Development of a model promoting health literacy with community participation for type 2 diabetes patients in the Sub-District Health Promotion Hospital in Ongkharak District, Nakhon Nayok Province

Abstract

The research and development study aimed to: 1) develop a model for promoting health literacy (HL) 2) compare health literacy and health behaviors and 3) compare HbA1c levels among type 2 diabetes  (T2DM) patients  in Ongkharak District, Nakhon Nayok Province. The research methods included: 1) a literature review 2) development of the health literacy model 3) expert system audits and improvements of the developed model and 4) implementation of the system. The participants were 30 type 2 diabetes mellitus (T2DM) patients who participated in the health literacy model for 16 weeks. Purposive random sampling was applied for this study. The instruments were the health literacy model a health literacy and health behavior questionnaire with reliabilities of 0.78, 0.75, 0.89, 0.90, 0.91 and 0.88, and an HbA1c recording form. Percentages, means, standard deviations, One way ANOVAs with repeated measures, and Paired sample t-tests were applied for data analysis.

The results were as follows: First of all. The health literacy model was composed of 4 aspects including: 1) Input, which included study model, survey health literacy, assess local context, and participation 2) Process, which included patient preparation, management and communication; participatory planning and evaluation 3) Output, which included health literacy, health behaviors, and hemoglobin A1c level control and 4) Feedback, which included knowledge management, and improvement. Additionally, based on the one-way repeated measure ANOVAs, the HL and health promoting behaviors were statistically significantly improved (p ≤ 0.01) after participation. Third. after implementing the HL model, T2DM patients had statistically significantly better hemoglobin A1c levels than before participating in the program (p ≤ 0.01). Therefore, the health literacy promotion model for T2DM patients was able to help improve their health literacy, health behaviors and hemoglobin A1c level control. The findings indicate that healthcare staff involved in T2DM patient care should adopt the model to promote diabetic patients’ potential for successful glycemic control.