Prototype development and effectiveness evaluation of a health literacy promotion program on health behavior and outcomes of elderly people in the Khun Thale community, Surat Thani province
Keywords:
prototype development, participatory action research, health literacy, elderlyAbstract
This participatory action research (PAR) aimed to develop and evaluate a prototype health literacy promotion program for older adults in the Khun Thale community, Surat Thani Province. The program was grounded in Nutbeam’s three-tier model-Functional, Interactive, and Critical literacy-addressing five key components: information access, media literacy, knowledge exchange, decision-making, and self-management. It was integrated with the “3A2S” behavior model, focusing on nutrition, physical activity, emotional well-being, smoking cessation, and alcohol abstinence. Targeted health outcomes included: no falls, no forgetfulness, no depression, enjoyable eating, and quality sleep.
A purposive sample of 100 elderly participants was recruited. Data were collected before and after participating in the program using a validated researcher-developed questionnaire, with content validity confirmed by experts. Reliability test revealed cronbach's alpha coefficient ranging from .846–.917. Data were analyzed using paired t-tests and wilcoxon signed-rank tests.
The results indicated significant improvements in all levels and components of health literacy (p<0.001). Health behaviors notably improved in the areas of diet, physical activity, and emotional regulation (p<0.001), while smoking and alcohol behaviors remained unchanged, likely due to already appropriate baseline levels. Furthermore, all five intended health outcomes improved significantly, particularly sleep quality, fall prevention, and memory function (p<0.001).
In conclusion, the prototype program developed under the concept of health literacy and community participation was effective in systematically enhancing the self-care capacity of the elderly and can be expanded to other similar community settings.
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