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
Main Article Content
Keywords
Health literacy, type 2 diabetes mellitus, health behavior, blood glucose, telehealth
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.
References
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26. Tudpor, K., Saisawai, C., Kaewpho, S., & Jitseeda, A. (2021). Psychological Stress Is a Risk Factor for Type 2 Diabetes Mellitus in College Students. Stud Health Technol Inform, 285, 296-299. https://doi.org/10.3233/SHTI210619
27. Wang, J., Zhao, Y., & Xie, F. (2022). Study on the Nursing Effect of Diabetes Health Education Nursing Methods Applied to Diabetes Patients in the Endocrinology Department. J Healthc Eng, 2022, 3363096. https://doi.org/10.1155/2022/3363096
28. Wang, M.-J., Hung, L.-C., & Lo, Y.-T. (2019). Glycemic control in type 2 diabetes: role of health literacy and shared decision-making. Patient preference and adherence, 13, 871.
29. Wu, H., Norton, V., Cui, K., Zhu, B., Bhattacharjee, S., Lu, Y. W., Wang, B., Shan, D., Wong, S., Dong, Y., Chan, S. L., Cowan, D., Xu, J., Bielenberg, D. R., Zhou, C., & Chen, H. (2022). Diabetes and Its Cardiovascular Complications: Comprehensive Network and Systematic Analyses. Front Cardiovasc Med, 9, 841928. https://doi.org/10.3389/fcvm.2022.841928
30. Xu, J., Chen, F., Liu, T., Wang, T., Zhang, J., Yuan, H., & Wang, M. (2019). Brain Functional Networks in Type 2 Diabetes Mellitus Patients: A Resting-State Functional MRI Study. Front Neurosci, 13, 239. https://doi.org/10.3389/fnins.2019.00239
2. Amanat, S., Ghahri, S., Dianatinasab, A., Fararouei, M., & Dianatinasab, M. (2020). Exercise and Type 2 Diabetes. Adv Exp Med Biol, 1228, 91-105. https://doi.org/10.1007/978-981-15-1792-1_6
3. Apidechkul, T., Chomchoei, C., & Upala, P. (2022). Epidemiology of undiagnosed type 2 diabetes mellitus among hill tribe adults in Thailand. Sci Rep, 12(1), 3969. https://doi.org/10.1038/s41598-022-07977-9
4. Bergman, B. C., Perreault, L., Hunerdosse, D., Kerege, A., Playdon, M., Samek, A. M., & Eckel, R. H. (2012). Novel and reversible mechanisms of smoking-induced insulin resistance in humans. Diabetes, 61(12), 3156-3166. https://doi.org/10.2337/db12-0418
5. Campbell, R. J., & Nolfi, D. A. (2005). Teaching elderly adults to use the Internet to access health care information: before-after study. Journal of medical Internet research, 7(2), e128.
6. Carpenter, R., DiChiacchio, T., & Barker, K. (2019). Interventions for self-management of type 2 diabetes: An integrative review. Int J Nurs Sci, 6(1), 70-91. https://doi.org/10.1016/j.ijnss.2018.12.002
7. Chiarella, D., & Keefe, L. (2008). Creating a Consumer Health Outreach Program for Western New York Senior Citizens: Continuing a Library School Project: Stewart M. Brower and Linda Hasman, Column Editors. Medical Reference Services Quarterly, 27(2), 220-227.
8. da Rocha, R. B., Silva, C. S., & Cardoso, V. S. (2020). Self-Care in Adults with Type 2 Diabetes Mellitus: A Systematic Review. Curr Diabetes Rev, 16(6), 598-607. https://doi.org/10.2174/15733998156661907021
61849
9. Erkoc, A., & Tan, M. (2017). Effect of repetitive education on cognitive-social factors among type 2 diabetic patients. International Journal of Research in Medical Sciences, 5(6), 2533.
10. Jeha, G. S., & Haymond, M. (2007). Understanding and interpreting laboratory test results in the clinical management of diabetes mellitus. Pediatr Endocrinol Rev, 5 Suppl 1, 608-628. https://www.ncbi.nlm.nih.gov/pubmed/18167470
11. Kriska, A., El Ghormli, L., Copeland, K. C., Higgins, J., Ievers‐Landis, C. E., Levitt Katz, L. E., Trief, P. M., Wauters, A. D., Yasuda, P. M., & Delahanty, L. M. (2018). Impact of lifestyle behavior change on glycemic control in youth with type 2 diabetes. Pediatric diabetes, 19(1), 36-44.
12. Morony, S., Weir, K., Duncan, G., Biggs, J., Nutbeam, D., & McCaffery, K. J. (2018). Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia. BMC Health Serv Res, 18(1), 162. https://doi.org/10.1186/s12913-018-2956-6
13. Muliyil, D. E., Vellaiputhiyavan, K., Alex, R., & Mohan, V. R. (2017). Compliance to treatment among type 2 diabetics receiving care at peripheral mobile clinics in a rural block of Vellore District, Southern India. Journal of Family Medicine and Primary Care, 6(2), 330.
