Development of a Model to Enhance Health Literacy in Diabetic Patients with Uncontrolled Blood Sugar Levels in Ban Bo Phawaen Health Promoting Hospital Area, Chiang Mai Province.

Abstract

Abstract

Type 2 diabetes mellitus (T2DM) patients with uncontrolled blood glucose often experience limited health literacy, leading to suboptimal self-care and poor adherence. This study evaluated knowledge, health care behaviors, medication adherence, and health literacy, and developed
a culturally adapted model to enhance literacy in rural communities. A cross-sectional developmental design was applied among 167 purposively selected T2DM patients with uncontrolled glycemia and five health personnel at Ban Bo Phawan Subdistrict Health Promoting Hospital, Chiang Mai Province, Thailand. Data were collected using a 69-item questionnaire covering five domains and participatory brainstorming with the Appreciation–Influence–Control (A-I-C) technique. Descriptive statistics and content analysis were employed.

Participants demonstrated moderate levels of knowledge ( X̄= 7.23, SD = 1.22), health care behaviors ( X̄= 23.46, SD = 2.55), medication adherence ( X̄= 25.07, SD = 2.45), and diabetes-related health literacy (X̄ = 91.87, SD = 19.08). The developed model emphasized the use of local dialects to support elderly comprehension, engagement of village health volunteers and family members as facilitators, provision of mobile services beyond official hours to reduce access barriers, and the use of indigenous media and experiential learning to enhance participation.

This culturally tailored model provides a practical and context-sensitive framework for strengthening health literacy, promoting effective self-management, and improving glycemic outcomes in patients with T2DM in rural settings. Broader implementation may support health system strategies aimed at reducing diabetes-related complications and inequities.