Results of a Surveillance and Control Model for Community-Acquired Pneumonia Among High-Risk Groups Supported by Social Support Mechanisms in Khon Kaen Province

Abstract

This study aimed to develop and evaluate the effectiveness of a community-based surveillance and control model for pneumonia among high-risk groups, utilizing social support factors. The study was conducted in three phases. Phase 1 involved problem identification through focus group discussions with a sample of 21 participants, followed by model development. Phase 2 involved a pilot implementation of the model at 9 Tambon Health Promoting Hospitals (THPHs), with data collected from 49 high-risk individuals and 73 Village Health Volunteers (VHVs), followed by model refinement. Phase 3 involved implementing the model at 52 THPHs, followed by satisfaction evaluation among 221 individuals in the pneumonia risk group and 256 stakeholders; morbidity rate evaluation using illness data obtained from the Health Data Center (HDC); and lesson-learning synthesis with a sample of 30 participants. The data collection instruments included a knowledge questionnaire (KR-20 reliability coefficient = 0.78), attitude, practice, and satisfaction questionnaires (reliability coefficients of 0.84, 0.88, and 0.80, respectively), and an illness data collection form. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using percentage, mean, standard deviation, and morbidity rate. Mean scores were compared using the paired t-test, and morbidity rates were compared using the chi-square test.

The results showed that the developed model comprised the following components: establishing a registry of high-risk individuals and influenza-vaccinated persons; conducting home visits to screen high-risk individuals; classifying individuals into normal, mild illness, and severe illness groups; providing data feedback and risk communication; and managing the community environment. The sample's mean scores after model implementation were significantly higher than before implementation. Among VHVs, knowledge scores increased by 1.13 (95% CI: 1.05–1.20, p-value <0.001), attitude scores increased by 1.14 (95% CI: 1.05–1.23, p-value <0.001), and practice scores increased by 1.17 (95% CI: 1.08–1.26, p-value <0.001). Among the high-risk group, knowledge scores increased by 1.54 (95% CI: 1.36–1.72, p-value <0.001), attitude scores increased by 0.92 (95% CI: 0.61–0.95, p-value < 0.001), and practice scores increased by 1.06 (95% CI: 0.92–1.20, p-value <0.001). The results also showed that the new-case morbidity rate decreased from 0.74% to 0.62% when compared over the same period. Satisfaction with the model among the high-risk group and stakeholders was at a moderate level.