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postgraduate thesis: The effect of a health literacy oriented program on physical activity among Chinese patients with type 2 diabetes mellitus
Title | The effect of a health literacy oriented program on physical activity among Chinese patients with type 2 diabetes mellitus |
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Authors | |
Issue Date | 2014 |
Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
Citation | Lam, H. [林絢琛]. (2014). The effect of a health literacy oriented program on physical activity among Chinese patients with type 2 diabetes mellitus. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5334852 |
Abstract | Physical inactivity has been widely regarded as a leading cause of non-communicable chronic diseases such as type 2 diabetes mellitus (T2DM) and hypertension. Physical activity (PA) has been shown to be the most effective self-care behaviour in alleviating T2DM, an incurable chronic disease. Previous behavioural modification programs intended to encourage and maintain PA behaviour among middle-aged and older patients with T2DM have had inconsistent results. PA has remained as a recommended diabetes self-care behaviour with the lowest compliance rate in many regions of the world.
This thesis proposes a program focusing on health literacy (HL) as a means to nurture T2DM patients’ ability to navigate, read, understand, process, comprehend and act on health information, and thereby modify PA behaviour. This approach is proposed for three reasons: (1) the flood of available health information of varying quality affects patients’ decision making with regard to self-care behaviour; (2) the high prevalence of low HL in the US, Europe, and Asia affects the comprehension of self-care behaviour programs; (3) because 50% of older T2DM patients are impaired cognitively due to the impact of aging and hence have difficulty in carrying out suitable self-care behaviour without proper guidance. All of these factors can influence the effectiveness of PA behavioural modification programs designed to help middle-aged and older T2DM patients make self-care decisions based on sound health information according to their level of HL.
This thesis reviews existing HL-oriented programs and models and validates the instrument used to examine the effects of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour among middle-aged and older patients with T2DM. In the study, 324 middle-aged and older Chinese T2DM patients recruited from two hospital diabetes centres in Hong Kong were divided randomly into intervention and control groups. The intervention group participated in an HL-oriented program on PA behaviour. The program significantly improved the mean of PA behaviour of patients in the intervention group from a sedentary level (under 1,000 average Metabolic Equivalents/minutes/week; 4463 mean number of steps per week) to an internationally acceptable standard (over 2,000 average METs-minutes/week; 7459 mean number of steps per week), and this improvement was maintained at three- and six-month follow-ups. The PA behaviour of the control group actually subsided. This study showed that a program addressing and nurturing patients’ ability to explore, understand and manage health information on T2DM and PA was effective in improving the PA behaviour of middle-aged and older adults with T2DM.
This thesis is the first study to use objective measurements to evaluate the effect of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour. It extends the generalizability of culture and language-sensitive HL oriented programming from the United States (where previous HL studies were conducted) to China. The study can serve as a model for future investigations of self-care behaviour among patients with different chronic illnesses in various regions of China. |
Degree | Doctor of Philosophy |
Subject | Self care, health Exercise therapy Diabetics - Care |
Dept/Program | Nursing Studies |
Persistent Identifier | http://hdl.handle.net/10722/207169 |
HKU Library Item ID | b5334852 |
DC Field | Value | Language |
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dc.contributor.author | Lam, Huen-sum | - |
dc.contributor.author | 林絢琛 | - |
dc.date.accessioned | 2014-12-18T23:17:51Z | - |
dc.date.available | 2014-12-18T23:17:51Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Lam, H. [林絢琛]. (2014). The effect of a health literacy oriented program on physical activity among Chinese patients with type 2 diabetes mellitus. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5334852 | - |
dc.identifier.uri | http://hdl.handle.net/10722/207169 | - |
dc.description.abstract | Physical inactivity has been widely regarded as a leading cause of non-communicable chronic diseases such as type 2 diabetes mellitus (T2DM) and hypertension. Physical activity (PA) has been shown to be the most effective self-care behaviour in alleviating T2DM, an incurable chronic disease. Previous behavioural modification programs intended to encourage and maintain PA behaviour among middle-aged and older patients with T2DM have had inconsistent results. PA has remained as a recommended diabetes self-care behaviour with the lowest compliance rate in many regions of the world. This thesis proposes a program focusing on health literacy (HL) as a means to nurture T2DM patients’ ability to navigate, read, understand, process, comprehend and act on health information, and thereby modify PA behaviour. This approach is proposed for three reasons: (1) the flood of available health information of varying quality affects patients’ decision making with regard to self-care behaviour; (2) the high prevalence of low HL in the US, Europe, and Asia affects the comprehension of self-care behaviour programs; (3) because 50% of older T2DM patients are impaired cognitively due to the impact of aging and hence have difficulty in carrying out suitable self-care behaviour without proper guidance. All of these factors can influence the effectiveness of PA behavioural modification programs designed to help middle-aged and older T2DM patients make self-care decisions based on sound health information according to their level of HL. This thesis reviews existing HL-oriented programs and models and validates the instrument used to examine the effects of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour among middle-aged and older patients with T2DM. In the study, 324 middle-aged and older Chinese T2DM patients recruited from two hospital diabetes centres in Hong Kong were divided randomly into intervention and control groups. The intervention group participated in an HL-oriented program on PA behaviour. The program significantly improved the mean of PA behaviour of patients in the intervention group from a sedentary level (under 1,000 average Metabolic Equivalents/minutes/week; 4463 mean number of steps per week) to an internationally acceptable standard (over 2,000 average METs-minutes/week; 7459 mean number of steps per week), and this improvement was maintained at three- and six-month follow-ups. The PA behaviour of the control group actually subsided. This study showed that a program addressing and nurturing patients’ ability to explore, understand and manage health information on T2DM and PA was effective in improving the PA behaviour of middle-aged and older adults with T2DM. This thesis is the first study to use objective measurements to evaluate the effect of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour. It extends the generalizability of culture and language-sensitive HL oriented programming from the United States (where previous HL studies were conducted) to China. The study can serve as a model for future investigations of self-care behaviour among patients with different chronic illnesses in various regions of China. | - |
dc.language | eng | - |
dc.publisher | The University of Hong Kong (Pokfulam, Hong Kong) | - |
dc.relation.ispartof | HKU Theses Online (HKUTO) | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works. | - |
dc.subject.lcsh | Self care, health | - |
dc.subject.lcsh | Exercise therapy | - |
dc.subject.lcsh | Diabetics - Care | - |
dc.title | The effect of a health literacy oriented program on physical activity among Chinese patients with type 2 diabetes mellitus | - |
dc.type | PG_Thesis | - |
dc.identifier.hkul | b5334852 | - |
dc.description.thesisname | Doctor of Philosophy | - |
dc.description.thesislevel | Doctoral | - |
dc.description.thesisdiscipline | Nursing Studies | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.5353/th_b5334852 | - |
dc.identifier.mmsid | 991040026309703414 | - |