Mixed Method of Health Literacy and Diabetes Self- Management Among Saudi Adults with Type 2 Diabetes Mellitus

Abstract

The worldwide threat of Diabetes Mellitus (DM) has been increasing rapidly, and is now an estimated 463 million, of which 55 million people originate from Middle East and Nort African (“MENA”) region (international Diabetes Federation [“IDF’], 2020). In Saudi Arabia, the prevalence of diabetes has roughly reached a ten-fold increase in the past three decades, placing Saudi Arabia’s incidence as one of the highest globally (Almubark et al., 2022). The purpose of the study was to examine the relationship between health and diabetes self-management among Saudi adults with Type 2 Diabetes Mellitus (T2DM). The study further aimed to explore how Saudi adult with T2DM seek and utilize diabetes knowledge to self-manage their diabetes. The study was guided by Leininger’s Culture Care Diversity and Universality Theory (2002). Leininger’s Sunrise Enabler- Model provided a framework to explore the various factors that affect diabetes self-management through a cultural lens. This model provides a comprehensive understanding pf multiple factors influencing diabetes self-management. A sample of 66 Saudi adults with T2DM aged 40-61 and older was recruited from diabetes center and Primary Healthcare Center (PHCC) at National Guard Hospital King Abdulaziz Medical City Jeddah, Saudi Arabia. A Parallel Mixed Method (PPM) design was applied, using semi-structured interviews, Diabetes Self-management Questionnaire (DSMQ), Short Test of Functional Health Literacy in Adult (S-TOFHLA), and sociodemographic surveys. The majority of participants were females (n = 39, 59.09%), between the ages 51-55 years (n = 17, 25.76%); had an elementary level of education (n = 26, 39.39%); married (n = 49, 74.24%); unemployed (n = 34, 51.52%); and reported a monthly income less than 5,000 Saudi Riyals (SR) (n = 24, 36.36%). There was a significant positive correlation between health literacy level and DSMQ scores, with a correlation of .25 (p = .047). Six underlying themes emerged from the qualitative data each containing subthemes. The themes were classified as Understanding My Diabetes, Managing My Diabetes, Staying Away from Sugars, Support from My Family and Doctors, Praise Be to God, Difficulties I Face. Next steps include development and testing a culturally relevant, novel educational program’s effectiveness in optimizing glucose control and enhancing diabetes self-management behavior in Saudi Arabia.