Development of a model for prevention and control of hypertension and stroke in urban areas of Surat Thani Province

Abstract

This action research aimed to develop and evaluate the effectiveness of a model for prevention and control of hypertension and stroke in urban areas. The research was conducted in three phases: 1) preparation, 2) implementation, and 3) evaluation phases. The model was developed using the action research methodology based on Kemis and McTaagrt's actions research concept, which consisted of four steps; planning, action, observation and reflection. A total of 46 participants were involved, including community health center personnel, village health volunteers, disease control volunteers, community leaders, and residents in Village A, Surat Thani Province. Five key empowered activities were implemented: 1) education on hypertension and salt consumption, 2) measuring salt levels in food, 3) promoting physical exercise, 4) blood pressure monitoring and data referral to the community health center, and 5) smoking and alcohol cessation campaigns. Quantitative data were analyzed using descriptive statistics and paired t-tests, while qualitative data were analyzed through content analysis.
The findings revealed that post-intervention, knowledge scores on hypertension and knowledge scores on salt consumption significantly increased (p<0.001). Household sodium levels decreased from an average of 0.72±0.48 mg/dL to 0.69±0.24 mg/dL, which was not different (p=0.62). The average systolic blood pressure decreased from 119.67±12.31 mmHg before the intervention to 113.03±13.48 mmHg after the intervention (p<0.001), and the average diastolic blood pressure decreased from 78.50±9.39 mmHg before the intervention to 72.80±10.19 mmHg after the intervention (p<0.001). The number of people participating in group exercise within the village increased by 32 people instead of the previous pattern of traveling outside the village for exercise. Lessons learned from the project showed that the developed model directly benefited villagers’ health and could be applied in daily life. Community leaders proposed that the municipality support exercise equipment, improve exercise places to meet standards, and provide sodium measurement tools for sustainability and continuity of activities.
In conclusion, the developed model can effectively increase knowledge, promote appropriate healthy behaviors, and reduce disease risk, which can be applied in other urban contexts.