Integrated Communicative Health Literary(ICHL) among Thai type 2 diabetic patients in SamutSongkram Province Thailand: a case study of CHL towarddiabetes type outcome

Abstract

This multi –phasing study aimed to develop and evaluate an integrated communicative health literacy program (ICHL Program) for type 2 diabetic patients in Bangkonthee district, Samut Songkram province, Thailand. The study divided into four phases. Phase 1-2 : Cross sectional study was conducted using quantitative (n =415) and qualitative study (n =14) which aimed to assess the level of health literacy of the DM patients aged 50-80 years old and describing providers’ and patients’ perception towards promoting health literacy. Phase 3: Developing and implementing ICHL (based on the findings of cross-sectional study). Phase 4: Evaluating the effect of the ICHL. The cross-sectional study shown that the participants has moderate level of health literacy. The quasi experimental study was employed to evaluate the effect of the ICHL. 70 diabetes patients aged between 50 and 80 years, living in a rural Thai community was purposively selected and divided into two groups of 35 patients. Then, they were selected to be an intervention groups receiving the ICHL program and a control group receiving a regular health literacy promotion program. A questionnaire was used to assess socio-demographic characteristics, and self-care behavior. The 3-level Health Literacy Scale developed by Ishikawa was used to assess health literacy level. Patients’ blood sugars (HbA1c) were retrieved from hospital patient health records. The measurements of dependent variables were conducted three times: at baseline, after the intervention (three months), and during six months follow up. Descriptive statistic, Chi square, t-test, and repeated-measure ANOVA were used for data analysis. The finding showed the significant improvement in health literacy, self-care behavior, and HbA1c after 3 month participation in the program ( p-value <0.05), but not sustainable through 6 month participation. It was concluded that the Integrated Communicative Health Literacy program could enable diabetic patients to control their blood sugar, increase health literacy and enhance their self-care behavior to control their blood sugar.