Developing Health Literacy and Health Behavior through a Participatory Learning Process of the People at Risk for Diabetes, Mueang Roi-Et District Roi-Et Province

Abstract

This action research aims to develop health literacy and health behaviors through a participatory learning process of the people at risk for diabetes in Mueang Roi-Et District,        Roi-Et Province. Divided into 3 phases, with the first phase, being a study of community context and situation. The second phase was the development of the model, and the third phase to evaluates the development results. The sample were 217 persons who were at risk for diabetes by purposive sampling according to the study inclusion criteria. The tool consisted of 2 sets of the quantitative tools and 3 sets of the qualitative tools. The quality of the instrument was checked for content and construct validity by three experts. The reliability of health literacy and health behavior interview form passed the confidence test by the Health Education Division with a Cronbach's Alpha value equal to 0.90 and 0.62, respectively. The statistics used to analyze the quantitative data were descriptive statistics and using Paired t-test to compare the mean scores of health literacy and health behaviors before and after intervention. The content analysis method for analyzing the qualitative data.

 The results found that ; 1) The context of SA-Ard Somboon Sub-district was characterized by semi-rural and urban society. Most people like to use fermented fish as an important ingredient in food and eat sticky rice. The model for caring for people at risk of diabetes in the community was operating by Village Health Volunteers (VHVs), sometimes provide health education without a clear monitoring and surveillance system. As a results, there will be an increase in new cases of diabetic every year. The sample had a Body Mass Index (BMI) in the overweight range at 61.29 percent. All had blood sugar levels within the risk range for diabetes. Their health literacy and health behavior at a poor level, 55.29 percent and 53.46 percent, respectively. 2) The model uses a participatory learning process consisting of 4 steps: 1) A workshop by creating motivation to set goals and plan for reducing blood sugar levels individually. 2) Implementation of health behavior change according to community strategies. 3) Organize a monitoring system through participatory empowerment visits to each village, and 4) After action review of health behavior change, knowledge sharing and feedback information. 3) The development results showed that there were no new cases of diabetes among project participants. The BMI in the overweight category decreased to 36.87 percent. The blood sugar level in the diabetes risk category decreased to 42.86 percent. The average score of health literacy and health behavior increased significantly. The results of this research were that relevant health personnel can apply the development model in the area by creating and developing networks to participate in strengthening health literacy and health behavior for people at risk of diabetes. This will reduce the number of new diabetes patients. And is an appropriate model for managing diabetes problems in the community.