kakahthum P, Lagampan S, Amnartsatsue K. Effects of health literacy improvement program on self-care behaviors and health outcomes in older adults with type 2 diabetes and hypertension comorbidities: 10.55131/jphd/2022/200203. JPHD [Internet]. 2022 May 1 [cited 2022 Aug. 10];20(2):32-4. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/256033
Original Articles
Author Biographies

Pimnada Kakahthum, Faculty of Public health, Mahidol University, Thailand

Faculty of Public health, Mahidol University, Thailand

Sunee Lagampan, Faculty of Public health, Mahidol University, Thailand

Faculty of Public health, Mahidol University, Thailand

Kwanjai Amnartsatsue, Faculty of Public health, Mahidol University, Thailand

Faculty of Public health, Mahidol University, Thailand


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