Effects of an Intensive Health Behavior Modification Program on Health Behaviors and Diabetes Remission among Type 2 Diabetes Mellitus Patients in the Maharaj Nakhon Si Thammarat Hospital Network
Article Sidebar
Main Article Content
Abstract
This quasi-experimental research with a two-group pretest–posttest design aimed to examine the effects of an intensive health behavior modification program on knowledge, health behaviors, glycated hemoglobin (HbA1c) levels, and remission among patients with type 2 diabetes mellitus in the Maharaj Nakhon Si Thammarat Hospital Network. The sample consisted of 70 patients with type 2 diabetes mellitus diagnosed within the past five years. Participants were selected through purposive sampling and matched by sex, age, and educational level before being assigned to either the experimental group or the control group, with 35 participants in each group. Data were collected using a knowledge questionnaire with a Kuder–Richardson 21 reliability coefficient of .83 and a health behavior questionnaire with a Cronbach’s alpha coefficient of .82. Data were analyzed using descriptive statistics and t-tests. The results revealed that:
1. After participating in the program, patients in the experimental group had significantly higher mean scores for knowledge and health behaviors than before the intervention (t = 27.81, 34.90; p < .001) and significantly higher than those in the control group (t = 29.53, 67.63; p < .001). In addition, HbA1c levels in the experimental group were significantly lower than before participation and lower than those in the control group at the .001 significance level (t = 24.88, 14.38; p < .001).
2. Following participation in the program, 57.14% of patients in the experimental group achieved diabetes remission, 22.85% were able to discontinue medication, and 17.14% were able to reduce medication dosage.
The findings suggest that diabetes clinic personnel may apply this program through multidisciplinary care and continuous follow-up to promote health behavior modification, improve glycemic control, and increase the likelihood of diabetes remission among patients with type 2 diabetes mellitus.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Content and information published in the Journal of Prachomklao College of Nursing, Phetchaburi Province are the comment and responsibility of the authors. Articles, information, images, etc. published in this journal are the copyright of the Journal of Prachomklao College of Nursing, Phetchaburi Province. If any person or entity wants to take all or part of it for publication for any purposes, please reference the Journal of Prachomklao College of Nursing, Phetchaburi Province.
References
American Diabetes Association Professional Practice Committee. (2021). 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2021. Diabetes Care, 44(Suppl 1), S15–S33. https://doi.org/10.2337/dc21-S002
Bloom, B. S. (1971). Handbook on formative and summative evaluation of student learning. McGraw-Hill.
Chaipetch, N., Tinnachartarak, P., & Khotchanam, M. (2024). Effectiveness of the health behavior change program aimed at diabetes remission in controlling type 2 diabetes at Mueangphotawat Community Health Center, Mueang District, Surat Thani Province. Sisaket Journal of Research and Health Development, 4(1), 328-339. (in Thai)
Division of Noncommunicable Diseases. (2023). Annual report on non-communicable diseases 2023. Department of Disease Control, Ministry of Public Health. (in Thai)
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Cusi, K., Das, S. R., Gibbons, C. H., Giurini, J. M., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Kosiborod, M., Leon, J., Lyons, S. K., Murdock, L., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., Sun, J. K., Woodward, C. C., Young-Hyman, D., Gabbay, R. A., & American Diabetes Association. (2023). Introduction and methodology: Standards of care in diabetes-2023. Diabetes Care, 46(Suppl.1), S1–S4. https://doi.org/10.2337/dc23-SINT
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/bf03193146
Intharakamhaeng, A. (2017). Health literacy: Measurement and development. Sukhumvit Printing. (in Thai)
Khamkor, S., & Duangsong, R. (2020). Effects of the health behavior modification program by applying health literacy to prevent type 2 diabetes among risk groups who live in area responsibility of Ban Pancharoen Sub-District Health Promoting Hospital Wanon Niwat District, Sakon Nakhon Province. KKU Journal for Public Health Research, 13(3), 56–68. (in Thai)
Kianbun, D., Punpipatpaibun, P., Mayusiri, B., & Navawatcharin, N. (2024). Development for type 2 diabetes patients care model with strict behavior modification to enter diabetes in remission Subdistrict Health Promoting Hospital, Chumphon Province. Journal of Environmental and Community Health, 9(6), 540-550. (in Thai)
Laoprasit, P. (2023). The development of diabetes mellitus patients care model that uncontrolled blood sugar in community hospital and network. Region 11 Medical Journal, 37(1), 32-48. (in Thai)
Lean, M. E., Leslie, W. S., Barnes, A. C., et al. (2019). Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. The Lancet Diabetes & Endocrinology, 7(5), 344–355. https://doi.org/10.1016/S2213-8587(19)30068-3
Nakhon Si Thammarat Provincial Public Health Office. (2025). The report system sends 43 files (HDC). https://nrt.hdc.moph.go.th/hdc/main/index_pk.php (in Thai)
Ngamwong, M., Utta, S., Polbuppha, A., Mudpha, C., & Jampa, A. (2019). A synthesis of the behavioral change intervention in risky people to diabetes mellitus (DM). The Office of Disease Prevention and Control 10th Journal, 17(1), 56-71. (in Thai)
Pornpatkul, V., Nopparatchon, S., & Tejativaddhana, P. (2024). The strategies to support lifestyle modifications for achieving diabetes remission. Thailand Journal of Health Promotion and Environmental Health, 47(4), 11-25. (in Thai)
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395. https://doi.org/10.1037/0022-006X.51.3.390
Sribantao, K. (2025). Model of care for type 2 diabetic patients to enter diabetes remission, Ban Na Champa Subdistrict Health Promotion Hospital, Don Chan District, Kalasin Province. Journal of Environmental and Community Health, 10(4), 544-551. (in Thai)
Suksabai, P. (2024). Effectiveness of caring for type 2 diabetic patients to diabetes remission with intensive lifestyle modification, Suratthani Province. Region 11 Medical Journal, 38(1), 27-43. (in Thai)
Taylor, R., Al-Mrabeh, A., & Sattar, N. (2018). Understanding the mechanisms of reversal of type 2 diabetes. The Lancet Diabetes & Endocrinology, 7(9), 726-736. https://doi.org/10.1016/S2213-8587(19)30076-2
Thai Health Promotion Foundation. (2024). Diabetes situation in Thailand 2024. Thai Health Promotion Foundation. (in Thai)
The Diabetes Association of Thailand. (2023). Clinical practice guideline for diabetes 2023. Srimuang Printing. (in Thai)
