Effects of a health literacy program on self-management behaviors of patients with uncontrolled type 2 diabetes in Thailand: A quasi-experimental study

Background: Uncontrolled type 2 diabetes results in major complications that threaten patients’ life. Patients with uncontrolled type 2 diabetes often have inadequate health literacy, making them less motivated to perform self-management behaviors for glycemic control. Earlier health literacy interventions were effective in promoting self-management behaviors and reducing blood glucose, but evidence is lacking for those with uncontrolled type 2 diabetes. Objective: This study aimed to investigate the effect of a health literacy program on self-management behaviors of patients with uncontrolled type 2 diabetes. Methods: This two-group quasi-experimental study with pre-posttest design was done between September 2024 and June 2025. The participants were 64 patients with uncontrolled type 2 diabetes who lived in a community in a province in central Thailand selected using simple random sampling. The experimental group (n= 32) underwent the health literacy program with eight weekly sessions along with usual care while the control group (n = 32) was given usual care only. Data were collected using a Demographic Data Questionnaire, the Functional, Communicative and Critical Health Literacy Scale, the Self-Management Behavior Scale, and hemoglobin A1C (HbA1C) testing. Data analysis was performed with descriptive statistics, paired t-test and independent t-test. Results: No significant between-group differences were noted in baseline data. At post-test, the experimental group had a significantly higher mean score of overall health literacy (t = 3.720, Cohen’s d = 2.67), functional health literacy (t = 0.399, Cohen’s d = 2.43), communicative health literacy (t = 7.90, Cohen’s d = 1.76), and critical health literacy (t = 12.972, Cohen’s d = 3.14), and self-management behavior (t = 21.862, Cohen’s d = 2.84), and a significantly lower level of HbA1C (t = 3.436, Cohen’s d = -0.82) than before receiving the program and than the control group (all p