Factors Associated with Health Literacy, Self-Efficacy, Social Support, and Oral Health Care Behaviors Among Elderly in Northern Border Community Thailand

Pattaraporn Khamrin,1,2 Sorawit Boonyathee,1 Sasivimol Bootsikeaw,3 Parichat Ong-Artborirak,4 Katekaew Seangpraw3 1School of Medicine, University of Phayao, Phayao, 56000, Thailand; 2Ban Mai Health Promotion Hospital, Chiang Mai, 50180, Thailand; 3School of Public Health, University of Phayao, Phayao, 56000, Thailand; 4Faculty of Public Health, Chiang Mai University, Chiang Mai, 50200, ThailandCorrespondence: Katekaew SeangprawSchool of Public Health, University of Phayao, Phayao, 56000, ThailandTel +66 54 466 66Email [email protected]: Oral health problems among elderly people are an important public health issues worldwide. Oral healthcare is essential to the health and well-being of elders and is one of the key indicators determining their quality of life. This research aimed to study oral health literacy, self-efficacy, social support, and demographic characteristic factors associated with the oral health care behaviors of elderly people living in the rural areas of northern Thailand.Methods: This research was a cross-sectional study that recruited 406 elderly participants using convenience and snowball samplings. Participants’ names were obtained from the registration list of the Java Health Center Information System (JHCIS) program, where they received a health service between 2018 and 2020. Data were obtained through face-to-face interviews with participants, while they were waiting to receive a health service or through a phone interview. Linear regression was analyzed to determine the factors associated with oral healthcare behaviors.Results: The majority of participants (85%) had inadequate functional health literacy, 52% had moderate self-efficacy toward oral health behaviors, 91.9% had moderate social support, and 53% admitted to moderate oral health behaviors. The results from the model show that self-efficacy, social support, and oral health literacy are positively associated with oral health care behaviors among the elderly (p-value < 0.05). The multiple regression model can account for 47.2% of the variance in oral health care behaviors.Conclusion: Improving oral health care behaviors among elderly people should be considered by health care providers and those who provide social support. Self-esteem, communication skills among service providers and service receivers, and self-management of oral healthcare should receive special attention. Moreover, social support and relevant agencies can help promote oral healthcare by collaborating with other healthcare providers for better oral health outcomes among elderly people.Keywords: health literacy, self-efficacy, social support, oral health, elderl

Effect of Health Literacy Intervention on Glycemic Control and Renal Function Among Thai Older Adults at Risk of Type 2 Diabetes Mellitus

Katekaew Seangpraw,1 Parichat Ong-Artborirak,2 Sorawit Boonyathee,3 Sasivimol Bootsikeaw,1 Supakan Kantow,1 Pitakpong Panta,4 Prakaipetch Winaiprasert5 1School of Public Health, University of Phayao, Phayao, 56000, Thailand; 2Faculty of Public Health, Chiang Mai University, Chiang Mai, 50200, Thailand; 3School of Medicine, University of Phayao, Phayao, 56000, Thailand; 4School of Nursing, University of Phayao, Phayao, 56000, Thailand; 5Faculty of Nursing, Thammasat University, Pathum Thani, 12121, ThailandCorrespondence: Pitakpong Panta, Email [email protected]: Diabetes patients with low health literacy often have poor health and clinical outcomes. The study aimed to assess the effectiveness of a health literacy intervention on glycemic control and renal function among Thai older adults at risk of type 2 diabetes mellitus (T2DM).Methods: A quasi-experimental study was carried out in rural areas of Phayao Province in northern Thailand. The participants were older adults with T2DM who recorded blood glucose levels ranging from 140 to 180 mg/dL and who were not receiving prescribed medication. The intervention lasted 12 weeks, and data were collected at three points: baseline, post-intervention, and at 3 months’ follow-up. The study outcomes included the measurement of fasting blood sugar (FBS), hemoglobin A1C (HbA1c), and glomerular filtration rate (eGFR) levels after the intervention. A linear mixed model and generalized estimating equations model were used to assess the intervention effect for continuous and binary outcomes, respectively.Results: From baseline to post-intervention, FBS and HbA1c decreased more in the intervention group than in the control group by 8.2 mg/dL (p < 0.001) and 0.1% (p = 0.029), respectively, whereas eGFR increased by 8.0 mL/min/1.73m2 (p < 0.001). The absolute effect of the intervention at follow-up was − 9.8 units for FBS, − 0.4 units for HbA1c, and 14.0 units for eGFR. Abnormal HbA1c level (≥ 6.5%) of the intervention group was reported as 70.3% at baseline, 31.3% at post-intervention, and 9.4% at follow-up. Compared to baseline levels, the T2DM patients who received the intervention were 0.31 times less likely to have abnormal HbA1c levels than the control subjects at follow-up (p = 0.003) who received no intervention.Conclusion: Our findings suggest that this intervention may potentially improve diabetes self-management and prevention behaviors, thereby reducing the diabetes burden in rural communities in northern Thailand.Keywords: health literacy, glycemic control, renal function, older adult