The Development of the Model for Enhancing Health literacy Behaviors According the 3E2S of the Elderly with Diabetes in Kokha District, Lampang Province

Abstract

         This study aimed to examine health literacy challenges based on the 3E 2S health behavioral principles, develop an intervention model to enhance health literacy, and evaluate the impact of a health literacy enhancement program among elderly individuals with diabetes in Ko Kha District, Lampang Province. A cluster random sampling method was used to select 30 participants who met the inclusion criteria. Research tools included: 1) health literacy and behavior assessment questionnaires based on the 3E 2S principles for program development, and 2) a structured questionnaire designed to measure improvements in health literacy aligned with those principles. Data were analyzed using content analysis, descriptive statistics, and paired t-tests. Initial findings revealed that existing applications of the 3E 2S principles did not fully address the health literacy needs of elderly individuals with diabetes. Baseline health literacy and behaviors were found to be at a moderate level. A five-activity intervention based on the 3E 2S framework was implemented. The first activity included interactive stations focusing on food, exercise, and relaxation. The second involved behavior observation. The third identified barriers and influencing factors. The fourth focused on model development based on participant input. The fifth emphasized overcoming challenges through emotional support, motivation, and empowerment strategies. Post-program results indicated statistically significant improvements in both health literacy and health behaviors (p < 0.05), demonstrating the program’s effectiveness.
         The study recommends extending the developed model to benefit other groups with chronic conditions and highlights the importance of ongoing support and contextual adaptation when applying the 3E 2S behavioral framework.