Development of Carbohydrate Counting by Carb Counting Measuring Instrument

Abstract

This study aimed to develop a health promotion model based on carbohydrate counting using the Carb Counting Measuring Instrument an innovative educational tool designed to enhance nutritional literacy and appropriate dietary behaviors among working-age adults (20–59 years) in Thailand’s Health Region 7. The research was conducted in four phases: (1) situation analysis, (2) design and development of the Carbohydrate Counting Ruler, (3) model implementation, and (4) evaluation.The research instruments included a personal information questionnaire, knowledge assessment, behavioral assessment, satisfaction survey, and the Carbohydrate Counting Ruler. All instruments were validated by experts with an index of item-objective congruence (IOC) ranging from 0.66 to 1.00. Reliability was confirmed with KR-20 = 0.82 and Cronbach’s alpha = 0.89. Quantitative data were analyzed using descriptive statistics (mean, standard deviation, percentage) and inferential statistics (paired t-test) to compare pre- and post-intervention differences, while qualitative data were analyzed using content analysis. The findings revealed that, in Phase 1, insufficient nutritional knowledge and the lack of practical educational media were identified as major problems. In Phase 2, the Carb Counting Measuring Instrument was developed as a simple and user-friendly tool that received high satisfaction scores. In Phase 3, pilot implementation showed statistically significant improvements (p < 0.05) in participants knowledge and dietary behavior scores, analyzed using mean, standard deviation, and paired t-test. In Phase 4, evaluation demonstrated that health officers, village health volunteers, and community members were able to effectively apply the health promotion model in real settings. The model enhanced knowledge, improved dietary behavior, and supported self-care practices suitable for the working-age population, thereby contributing to the prevention and control of non-communicable diseases (NCDs) in the future.