14. Naserrudin, N. A., Jeffree, M. S., Kaur, N., Syed Abdul Rahim, S. S., & Ibrahim, M. Y. (2022). Diabetic retinopathy among type 2 diabetes mellitus patients in Sabah primary health clinics-Addressing the underlying factors. PLoS One, 17(1), e0261249. https://doi.org/10.1371/journal.pone.0261249
15. Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health promotion international, 15(3), 259-267.
16. Nutbeam, D., & Kickbusch, I. (1998). Health promotion glossary. Health promotion international, 13(4), 349-364.
17. Pouwer, F., Kupper, N., & Adriaanse, M. C. (2010). Does emotional stress cause type 2 diabetes mellitus? A review from the European Depression in Diabetes (EDID) Research Consortium. Discovery medicine, 9(45), 112-118.
18. Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2017). Health literacy and the social determinants of health: a qualitative model from adult learners. Health Promot Int, 32(1), 130-138. https://doi.org/10.1093/heapro/dav093
19. Salas-Salvado, J., Becerra-Tomas, N., Papandreou, C., & Bullo, M. (2019). Dietary Patterns Emphasizing the Consumption of Plant Foods in the Management of Type 2 Diabetes: A Narrative Review. Adv Nutr, 10(Suppl_4), S320-S331. https://doi.org/10.1093/advances/nmy102
20. Schillinger, D., Grumbach, K., Piette, J., Wang, F., Osmond, D., Daher, C., Palacios, J., Sullivan, G. D., & Bindman, A. B. (2002). Association of health literacy with diabetes outcomes. JAMA, 288(4), 475-482. https://doi.org/10.1001/jama.288.4.475
21. Singsalasang, A., Nguanjairak, R., & Salawonglak, T. (2022). Health literacy and behaviors influencing blood sugar level control among type 2 diabetes patients in primary care units, Thailand: A cross-sectional study. F1000Research, 11(332), 332.
22. Steiner, J. L., Crowell, K. T., & Lang, C. H. (2015). Impact of alcohol on glycemic control and insulin action. Biomolecules, 5(4), 2223-2246.
23. Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B. B., Stein, C., Basit, A., Chan, J. C. N., Mbanya, J. C., Pavkov, M. E., Ramachandaran, A., Wild, S. H., James, S., Herman, W. H., Zhang, P., Bommer, C., Kuo, S., Boyko, E. J., & Magliano, D. J. (2022). IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract, 183, 109119. https://doi.org/10.1016/j.diabres.2021.109119
24. Tajdar, D., Luhmann, D., Fertmann, R., Steinberg, T., van den Bussche, H., Scherer, M., & Schafer, I. (2021). Low health literacy is associated with higher risk of type 2 diabetes: a cross-sectional study in Germany. BMC Public Health, 21(1), 510. https://doi.org/10.1186/s12889-021-10508-2
25. Tefera, Y. G., Gebresillassie, B. M., Emiru, Y. K., Yilma, R., Hafiz, F., Akalu, H., & Ayele, A. A. (2020). Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a university hospital in Ethiopia. PLoS One, 15(4), e0231291. https://doi.org/10.1371/journal.pone.0231291
26. Tudpor, K., Saisawai, C., Kaewpho, S., & Jitseeda, A. (2021). Psychological Stress Is a Risk Factor for Type 2 Diabetes Mellitus in College Students. Stud Health Technol Inform, 285, 296-299. https://doi.org/10.3233/SHTI210619
27. Wang, J., Zhao, Y., & Xie, F. (2022). Study on the Nursing Effect of Diabetes Health Education Nursing Methods Applied to Diabetes Patients in the Endocrinology Department. J Healthc Eng, 2022, 3363096. https://doi.org/10.1155/2022/3363096
28. Wang, M.-J., Hung, L.-C., & Lo, Y.-T. (2019). Glycemic control in type 2 diabetes: role of health literacy and shared decision-making. Patient preference and adherence, 13, 871.
29. Wu, H., Norton, V., Cui, K., Zhu, B., Bhattacharjee, S., Lu, Y. W., Wang, B., Shan, D., Wong, S., Dong, Y., Chan, S. L., Cowan, D., Xu, J., Bielenberg, D. R., Zhou, C., & Chen, H. (2022). Diabetes and Its Cardiovascular Complications: Comprehensive Network and Systematic Analyses. Front Cardiovasc Med, 9, 841928. https://doi.org/10.3389/fcvm.2022.841928
30. Xu, J., Chen, F., Liu, T., Wang, T., Zhang, J., Yuan, H., & Wang, M. (2019). Brain Functional Networks in Type 2 Diabetes Mellitus Patients: A Resting-State Functional MRI Study. Front Neurosci, 13, 239. https://doi.org/10.3389/fnins.2019.00239
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Apr 5, 2023
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Thanakorn Panyasaisophon, Ammara Visuttranukul, Phitsaran Thamrongworakun, Thananyada Buapian, Kukiat Tudpor, & Napatsawan Thanaphonganan. (2023). 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. Journal of Population Therapeutics and Clinical Pharmacology, 30(5), 598–606. https://doi.org/10.47750/jptcp.2023.30.05.059
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