The Development of a Community Cerebrovascular Disease Surveillance Model for Community Health Volunteers (CHVs), Songkhla Province

Abstract

This research and development project aims to investigate the stroke incidence among patients in Sadao District, Songkhla; develop a community-based stroke surveillance model and curriculum for community health volunteers (CHVs); compare the mean scores of knowledges, decision-making, and competency in stroke surveillance; and evaluate the satisfaction regarding the developed model and curriculum. The study was conducted between April and October 2024 and employs both quantitative and qualitative research methodologies across four phases: Phase 1, Situations Analysis in stroke patients, caregivers, CHVs, and community leaders, using a purposive sampling method with 25 individuals recruited; Phase 2 focuses on designing and developing the model with input from experts in stroke care including physicians, professional nurses, public health personnel, and emergency medical staff, purposively selected, totaling 15 experts; Phase 3, Pilot Testing and Model Refinement, involves with 36 CHVs randomly selected purposively; and Phase 4, Implementation Evaluation, evaluates the effectiveness and satisfaction of the implemented model among the same 36 CHVs in phase 3. The research instruments employed include a semi-structured interview protocol and knowledge, decision-making, and competency questionnaires, as well as the stroke surveillance model and the curriculum. Data analysis for quantitative data comprises descriptive statistics, satisfaction comparisons using the Wilcoxon Signed Ranks Test, and Repeated measures ANOVA with Bonferroni to compare means in knowledge, decision-making, and competency. The qualitative data were analyzed using content analysis. The findings indicate that the developed stroke surveillance curriculum was derived from an in-depth study of the local context and incorporates lectures emphasizing stroke knowledge based on the BEFAST protocol, hands-on workshops integrating real patient experiences, and principles from Bloom’s Revised Taxonomy to foster competency development through simulated scenarios. Statistically significant increases in the mean scores for knowledge, decision-making, and competency were observed following the training and subsequent application of the model, and participants reflected positively on the curriculum, reporting enhanced confidence and competency. The research findings suggest that competency related to stroke should be developed continuously at least every 6 months, focusing on knowledge, decision-making, and communication for emergency assistance to maintain volunteers' competency.