Effectiveness of a Diabetes Mellitus and Hypertension-Reducing Intervention Program among Akha Adults in Northern Thailand

  • Ratipark Tamornpark
  • Panupong Upala Center of excellence for the hill tribe health research, Mae Fah Luang university
  • Chalitar Chomchoei Center of excellence for the hill tribe health research, Mae Fah Luang university
Keywords: Diabetes mellitus, Hypertension, Intervention, Hill tribe, Akha, Adults

Abstract

Background: Noncommunicable diseases (NCDs) are a major global challenge, especially for those with poor socioeconomic status. Akha is one of the hill tribes living lower than the national poverty line in northern Thailand that is facing problems with NCDs.  This study aimed to assess the effectiveness of a diabetes- (DM) and hypertension (HT)-reducing intervention model. Method: A community-based experimental design was used to assess the effectiveness of a diabetes (DM) and hypertension (HT)-reducing intervention model. The experiment was conducted in two villages in Akha. In each village, 30 persons aged 30 years and over were randomly selected as key participants. Specific training programs on DM and HT prevention and control, healthy food preparation, and cooking demonstrations were provided, including the promotion of regular exercise between September and December 2019. A validated questionnaire, physical examination (checking both blood pressure and HbA1c), and lipid profile were used as indicators of the study. A model was developed and used as a key intervention. A chi-square and t-test were used to detect a significance level of a=0.05. Results: A total of 60 participants were recruited for the study, with 30 in the intervention village and 30 in the control village. Of the participants from the intervention village, 50.0% were female, 43.3% were aged 30–45 years (mean=47.6, SD=9.6), 100.0% were married, 100.0% were Christian, and 90.0% were non-educated, while of the participants from the control village, 50.0% were female, 43.3% were aged 30-45 years (mean= 50.5, SD=10.0), 90.0% were married, 96.7% were Christian, 100.0% were non-educated, and 53.3% were employed daily. The quantity of monosodium glutamate used for cooking (p-value<0.001) and the quantity of cooking oil used during cooking (p-value=0.004) were found to be different between the groups. Comparisons of biomarkers between the control and intervention groups after the intervention showed that triglyceride levels were statistically significant between the groups (p-value=0.048). However, knowledge and attitudes toward DM and HT prevention and care increased. Conclusion: The community-based intervention could improve people health especially in reducing lipid levels among Akha hill tribe adults.

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References

Jayanna K, Swaroop N, Kar A, Ramanaik S, Pati MK, Pujar A, et al. Designing a comprehensive Non-Communicable Diseases (NCD) programme for hypertension and diabetes at primary health care level: evidence and experience from urban Karnataka, South India. BMC Public Health 2019;19. https://doi.org/10.1186/s12889-019-6735-z.

Gupta R, Xavier D. Hypertension: The most important non communicable disease risk factor in India. Indian Heart Journal 2018;70:565–72. https://doi.org/10.1016/j.ihj.2018.02.003.

World Health Organization (WHO). Noncommunicable diseases: diabetes. Available from: http://www.emro.who.int/noncommunicable-diseases/diabetes/index.html. Accessed August 7, 2021.

World Health Organization (WHO). Noncommunicable disease. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. Accessed August 7, 2021.

World Health Organization (WHO). Fact sheets on sustainable development goals: health targets: noncommunicable diseases. Available from: https://www.euro.who.int/data/assets/pdf_file/0007/350278/Fact-sheet-SDG-NCD-FINAL-25-10-17.pdf. Accessed August 7, 2021.

Ministry of Public Health. 5-year national NCDs prevention and control strategic and action plan (2017- 2021). Available from: https://www.who.int/docs/default-source/thailand/ncds/national-ncd-prevention-and-control-plan-2017-2021-eng.pdf. Accessed August 7, 2021.

Tran Kien N, Phuong Hoa N, Minh Duc D, Wens J. Health-related quality of life and associated factors among patients with type II diabetes mellitus: A study in the family medicine center (FMC) of Agricultural General Hospital in Hanoi, Vietnam. Health Psychology Open 2021;8:205510292199617. https://doi.org/10.1177/2055102921996172.

Uchmanowicz B, Chudiak A, Mazur G. The influence of quality of life on the level of adherence to therapeutic recommendations among elderly hypertensive patients. PPA 2018;Volume 12:2593–603. https://doi.org/10.2147/ppa.s182172.

