Sociodemographic Factors Associated with Health Literacy Toward Complementary and Alternative Medicine : A Cross-Sectional Study Among Patients with Type 2 Diabetes Mellitus in Bali, Indonesia

Abstract

Introduction: Complementary and Alternative Medicine (CAM) is widely utilized by individuals with Type 2 Diabetes Mellitus (T2DM), particularly in culturally embedded communities. However, misconceptions related to CAM health literacy may lead to health risks and are potentially shaped by sociodemographic factors. This study aimed to examine the association between sociodemographic characteristics and misconceptions related to CAM health literacy among patients with T2DM in Denpasar, Bali.

Methods: A cross-sectional study was conducted at Osadha Klinik Pratama, Denpasar, from February to April 2025. Using purposive sampling, 104 T2DM patients were selected based on eligibility criteria. A validated 16-item questionnaire was used to assess misconceptions about CAM. Descriptive statistics were applied, and non-parametric tests, Mann-Whitney U and Kruskal-Wallis, were used to analyze associations between misconception scores and sociodemographic variables.

Results: Gender was significantly associated with CAM knowledge, with male participants scoring higher (p-value = 0.041). While age, education, occupation, income, and diabetes duration did not show statistical significance, trends revealed greater misconceptions among younger adults, individuals with low income, and recently diagnosed patients. Conclusion: The study emphasizes the need for targeted, gender-sensitive educational strategies to address CAM-related misinformation. Strengthening health literacy through context-specific health communication is crucial to ensuring safe CAM use among diabetic populations.