Effects of health literacy improvement program on self-care behaviors and health outcomes in older adults with type 2 diabetes and hypertension comorbidities

Abstract

Health literacy is a necessary factor affecting self-care behaviors. This randomized control trial research aimed to study the effects of a health literacy improvement program on self-care behaviors and health outcomes in older adult patients with diabetes and hypertension comorbidities. Older adults at a private primary care unit, Bangkok, Thailand; aged 60-69 years, who had been diagnosed with diabetes and hypertension, were selected by simple random sampling into experimental and control groups, of 30 people each. The experimental group received eight weeks of a health literacy improvement program. Group activities were held in three sessions at 4-week intervals. The control group received standard care only. Data were collected by using interview questionnaires at baseline, post-intervention, and follow-up. Research instrumentation included collected data on general characteristics and illness history. Health literacy, self-care behavior, healthy eating, physical activity, stress management, and medication adherence scales were also included. In addition, blood pressure and HbA1C were examined at baseline and follow-up. Descriptive statistics, independent t-test, chi-square, Repeated Measures ANOVA, and Bonferroni post hoc test were used for data analysis. After the intervention and follow-up, the experimental group had the following mean scores: health literacy (ME.118.33±7.79, 123±4.90; MC 94.53±7.51; 94.17±5.86, p<.001), self-care behaviors in healthy eating (ME 49.10±3.14, 52.13±3.19; MC 43. 70±2. 83, 43. 66±3. 25, p<. 001), physical activities (ME36. 90±2. 26, 38. 53±2. 56; MC 26. 90±2. 67,26. 83±2. 67, p<. 001), stress management (ME26. 83±1. 89, 28. 30±1. 89; MC 21. 33±2. 00,21. 60±2. 09, p<. 001), and medication adherence (ME34. 60±2. 47, 36. 07±1. 87; MC 27. 40±2. 64, 28. 30±3. 18, p<. 001), all of which were significantly higher than the control group. Furthermore, HbA1C (Diff_ME-0.46±0.50; Diff_MC.0.06±0.45, p<.05) and systolic blood pressure (Diff_ME-9.70±9.29; Diff_MC.-1.26± 12.89, p<.05) were significantly lower than the control group.