Patient empowerment interacts with health literacy to associate with subsequent self-management behaviors in patients with type 2 diabetes: A prospective study in Taiwan

• Empowerment interacts with health literacy to influence self-management behaviors of patients.
• Empowerment may improve self-management behaviors in patients with high health literacy.
• Empowerment may be useless on self-management behaviors in patients with low health literacy.

ObjectiveTo examine association of interactions between patient empowerment (PE) and health literacy with 1-year-later self-management behaviors in patients with type 2 diabetes (T2DM).MethodsA prospective design was employed in this study. Overall, 395 patients with T2DM completed self-reported questionnaires at baseline and 1 year later. A hierarchical multiple regression was used to identify the association of interactions between PE and health literacy at baseline with the 1-year-later self-management behaviors.ResultsInteractions between PE and communicative and critical health literacy (CCHL) at baseline significantly associated with the 1-year-later global self-management behaviors in patients with T2DM. Among the participants who exhibited high PE at baseline, the scores of 1-year-later global self-management behaviors of the participants with a high CCHL at baseline were significantly higher than those with a low CCHL at baseline. Nevertheless, among the participants who exhibited low PE at baseline, no significant differences were identified in the 1-year-later global self-management behaviors between the participants with high vs. low CCHL at baseline.ConclusionsPE may improve self-management behaviors in patients with high CCHL, but may prove useless in patients with low CCHL.Practice implicationsHealthcare providers should ensure that patients with T2DM have adequate CCHL prior to empowering them.