Development of a Health Literacy Promotion Model for Carbohydrate Consumption in Patients with Uncontrolled Diabetes
Keywords:
health literacy, carbohydrate counting, diabetes mellitus type 2Abstract
This research aimed to develop and evaluate the effectiveness of a health literacy promotion model for carbohydrate consumption in patients with uncontrolled diabetes. The study consisted of a situation and needs analysis; the development and content validation of a model; and an effectiveness study using a two-group, pretest-posttest quasi-experimental design. The sample was comprised of 60 diabetic patients with uncontrolled diabetes receiving services at the diabetes clinic of Moei-wadee Hospital. They were divided into experimental and control groups (30 participants each) using simple random sampling. Research instruments included a focus group discussion guide, a patient data and clinical outcome record form, a health literacy regarding carbohydrate consumption questionnaire (KR-20=0.84), and a carbohydrate consumption behavior assessment (Cronbach's Alpha = 0.87). Data were analyzed using descriptive statistics, chi-square tests, and t-tests.
Results: The situation analysis revealed that patients lacked understanding and skills in managing carbohydrate consumption and that their glycated hemoglobin (HbA1c) levels were not at the target goal. A model aligned with the identified problems and real-world contexts was subsequently developed, comprised of: 1) the 'Miracle Kratib' (a sticky rice container innovation in three sizes), 2) the 'Isaan-style Carb Counting Handbook', and 3) individual counseling and group learning plans. The experimental group demonstrated significantly higher mean scores in health literacy and carbohydrate consumption behavior than the control group. Additionally, the experimental group's HbA1c levels significantly decreased and were significantly lower than those of the control group. Thus the developed model was shown to be appropriate for the Isaan cultural context, effectively enhanced health literacy, and enabled patients to better control their carbohydrate intake and blood glucose. Therefore, it should continue to be implemented in contexts where sticky rice is consumed as the main staple food.
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