Effects of a Short-time health literacy promotion program (HeLPP) on biochemical factors, self-care and quality of life among rural patients with type-2 diabetes: A field trial with Solomon four-group design.
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Abstract
Background: Current evidence suggests that health literacy (HL) impacts self-care behaviors and quality of life (QOL) in patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the impact of a short-time health literacy promotion program (HeLPP) on self-care behaviors and QOL in rural patients with type 2 diabetes.
Methods: Conducted from 2018 to 2019 in Chaldoran county, Iran, this randomized controlled trial followed the Solomon four-group design. Participants included 160 rural individuals with T2DM, who were divided into two intervention (A and C) and two control (B and D) groups. Pre-tests were conducted for intervention group A and control group B, with post-tests administered to all groups at three and six months. Interventions, consisting of five training sessions lasting 45 to 55 minutes, were planned and executed based on pre-test analyses. Primary outcomes were QOL and self-care behaviors, and secondary outcomes were glycated hemoglobin (HbA1c), HL and patients' awareness of the disease.
Results: Prior to the intervention, there was no significant difference in awareness, HL, self-care behaviors, HbA1c, and QOL between intervention group A and control group B (P>0.05). However, at three and six months after the educational program, intervention group A exhibited significantly increased average scores in awareness, HL, self-care behaviors, and QOL, along with reduced HbA1c levels (P<0.05) compared to control group B. No interaction was detected between the pre-test and the primary and secondary outcome scores after intervention.
Conclusion: Implementing intervention programs like HeLPP focusing on enhancing practical HL and empowering T2DM patients seems to be promising in improving patients' self-care behaviors and QOL, while reducing their HbA1c levels.
背景：目前的证据表明，健康素养（HL）会影响2型糖尿病（T2DM）患者的自我护理行为和生活质量（QOL）。本研究旨在评估短期健康素养促进项目（HeLPP）对农村2型糖尿病患者自我护理行为和QOL的影响：这项随机对照试验于2018年至2019年在伊朗恰尔多兰县进行，采用所罗门四组设计。参与者包括 160 名农村 T2DM 患者，他们被分为两组干预组（A 组和 C 组）和两组对照组（B 组和 D 组）。对干预组 A 和对照组 B 进行了前测，并在三个月和六个月时对所有组别进行了后测。干预措施包括五次培训课程，每次 45 至 55 分钟，根据前测分析进行计划和实施。主要结果为QOL和自我护理行为，次要结果为糖化血红蛋白（HbA1c）、HL和患者对疾病的认识：干预前，干预组 A 和对照组 B 在认知、HL、自我护理行为、HbA1c 和 QOL 方面没有明显差异（P>0.05）。然而，在教育项目结束后的三个月和六个月，干预组 A 在认知、HL、自我护理行为和 QOL 方面的平均得分都有了明显提高，同时 HbA1c 水平也有所下降（结论：HeLPP 等干预项目的实施，不仅能提高患者的生活质量，还能改善他们的健康状况：实施像HeLPP这样的干预项目，重点是增强T2DM患者的实际HL和能力，这似乎有望改善患者的自我护理行为和QOL，同时降低他们的HbA1c水平：试验注册：Identifier：IRCT20131116015422N7; https://irct.behdasht.gov.ir/trial/35569.
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