# Evaluation of a Family-Based, Health Literacy-Adapted Educational Intervention Program in Patients With Type 2 Diabetes Mellitus

## TL;DR

A family-based educational program improved diabetes control and health literacy in patients with type 2 diabetes.

## Contribution

A novel family-based, health literacy-adapted intervention for type 2 diabetes management was evaluated.

## Key findings

- The intervention group showed significant improvements in glycemic control, weight, health literacy, and self-efficacy.
- The proportion of patients achieving glycemic goals increased substantially in the intervention group.
- Self-efficacy fully mediated the relationship between health literacy and glycemic control immediately after the intervention.

## Abstract

Background

Glycemic goals are linked to both health literacy (HL) and self-efficacy (SE) in type 2 diabetes mellitus (T2DM) management. This study aims to investigate the effectiveness of an HL-adapted educational intervention for patients with type T2DM at home in achieving glycemic control goals and improving HL and SE.

Method

This randomized controlled trial involved an intervention group and a control group, comprising random samples of 60 patients with T2DM monitored at the diabetes clinic and home care department of the Hospital of Drama, Drama, Greece. The intervention group participated in a structured home education program, while the control group continued to receive standard care during routine visits. All participants completed the following two scales at baseline, immediately post-intervention, and three months after intervention: the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) to measure HL and the Diabetes Management Self-Efficacy Scale (DMSES) to measure SE. Demographic characteristics, BMI, medical history, and glycemic control metrics, including HbA1c (A1C), fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) were recorded.

Results

We approached 130 T2DM patients, of whom 120 participated (92.3% response rate), evenly split between intervention and control groups. The groups had similar baseline characteristics. Three months post-intervention, the intervention group showed significant improvements in glycemic control (A1C, FPG, PPG), weight, HL, and SE. The proportion of patients achieving glycemic goals increased substantially in the intervention group. SE fully mediated the relationship between HL and A1C immediately after the intervention. Overall, the intervention group demonstrated superior outcomes compared to the control group.

Conclusion

The findings confirm that family-based and HL-adapted intervention programs can effectively support the management of T2DM. Such interventions can help patients achieve glycemic control goals while enhancing HL and SE.