Effects of Enhance Health Literacy through Transformative Learning Program on Self-Management and Hemoglobin A1C Level Among Adults with Uncontrolled Type 2 Diabetes: A Randomized Controlled Trial

Abstract

Health literacy is fundamental to people’s ability to manage their health and make appropriate health decisions. Health literacy enhancement can maximize self-management and health outcomes, especially among uncontrolled type 2 diabetes persons with chronic symptoms that can cause microvascular and macrovascular complications. This randomized controlled trial examined the effects of the Enhance Health Literacy through Transformative Learning Program on self-management and HbA1C levels among adults with uncontrolled type 2 diabetes. The sample included 64 adults with uncontrolled type 2 diabetes visiting two healthpromoting hospitals in a province in central Thailand. They were randomly allocated to either the experimental group (n = 32) receiving the 4-week transformative learning program in addition to usual care or the control group (n = 32) receiving only usual care. A demographic data questionnaire, the Self-Management Behaviors Scale, and the HbA1C record form were instruments for obtaining data. Data were analyzed using descriptive statistics, two-way repeated measures ANOVA, and independent t-tests. Results showed that after receiving the program, the experimental group had significantly higher self-management scores than the control group and was more elevated. In addition, the experimental group had significantly lower HbA1C levels than the control group after the intervention at 12 weeks than before receiving the program. In conclusion, the Enhance Health Literacy through Transformative Learning Program can increase self-management behaviors and lower HbA1C levels. However, nurses need to further test the effectiveness of the literacy program before implementing widely in practice.