Meaning of Picture-Based Health Education in Diabetes With Low Health Literacy Population

Purpose: Type 2 diabetes (T2DM) ranks as the seventh-leading cause of disease-related death in the United States. Of the U.S. population, 29.1 million people, or 9.3%, have diabetes. Only 12% of people have proficient health literacy in the United States. T2DM self-management is important to prevent complications and that self-management has a relationship with the diabetes patient’s level of health literacy. To increase diabetes self-management, it is important to educate people using appropriate education tools, especially those who have a low health literacy level. The purpose of this qualitative study is to explore the meaning of pictures-based health education regarding self-management of T2DM by people who have low health literacy using a theoretical framework, the Health Belief Model (HBM).

Methods: This study used a qualitative explorative descriptive design. The researcher used a postpositivist theoretical perspective along with her modification of the HBM. For measuring health literacy status, this research used the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the researcher used the open-ended interview, filed notes, and audio recording for this study.

Results: Total participants consisted of 12 people. The mean of S-TOFHLA was 14, which indicated participants have an inadequate functional health literacy. The majority of participants have susceptibility because they stated that they have family history of T2DM. The participants had perceived severity of having T2DM; most participants worried about the T2DM complications. Participants also indicated that they have language barriers because even though they can easily understand English regularly, the medical terms are difficult to understand. They stated, however, that using pictography health education materials for T2DM who have low health literacy was easy to understand.

Conclusion: Whether they had low health literacy or not, the pictography health education materials for T2DM self-management proved useful. This framework could guide the health education of T2DM patients with low health literacy.