Effectiveness of a health literacy program among type 2 diabetes patients for the prevention of chronic kidney disease.

Abstract

      The objectives of this study were to: 1) compare the health literacy levels of patients with type 2 diabetes before and after participating in the program, 2) compare the self-care behavior levels of patients with type 2 diabetes before and after participating in the program, and 3) compare the clinical outcomes of patients with type 2 diabetes before and after participating in the program. This study utilized a quasi-experimental research design (two-group pretest-posttest design). The study population comprised patients with type 2 diabetes receiving treatment at Phra Nakhon Si Ayutthaya Hospital between October 1, 2024, and September 30, 2025. A total sample of 60 patients was divided into an experimental group of 30 participants (who received the 8-week health literacy enhancement program) and a control group of 30 participants (who received usual care). Research instruments included: 1) the 8-week health literacy program 2) a data recording form for personal data, health behaviors, and clinical outcomes, and 3) a health literacy assessment tool based on the 3E2S principles. Demographic data were analyzed using descriptive statistics, and comparisons were conducted using the independent t-test.

      Results: (1) Baseline personal characteristics and pre-intervention clinical outcomes showed no statistically significant differences between the two groups. (2) Regarding health literacy, post-intervention health literacy levels in the experimental group were significantly higher than pre-intervention levels (t=-7.368, p<0.001) whereas no significant difference was observed in the control group (t=0-0.929,p=0.360) (3) Regarding clinical outcomes, after completing the program, the experimental group showed statistically significant improvements across almost all variables compared to pre-intervention levels (p<0.05) and showed statistically significant differences compared to the control group. Specifically, the experimental group exhibited significantly lower levels of blood glucose (FBS, HbA1c), renal function parameters (BUN, Cr), total cholesterol, and blood pressure (SBP, DBP), as well as higher levels of high-density lipoprotein (HDL) compared to the control group. No statistically significant differences were observed between the groups for triglycerides and LDL(p<0.05). The control group showed no significant pre- and post-intervention differences in clinical outcomes.