Health Literacy, Self-Care Behaviors, and Associated Factors Among Adult Diabetes Attending East Arsi Zone Public Hospitals, Ethiopia: Cross-Sectional Study

Background: Diabetes health literacy (DHL) and self-care behavior play an important role in avoiding and controlling complications of diabetes mellitus and are positively associated with good glycemic control and quality of life improvement. However, we lack evidence describing their magnitude in the East Arsi zone of the Oromia regional state of Ethiopia. Objectives: This study was aimed to assess the magnitude of DHL, self-care behavior, and associated factors among adult diabetes patients attending follow-up care at selected public hospitals in the East Arsi zone, Oromia, Ethiopia, 2025. Methods: An institutional based cross-sectional study was employed in five public hospitals found in the East Arsi zone. A total of 468 participants were included using a simple random sampling technique. Data were collected using a structured questionnaire and analyzed using binary logistic regression to assess associations between dependent and independent variables. Result: More than half of the study participants (57.7%) exhibited low DHL, while 55.6% demonstrated poor self-care behavior. Significant factors associated with low DHL included being male, low education level, residing in rural areas, lack of diabetes education attendance, poor self-care behavior, and receiving diabetes information from only one source. Additionally, younger individuals, those living in rural areas, lack of exposure to diabetes education, and lower monthly incomes were significantly linked to poor diabetes self-care behavior. Conclusion: These findings highlight the urgent need for targeted educational and behavioral interventions, particularly among rural residents, males, individuals with low income, low education, and those lacking exposure to diabetes education, to enhance DHL and improve self-care practices.