Effects of the ADL alert application on enhancing health literacy among caregivers of dependent older adults in Northeastern Thailand

Limited health literacy among family caregivers may hinder their ability to care for dependent older adults, and mobile health applications may help improve caregivers’ knowledge and caregiving practices. This study aimed to evaluate the effectiveness of the ADL Alert application in improving health literacy and older adult care behaviors among caregivers of dependent older adults in Northeastern Thailand. A quasi-experimental two-group pretest-posttest study assessed health literacy and older adult care behavior among 60 caregivers of dependent older adults before and after a 12-week intervention, comparing an intervention group (n = 30, ADL Alert application) with a comparison group (n = 30, routine health services). Because groups differed significantly at baseline, ANCOVA adjusting for baseline scores served as the primary between-group analysis, with effect sizes reported and Holm-Bonferroni correction applied across the six health literacy subscales. After baseline adjustment, the intervention group had significantly higher post-test older adult care behavior scores than the comparison group (adjusted MD = 14.81, 95% CI: 13.24–16.37; partial η2 = 0.86, Hedges’ g = 4.64). Significant within-group gains also occurred for older adult care behavior and all six health literacy subscales (adjusted MDs 8.89–14.76 after correction; partial η2 = 0.77–0.95). The comparison group showed no significant change. The ADL Alert application was associated with improvements in health literacy and older adult care behavior after baseline adjustment. However, because treatment was assigned by community rather than individual randomization, and outcomes were assessed only immediately post-intervention by self-report, findings should be read as preliminary rather than generalizable, pending cluster-randomized trials with longer, objective follow-up.