Hegazy N, ElShazly H. Socioeconomic determinants affecting the quality of life among diabetic and hypertensive patients in a rural area, Egypt. J Family Med Prim Care 2017;6:141. https://doi.org/10.4103/jfmpc.jfmpc_31_17.

Mee-inta A, Tamornpark R, Yeemard F, Upala P, Apidechkul T. Pulmonary function and factors associated with current smoking among the hill tribe populations in northern Thailand: a cross-sectional study. BMC Public Health 2020;20. https://doi.org/10.1186/s12889-020-09857-1.

Apidechkul T, Tamornpark R, Chomchoei C, Upala P, Yeemard F. Association Between Lifestyle Behaviors and Hypertension Among Hill Tribe Adults in Thailand: a Cross-Sectional Study. J Racial and Ethnic Health Disparities 2021. https://doi.org/10.1007/s40615-021-01090-9.

Apidechkul T. Prevalence and factors associated with type 2 diabetes mellitus and hypertension among the hill tribe elderly populations in northern Thailand. BMC Public Health 2018;18. https://doi.org/10.1186/s12889-018-5607-2.

Centers for Disease Control and Prevention (CDC). Poor nutrition. Available from: https://www.cdc.gov/chronicdisease/resources/publications/factsheets/nutrition.htm. Accessed August 7, 2021.

Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013;35:121. https://doi.org/10.4103/0253-7176.116232.

Sakane N, Sato J, Tsushita K, Tsujii S, Kotani K, Tominaga M, et al. Effect of baseline HbA1c level on the development of diabetes by lifestyle intervention in primary healthcare settings: insights from subanalysis of the Japan Diabetes Prevention Program. BMJ Open Diab Res Care 2014;2:e000003. https://doi.org/10.1136/bmjdrc-2013-000003.

Chomchoei C, Yeemard F, Tamornpark R, Upala P. Burden and Factors Associated with Hypertension Among the Adult Population of the Lisu Hill Tribe, Northern Thailand. Journal of Health Science and Alternative Medicine 2021;3:9–15. https://doi.org/10.14456/JHSAM.2021.3.

Satterfield DW, Volansky M, Caspersen CJ, Engelgau MM, Bowman BA, Gregg EW, et al. Community-Based Lifestyle Interventions to Prevent Type 2 Diabetes. Diabetes Care 2003;26:2643–52. https://doi.org/10.2337/diacare.26.9.2643.

Gyawali B, Bloch J, Vaidya A, Kallestrup P. Community-based interventions for prevention of Type 2 diabetes in low- and middle-income countries: a systematic review. Health Promotion International 2018;34:1218–30. https://doi.org/10.1093/heapro/day081.

Oba N, McCaffrey R, Choonhapran P, Chutug P, Rueangram S. Development of a community participation program for diabetes mellitus prevention in a primary care unit, Thailand. Nursing & Health Sciences 2011:no-no. https://doi.org/10.1111/j.1442-2018.2011.00627.x.

Correia JC, Lachat S, Lagger G, Chappuis F, Golay A, et al. Interventions targeting hypertension and diabetes mellitus at community and primary healthcare level in low- and middle-income countries:a scoping review. BMC Public Health 2019;19. https://doi.org/10.1186/s12889-019-7842-6.

Pereira DA, Costa NM da SC, Sousa ALL, Jardim PCBV, Zanini CR de O. The effect of educational intervention on the disease knowledge of diabetes mellitus patients. Rev Latino-Am Enfermagem 2012;20:478–85. https://doi.org/10.1590/s0104-11692012000300008.

Shirvani T, Javadivala Z, Azimi S, Shaghaghi A, Fathifar Z, Devender Bhalla HDR, et al. Community-based educational interventions for prevention of type II diabetes: a global systematic review and meta-analysis. Syst Rev 2021;10. https://doi.org/10.1186/s13643-021-01619-3.

Auemaneekul N, Chandanasotthi P, Rawiworrakul T, Sowattanangoon N, Boonsateam W. Community partnership, context-based intervention and diabetes control in Thailand. Journal of Public Health. 2016; 46(3): 236-47.

Published
2021-08-31
How to Cite
Tamornpark, R., Upala, P., & Chomchoei, C. (2021). Effectiveness of a Diabetes Mellitus and Hypertension-Reducing Intervention Program among Akha Adults in Northern Thailand. ournal of ealth cience and lternative edicine, 3(2), 7-14. https://doi.org/10.14456/jhsam.2021.7

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