Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition requiring effective self-management for optimal health outcomes. Diabetes self-management education (DSME) is pivotal in T2DM care, with its efficacy potentially affected by patients’ health literacy levels. This study explores the moderating impact of health literacy on the correlation between DSME and DM self-care activities among individuals with T2DM in Korea, addressing the literature gap on health literacy’s influence on diabetes self-management. Methods: This descriptive correlational study utilized data from the 2021 Korean Community Health Survey conducted by the Korea Disease Control and Prevention Agency, comprising 26,172 participants diagnosed with T2DM undergoing pharmacotherapy. The study assessed participants’ engagement in DSME, self-care monitoring activities (including HbA1c testing, retinal examinations, and microalbuminuria tests), and verbal and health text literacy levels. Statistical analyses, encompassing correlation and moderation analyses, were conducted using SPSS and SPSS Process Macro software. Results: It was found that 29.5% of the participants engaged in appropriate self-care monitoring activities, whereas 70.5% did not. Higher levels of verbal and health text literacy were significantly linked with enhanced self-care monitoring. Furthermore, both forms of health literacy significantly moderated the correlation between DSME and self-care monitoring activities, suggesting that health literacy levels can impact the efficacy of DSME in enhancing diabetes self-management. Conclusion: These findings underscore the critical role of health literacy in diabetes self-management. Healthcare professionals should account for patients’ health literacy levels when devising and implementing DSME programs, utilizing literacy-appropriate methods to ensure universal program benefits. This study emphasizes integrating health literacy considerations into DSME programs to enhance diabetes self-care. Subsequent research should examine the effects of various health literacy aspects on diabetes self-management and develop tailored educational strategies to improve health literacy among T2DM patients.