Health literacy and the health belief model in type 2 diabetes mellitus

Background: Health literacy (HL) and health beliefs are pivotal but historically separate determinants of self-management in type 2 diabetes mellitus (T2DM), and their combined research landscape has not been mapped. We aimed to characterize the intellectual structure, collaborative networks, and thematic evolution of research on HL and health beliefs in T2DM using a comprehensive bibliometric approach. Methods: Bibliographic records were retrieved on February 24, 2026 from the Web of Science core collection (science citation index-expanded, social sciences citation index, and emerging sources citation index) with no year restriction. A 3-concept Topic Search combining HL, health belief (including health belief model [HBM] constructs), and T2DM term sets returned 1750 records. Three sequential exclusion filters were then applied: document type (290), English-only language (23), and Citation Topics Meso domain (592), yielding a final corpus of 845 original articles (1982–2026). Performance indicators were computed in Biblioshiny/bibliometrix (open-source; M. Aria & C. Cuccurullo, University of Naples Federico II) and science mapping in VOSviewer 1.6.20. Analyses were descriptive and structural, with no inferential hypothesis testing. Results: The 845 articles were published in 347 journals by 3929 authors from at least 45 countries, yielding 20,426 citations (mean 24.17 per article). Annual output grew from 7 articles in 2005 to 84 in 2025. The United States contributed 39.6% of publications, and international co-authorship reached 17.99%. The HBM was explicitly named in only 7.9% of the corpus. Abstract-text mapping identified 4 thematic clusters: HL measurement and glycemic outcomes; self-management and behavioral constructs including the HBM; qualitative inquiry into patient access and experience; and randomized controlled trial design. Conclusions: HL and HBM research streams appear to remain largely separate within the T2DM literature. Integrated theoretical frameworks, culturally diverse samples, and interventions that address both literacy deficits and negative health beliefs are urgently needed. The findings support prioritizing studies that jointly model HL, perceived barriers, and self-efficacy against glycemic endpoints; validating these frameworks in the low- and middle-income regions that carry the greatest diabetes burden; and embedding both constructs within diabetes self-management education and support. Patient-education and counseling journals emerge as the natural venues for this integrated agenda.

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Journal
Medicine
Published
2026-09-25
DOI
https://doi.org/10.1097/md.0000000000050857
Primary Topic
Health Literacy and Information Accessibility
Type
article
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article

Health literacy and the health belief model in type 2 diabetes mellitus

Hatice Ağralı
Medicine
Health Literacy and Information Accessibility
article

Health literacy and the health belief model in type 2 diabetes mellitus

Hatice Ağralı
article en

Abstract

Background: Health literacy (HL) and health beliefs are pivotal but historically separate determinants of self-management in type 2 diabetes mellitus (T2DM), and their combined research landscape has not been mapped. We aimed to characterize the intellectual structure, collaborative networks, and thematic evolution of research on HL and health beliefs in T2DM using a comprehensive bibliometric approach. Methods: Bibliographic records were retrieved on February 24, 2026 from the Web of Science core collection (science citation index-expanded, social sciences citation index, and emerging sources citation index) with no year restriction. A 3-concept Topic Search combining HL, health belief (including health belief model [HBM] constructs), and T2DM term sets returned 1750 records. Three sequential exclusion filters were then applied: document type (290), English-only language (23), and Citation Topics Meso domain (592), yielding a final corpus of 845 original articles (1982–2026). Performance indicators were computed in Biblioshiny/bibliometrix (open-source; M. Aria & C. Cuccurullo, University of Naples Federico II) and science mapping in VOSviewer 1.6.20. Analyses were descriptive and structural, with no inferential hypothesis testing. Results: The 845 articles were published in 347 journals by 3929 authors from at least 45 countries, yielding 20,426 citations (mean 24.17 per article). Annual output grew from 7 articles in 2005 to 84 in 2025. The United States contributed 39.6% of publications, and international co-authorship reached 17.99%. The HBM was explicitly named in only 7.9% of the corpus. Abstract-text mapping identified 4 thematic clusters: HL measurement and glycemic outcomes; self-management and behavioral constructs including the HBM; qualitative inquiry into patient access and experience; and randomized controlled trial design. Conclusions: HL and HBM research streams appear to remain largely separate within the T2DM literature. Integrated theoretical frameworks, culturally diverse samples, and interventions that address both literacy deficits and negative health beliefs are urgently needed. The findings support prioritizing studies that jointly model HL, perceived barriers, and self-efficacy against glycemic endpoints; validating these frameworks in the low- and middle-income regions that carry the greatest diabetes burden; and embedding both constructs within diabetes self-management education and support. Patient-education and counseling journals emerge as the natural venues for this integrated agenda.

MedicineVol. 105(39)
Süleyman Demirel Üniversitesi (TR)
Quality Education
Openalex Percentile: Top 6%
Health Literacy and Information Accessibility
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