Effect Evaluation Of Health Literacy Intervention Among Community Middle-Aged And The Aged People With Diabetes

ObjectiveThe present study was conducted to develop the health literacy intervention strategies, and to illuminate the change of health literacy, self-management, and health status between before and after the intervention using pre- and post- comparison which would provide information for the health literacy intervention among chronic disease patients.MethodQuasi-experiment study design was used for this study. Participants were selected using non-probability sampling during the community diabetes patients screening. Health intervention strategies were developed under the direction of social cognitive theory and carried out for the community diabetes patients. Structural interview about health literacy, self-management, functional health statuses were conducted and biochemical parameter of the subjects including glucose, glycolated hemoglobin and blood-lipid were measured. T test, ANOVA were used to assess the homogeneity between intervention group and control group at the baseline and to compare the change of health literacy, self-management, glucose, glycolated hemoglobin, and health status between before and after the intervention.Results (1) More than one quarter of the diabetes patients had inadequate health literacy. Thefemale patients, Korea-Chinese, divorced or with other marital status, with lower education of middle school, with monthly income less than 1500 RMB, with other chronic diseases were more likely to had lower health literacy scores. Education level, race, gender, monthly income and suffered from other chronic diseases were the primary influencing factors of health literacy among diabetes patients which explained 40.0% variance of health literacy.(2) Glycolated hemoglobin between the age groups and races groups were significantly different. FPG and HDL-C were the primary factors influencing Glycolated hemoglobin, which explained 40.0% variance of Glycolated hemoglobin.(3) The functional physical health scores between different genders, marital status, BMI, monthly income, suffered from other chronic diseases were significant. And the gender, monthly income, and suffered from other chronic diseases were influencing factors of functional physical health. The functional mental health scores between different races were significant.(4) The change of readability, comprehension and total health literacy scores were significantly higher than the control group. ANCOVE indicated that the change of readability, comprehension and total health literacy scores were still significant after controlling for monthly income and the change of numeracy was not significant.(5) The scores of diet management, exercise management, monitoring management, medication management, and feet management were all significantly improved in the intervention group. ANCOVE indicated that the improvement of self-management was still higher than the control group after controlling for monthly income, and health literacy.(6) TC and FPG were both not changed after the intervention while HbAlc changed significantly. After controlling monthly income, or controlling for monthly income, health literacy, and self-management, the change of HbA1c still significant(7) The change of functional health status after the intervention was significant. After controlling for the monthly income, health literacy, and self-management, functional physical health did not changed significantly while the functional mental health improved significantly.Conclusion(1) More the one third of the community diabetes patients were with inadequate health literacy. The female patients, Korea-Chinese, divorced or with other marital status, with lower education of middle school, with monthly income less than 1500 RMB, with other chronic diseases were more likely to had lower health literacy scores.(2) The health literacy intervention was effective on improving the readability, comprehension, and the total health literacy scores, but the numeracy did not improved.(3) The health literacy intervention could improve the diet management, exercise management, monitoring management, and feet management, but the medication management changed a little.(4) The health literacy intervention was effective on improving the HbAlc, functional physical health, especially for the functional mental health.