การพัฒนารูปแบบการป้องกันและควบคุมภาวะโลหิตจางจากการขาดธาตุเหล็กในเขตสุขภาพที่ 8

Tanisa Anuyahong; Kanyarat  soimalai; Apichit sriouan; Duangjai kanthiya; Pornpimol Butala

Authors

Tanisa Anuyahong Health Promotion Center 8 Udon Thani, Department of Health, Ministry of Public Health, Mueang Udon Thani, Udon Thani, Thailand https://orcid.org/0009-0001-5591-9095
Kanyarat soimalai Health Promotion Center 8 Udon Thani, Department of Health, Ministry of Public Health, Mueang Udon Thani, Udon Thani, Thailand
Apichit sriouan Health Promotion Center 8 Udon Thani, Mueang Udon Thani, Udon Thani, Thailand
Duangjai kanthiya Health Promotion Center 8 Udon Thani, Department of Health, Ministry of Public Health, Mueang Udon Thani, Udon Thani, Thailand
Pornpimol Butala Health Promotion Center 8 Udon Thani, Department of Health, Ministry of Public Health, Mueang Udon Thani, Udon Thani, Thailand

Keywords:

Anemia, Health behavior, Research and Development, PRECEDE-PROCEED Model, Health Region 8

Abstract

Anemia is a significant public health concern in Health Region 8, Thailand, with prevalence rates of 29.5% among pregnant women, 20.5% among preschool children, and 37.6% among 6-year-old schoolchildren. This study aimed to develop and test a prevention and control program for anemia in Health Region 8 by integrating the four phases of the Research and Development (R&D) framework by Borg and Gall with the PRECEDE–PROCEED Model. Phase 1 assessed the situation through surveys of 839 service units across seven provinces and focus group discussions with 35 stakeholders, identifying four key barriers: inadequate screening coverage, lack of continuous follow-up systems, poor intersectoral coordination, and incorrect public knowledge and attitudes toward iron supplementation. Phase 2 developed the “R8 Iron MOM” program comprising five activities: anemia knowledge provision, iron-rich local food selection, proper iron supplementation techniques, health monitoring systems, and community-based support. Phase 3 tested the program using a one-group pretest-posttest design with 158 participants (pregnant women, children aged 6 months–5 years, and grade 1 students) over four weeks. Phase 4 evaluated and refined the program. Data were analyzed using paired t-tests and McNemar's tests. Results showed statistically significant improvement across all groups: mean hematocrit increased by 1.8–3.4% (p < 0.001, Cohen's d = 0.94–1.52), knowledge scores improved by 0.8–1.4 points (p < 0.001, Cohen's d = 0.91–1.65), and daily iron supplementation adherence increased from 46.8% to 89.2% (p < 0.001). Overall satisfaction was at the highest level (Mean = 4.2, SD = 0.7). The R8 Iron MOM program showed promising trends in improving hematocrit levels, knowledge, and iron supplementation behaviors; it may be adapted for other contexts with appropriate modifications. However, controlled trial designs are recommended to confirm effectiveness and establish causal relationships.

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