Development Model for a Health Literacy System for Health Behaviors and Hemoglobin A1C level control in Patients with Type 2 Diabetes Mellitus


  • Jongrak suwannarat Faculty of Allied Health Sciences Nakhon Ratchasima College
  • Thanakorn Panyasaisophon


research and development system, health literacy, type 2 diabetes patients


This research and development research project was conducted to develop a model for health literacy (HL) for health behaviors and hemoglobin A1C level control in patients with type 2 diabetes mellitus (T2DM).  The research methods included 1) reviewing literature, 2) developing the health literacy system, 3) auditing and improving the HL system, and  4) implementing the HL system. SixtyT2DM patients from the Nong Boon Mak (n=30) and Saraphi (n=30) health promotion hospitals were purposively selected to take part in the HL system. The research instruments were the HL system model, the health literacy and health behavior questionnaires, and hemoglobin A1c tests. Percentages, means, standard deviations, one-way repeated measure ANOVAs, and paired t-tests were employed for data analysis.

There were three major findings: 1) Based on the one-way repeated measure ANOVAs, the HL and health promoting behaviors statistically significantly improved at p=0.01. 2)  After implementing the HL system model, T2DM patients at Nong Boon Mak Hospital had statistically significantly better hemoglobin A1C levels than that of before participating in the program at p =0.01. 3) The development of health literacy system was composed of 4 aspects including: 1) Input (personnel, budget, corporate communication, and patients), 2) Process (context assessment; planning the HL system development, personnel management, support; and direct system and budget support), 3) Output (degree of health literacy, health behaviors and hemoglobin A1c level control), and 4) Feedback (internal process review and improvement and knowledge management).

Conclusions and recommendations: The development and implementation of this health literacy system for T2DM patients was able to help improve their health literacy, health behaviors and hemoglobin A1c level control. The findings indicate that the healthcare staff involved in T2DM patient care should adopt the health literacy system to promote the diabetic patients’ potential for successful glycemic control.


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How to Cite

suwannarat J, Panyasaisophon T. Development Model for a Health Literacy System for Health Behaviors and Hemoglobin A1C level control in Patients with Type 2 Diabetes Mellitus. J Nurs Healthc [Internet]. 2022 Jun. 29 [cited 2022 Sep. 27];40(2):95-104. Available from: