Development of health literacy organizational model to prevent diabetes in risk groups primary health care units Lopburi Province.

Abstract

      This action research aimed to: 1) examine the operational situation of health literate organizations in preventing diabetes among at-risk populations; 2) develop a health literate organization model; and 3) evaluate the effectiveness of the model in primary care units in Lopburi Province. The study employed design comprising three phases: situational analysis, model development, and implementation with evaluation. The sample consisted of 260 individuals aged 35 years and older at risk of diabetes, with fasting plasma glucose levels of 100–125 mg/dL. Research instruments included the Health Literate Organization model, a health literacy promotion practice questionnaire for personnel, a health literacy assessment for the at-risk group, a satisfaction questionnaire, and a clinical outcomes record form. Data were analyzed using descriptive statistics and paired t-test.

      The situational analysis revealed that the incidence of new diabetes cases among individuals with prediabetes (Pre-DM) in Lopburi Province during fiscal years 2022–2024 showed a continuous upward trend. This reflected limitations in policy, leadership, support systems, and the implementation of Health Literate Organizations (HLO) within primary care settings. Consequently, the LEADER–HLO Pre-DM Model was developed, consisting of five components: 1) L – Leadership & Policy Support 2) E – Establishing Health Literacy Culture           3) A – Advancing Health Literacy Role Modeling 4) D – Developing Supportive Systems & Environment 5) R – Risk-Group Focused Diabetes Prevention.

            The effectiveness evaluation demonstrated that, after implementation, healthcare personnel showed a statistically significant increase in health literacy promotion practice scores (p < 0.001), with the mean score rising from 108.14±0.78 to 198.27±0.83. The at-risk group also showed a statistically significant improvement in health literacy scores (p < 0.001), with the mean score increasing from 68.43±0.29 to 114.27±0.24. Clinical outcomes improved significantly, including a reduction in fasting plasma glucose (FPG) from 118.27 to 107 mg/dL, HbA1c from 6.12% to 5.98%, and body mass index (BMI) from 24.94 to 23.78 kg/m² (p < 0.001). Personnel satisfaction with the model was rated at a high level across all aspects.