Health Literacy Development Model to Promote Self-Management Behaviours and Its Health Impact on Older Adults with Both Type 2 Diabetes and Hypertension, in Primary Care Clusters in Saraburi Province


  • Somchit Sinthuchai Faculty of Nursing, Praboromarajchanok Institute
  • Nusara Namdej
  • Prapai Kittiboonthawal
  • Suda Dejpitaksirikul
  • Jeeraporn Chuencham
  • Kanyarat Ubolwan
  • Padthayawad Pragodpol


health literacy, older adults with both type 2 diabetes and hypertension, self-management behaviours, health impact, HbA1c, blood pressure


   Objective: To study the efficacy of a health literacy development model in promotion of self-management behaviours amongst older adults with type 2 diabetes and hypertension
   Design: Research and development
   Methodology: The research was conducted in four stages: 1) studying and analysing concepts, research studies, and current situation pertaining to health literacy and self-management amongst diabetic older adults with hypertension; 2) developing a model for health literacy and self-management for diabetic older adults with hypertension; 3) conducting analysis of the outcomes, namely, self-management behaviours, HbA1c, and blood pressure in 150 older adults with type 2 diabetes and hypertension; and 4) making post-experimental improvements. Data were collected from January 2020 to March 2021. The quantitative data were analysed with focus on percentage, mean, standard deviation, and independent T-test. Analysis of the qualitative data was conducted using content analysis.   


   1. The health literacy development model aimed to promote five major qualities: 1) confidence in making a change; 2) proper approach to and understanding of the disease; 3) health-related communication and decision-making; 4) self-determined direction of change; and 5) continued practice for positive health outcomes.

   2. Regarding the effcacy of the model, it was found that after the intervention, the experimental group’s average self-management behaviour score was signifcantly higher than that of the control group, (p < 0.001). The experimental group’s average HbA1c and systolic blood pressure levels were signifcantly lower than those of the control group (p < 0.01 and p < 0.001, respectively). The experimental group’s average systolic blood pressure level was also lower than that of the control group, but without any statistical signifcance.

   Recommendations: The findings of this study can be applied to improving the health literacy of older adults with type 2 diabetes and hypertension, for the purpose of promoting self-management behaviours as well as regulating their HbA1c and blood pressure.


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How to Cite

Sinthuchai S, Namdej N, Kittiboonthawal P, Dejpitaksirikul S, Chuencham J, Ubolwan K, Pragodpol P. Health Literacy Development Model to Promote Self-Management Behaviours and Its Health Impact on Older Adults with Both Type 2 Diabetes and Hypertension, in Primary Care Clusters in Saraburi Province. TJNC [Internet]. 2022 Jan. 31 [cited 2022 Nov. 28];37(01):58-74. Available from: