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

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.