HSB model comprising health literacy, self-efficacy, and blood sugar control behaviors to empower older patients with type 2 diabetes in Phetchaburi Province, Thailand

Background: This research aimed to develop an empowerment model (HSB model) to effectively control blood sugar levels and glycosylated hemoglobin (HbA1c) among older patients with uncontrolled type 2 diabetes in Phetchaburi Province, Thailand. Methods: The study utilized a mixed-methods approach comprising two phases. Phase 1 involved quantitative research on 300 participants using questionnaires to investigate the causal factors related to blood sugar control behavior (α = 0.85). Data analysis was conducted using descriptive statistics and Structural Equation Modeling (SEM). Phase 2 used qualitative research methods, specifically focus group discussions and brainstorming with relevant parties, to develop the HSB empowerment model based on the causal factors identified in Phase 1. Results: The SEM analysis in Phase 1 identified key factors, including attitude, social support, health literacy and self-efficacy and blood sugar control behaviors. The factors of attitude and social support had direct effects on self-efficacy (β=0.70, 0.83, p Conclusion: The developed HSB model shows high potential as an integrative healthcare model for older Type 2 Diabetes patients. It depends on community networks and incorporates existing resources within the Thai healthcare system to improve the quality of life for these patients. Keywords: Type 2 diabetes, Blood sugar control behaviors, Health literacy, Empowerment model, Self-efficacy, Thailand